目的：探讨舍曲林联合氨磺必利治疗难治性强迫症的临床疗效及安全性。方法：难治性强迫症患者45例，随机分为对照组23例和实验组22例。对照组单用舍曲林，实验组给予舍曲林合并氨磺必利治疗，均治疗8周。治疗前后采用耶鲁-布朗强迫量表（Y-BOCS）评定强迫症严重程度，不良反应量表（TESS）评定不良反应。结果：治疗8周后，对照组和实验组的总有效率分别为66.7%、90.1%，实验组优于对照组，差异有统计学意义（P<0.05）。治疗2周和4周后，实验组 Y-BOCS 评分较对照组降低（P<0.05），治疗8周末实验组的Y-BOCS 评分较对照组显著降低（P<0.01）。2组组内比较，除对照组在治疗2周末与治疗前比较 Y-BOCS 评分差异不明显，其余各周评分与治疗前比较均有显著性差异（P<0.01）。2组的不良反应中，唾液增多差异有统计学意义（P<0.05）。结论：舍曲林联合氨磺必利治疗难治性强迫症与舍曲林单药治疗比较，起效更早、疗效更好，安全性较好。%Objective: To explore the efficacy and safety of sertraline combined with amisulpride treatment on re-fractory obsessive-compulsive disorder (OCD). Methods: Forty-five OCD patientswere randomly divided into groups control (n=23) and experimental (n=22). The control group was given sertraline alone for 8 weeks, and the experimental group was given sertraline and amisulpride for 8 weeks. Before and after the treatment, Yale Brown Obsessive-Compulsive Scale (Y-BOCS) was used to assess the severity of symptoms and TESS was used to assess the adverse reactions. Results: After 8 weeks of treatment, the total effective rate of the control and experimental groups were 66.7% and 90.1%. At 2 and 4 weeks of treatment, Y-BOCS score of the experimental group was lower than that of the control group (P<0.05). At 8 weeks of treatment, the Y-BOCS score in the experimental group was significantly lower than that in the control group (P<0.01). For intra-group comparison of the both groups, Y-BOCS score at each week of treatment decreased significantly compared with the score before treatment (P<0.01), except for at 2 weeks of treatment in the control group (no significant difference compared with the score before treat-ment). In light of the adverse reactions, increased salivation showed a significant difference between the 2 groups (P<0.05). Conclusion: Sertraline combined with amisulpride treatment on refractory OCD is better than sertraline monotherapy, showing earlier start of therapeutic efficacy, higher effective rate and more safe.
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