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焦虑障碍伴糖调节受损帕罗西汀联合团体心理治疗的随机双盲对照研究 预览 被引量:11

Effects of paroxetine plus group psychotherapy in treatment of anxiety disorders accompanying impaired glucose regulation: A randomized double-blind controlled trial
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摘要 目的:比较帕罗西汀联合团体心理治疗与单用帕罗西汀治疗焦虑障碍伴糖调节受损患者的疗效。方法:本研究为随机双盲对照研究。选取52例符合国际疾病和相关健康问题统计分类第十版(ICD-10)焦虑障碍(包括惊恐障碍、广泛性焦虑障碍)诊断标准,同时伴有糖调节受损的患者,随机分为两组,每组26例,一组给予帕罗西汀联合团体心理治疗(团体+药物组),另一组单用帕罗西汀治疗(药物组),疗程6个月。采用Zung焦虑自评量表(SAS)评定焦虑症状及改善情况,检测空腹血糖(FPG)、葡萄糖耐量试验(OGTT)后2 h血糖(2hPG)和糖化血红蛋白(HbA1C)、空腹胰岛素(FINS)并计算胰岛素抵抗指数(HOMA-IR)来评价糖代谢和胰岛素抵抗水平,采用药物副反应量表(TESS)评定安全性。结果:治疗6个月后,两组的FPG、2hPG、HbA1C、FINS、HOMA-IR及SAS评分均低于治疗前(均P〈0.05);团体+药物组较药物组的2hPG、FINS、HOMA-IR、SAS评分降低更明显[(7.5±1.1)vs.(8.3±1.4),(8.3±1.3)vs.(9.9±1.6),(1.9±0.3)vs.(2.3±0.4),(41.2±4.5)vs.(45.3±5.7);均P〈0.05]。治疗后两组间FPG、HbA1C下降差异无统计学意义(P>0.05)。两组TESS评分差异无统计学意义(P>0.05)。结论:本研究提示,帕罗西汀联合团体心理治疗较单用帕罗西汀能更有效地降低焦虑障碍伴糖调节受损患者的餐后血糖水平,改善焦虑症状,提高胰岛素敏感性。 Objective:To compare the effect of paroxetine plus group psychotherapy with paroxetine only in treatment of anxiety disorders accompanying impaired glucose regulation. Methods: In this randomized double-blind and parallel control trial,52 patients w ith anxiety disorders (including panic disorder and generalized anxiety disorder) diagnosed according to the International Classification of Diseases and Related Health Problems,Tenth Revision (ICD-10) criteria,accompanying impaired glucose regulation w ere selected. They w ere randomly divided into plus-group (n = 26) receiving paroxetine plus group psychotherapy and drug-group (n = 26) receiving paroxetine only treatment for 6 months. The Self-Rating Anxiety Scale (SAS) w as used to assess anxiety symptoms. The fasting plasma glucose (FPG),oral glucose tolerance test (OGTT) after 2 h plasma glucose (2hPG),glycated hemoglobin (HbA1C),fasting insulin (FINS) and calculate insulin resistance index w as measured to evaluate the metabolism of glucose and the level of insulin resistance The Treatment Emergent Symptom Scale (TESS) w ere used to observe the safety. Results: At the end of the 6th month,the FPG,2hPG,HbA1C,FINS,HOMA-IR and SAS scores in both groups decreased compared w ith baseline (Ps〈0. 05),and the plus-group decreased more significantly than the drug- group in the reduction value of 2hPG,FINS,HOMA-IR and SAS scores[ (7. 5 ± 1. 1) vs. (8. 3 ± 1. 4), (8. 3 ± 1. 3) vs. (9. 9 ± 1. 6), (1. 9 ± 0. 3) vs. (2. 3 ± 0. 4), (41. 2 ± 4. 5) vs. (45. 3 ± 5. 7),Ps〈0. 05]. There w as no significant difference in the reduction value of FBG, HbA1C betw een plus-group and drug group after treatment. And there w as no significant difference in adverse effects betw een the tw o groups. Conclusion: This study suggests that paroxetine plus group psychotherapy obtains a better effect on treating anxiety disorders accompanying impaired glucose regulation than paroxetine only in the re
作者 蒋富贵 董再全 李西荣 付晓倩 张旭 张岚 余叶蓉 唐雷 孙学礼 JIANG Fu-Gui, DONG Zai-Quan, LI Xi-Rong, FU Xiao-Qian, ZHANG Xu, ZHANG Lan, YU Ye-Rong, TANG Lei, SUN Xue-Li( Mental Health Center, West China Hospital, Sichuan University, Chengdu 610041, China 2The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China 3Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, China 4North Sichuan Medical College Affiliated Hospital, Nanchong 637000, Sichuan Province, China)
出处 《中国心理卫生杂志》 CSSCI CSCD 北大核心 2014年第5期321-326,共6页 Chinese Mental Health Journal
基金 国家科技支撑计划课题-心身疾病常见心理问题的识别与干预(2009BAI77B06)
关键词 帕罗西汀 团体心理治疗 焦虑障碍 糖调节受损 胰岛素抵抗 随机双盲对照研究 paroxetine group psychotherapy anxiety disorders impaired glucose regulation insulin resist-ance randomized double-blind and parallel control trial
作者简介 通信作者:孙学礼sunxueli58@163.com
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