[1]李土明,毛家亮,钟萍,等.以头晕为主诉的无症状脑梗死患者躯体化障碍的临床分析[J].卒中与神经疾病杂志,2018,25(02):159-162.[doi:10.3969/j.issn.1007-0478.2018.02.010]
　Li Tuming*,Mao Jialiang*,Zhong Ping,et al.Clinical application of self-rating somatization symptoms scale in silent brain infarction patients with complaints of dizziness[J].Stroke and Nervous Diseases,2018,25(02):159-162.[doi:10.3969/j.issn.1007-0478.2018.02.010]
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以头晕为主诉的无症状脑梗死患者躯体化障碍的临床分析()
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《卒中与神经疾病》杂志[ISSN:1007-0478/CN:42-1402/R]

卷:
第25卷
期数:
2018年02期
页码:
159-162
栏目:
论 著
出版日期:
2018-04-26

文章信息/Info

Title:
Clinical application of self-rating somatization symptoms scale in silent brain infarction patients with complaints of dizziness
文章编号:
1007-0478(2018)02-0159-04
作者:
李土明; 毛家亮; 钟萍; 吴滢; 陈卉
200127 上海交通大学医学院附属仁济医院心内科[李土明 毛家亮(通信作者)]; 上海中医药大学附属上海市中西医结合医院神经内科(钟萍 吴滢 陈卉)
Author(s):
Li Tuming*; Mao Jialiang*; Zhong Ping; et al.
*Department of Cardiology,Renji Hospital Affiliated to Medicine College of Shanghai Jiaotong University,Shanghai 200127
关键词:
脑梗死 躯体化障碍 躯体化症状自评量表 干预研究 头晕
Keywords:
Brain infarction Somatization disorder The somatic self-rating scale Intervention study Dizzy
分类号:
R743.3
DOI:
10.3969/j.issn.1007-0478.2018.02.010
文献标志码:
A
摘要:
目的 探讨以头晕为主诉的无症状脑梗死(SBI)患者的心理状态,并观察明确为躯体化障碍的患者帕罗西汀治疗后的临床疗效。方法 采用躯体化症状自评量表(SSS)、汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)对157例以头晕为主诉的SBI患者进行心理状态评定,并根据ICD-10的诊断标准明确诊断为躯体化障碍患者给予帕罗西汀治疗8周,以临床症状缓解程度及治疗前后HAMA、HAMD、SSS及躯体化症状自评量表的躯体化因子(SSS-S)评分来评定疗效。结果 ①通过SSS评定,61.7%的患者存在心理障碍; ②经ICD-10诊断标准明确诊断为躯体化障碍患者32例,给予帕罗西汀治疗后头晕基本消失,临床症状缓解, HAMA、HAMD、SSS、SSS-S及SSS-S中单因子评分均明显降低(P<0.05)。结论 以头晕为主诉的SBI患者存在较多的心理障碍,明确为躯体化障碍的患者给予帕罗西汀治疗后头晕消失。
Abstract:
ObjectiveTo assess the mental state of silent brain infarction(SBI)patients with complaints of dizziness and to observe the efficacy of paroxetine.Methods SSS、HAMA and HAMD were administered to screen the SBI patients with mental disorder.Paroxetine was used to therapy Somatization disorder diagnosis which was made based on ICD-10 criteria.HAMD、HAMA、SSS and SSS-S were used to estimate the efficacy.Results 61.7% of patients existed mental disorder; and after paroxetine therapy,32 cases of patients with somatization disorder had shown clinical improvement.The grades of HAMA,HAMD,SSS,SSS-S and SSS-S were significantly decreased,while the difference was statistically significant(P<0.05).Conclusion There were elevated frequencies of mental disorder in silent brain infarction(SBI)patients with complaints of dizziness.It showed that the Paroxetine was effective in therapy for patients with somatization disorder.

参考文献/References:

[1] Vermeer SE,Longstreth Jr WT,Koudstaal PJ.Silent brain infarcts: a systematic review[J].The Lancet Neurology,2007,6(7):611-619.
[2] 李土明,毛家亮,钟萍,等.以头晕为主诉的无症状脑梗死患者躯体化症状自评量表的临床应用[J].中国医药导报,2017,14(8):88-91.
[3] 姜凤英.以头晕为主诉的无症状性脑梗死患者焦虑状态的临床分析[J].中国心理卫生杂志,2004,18(6):429-431.
[4] 孙伟铭,董香丽,于国华,等.躯体化障碍患者家属的家庭负担状况及相关因素分析[J].南昌大学学报(医学版),2016,56(5):73-76.
[5] 世界卫生组织ICD-10精神与行为障碍分类临床描述与诊断要点,范肖东,汪向东,等.译[M].北京:人民卫生出版社,1993:97-104.
[6] Zhu YC,Dufouil C,Tzourio C,et al.Silent brain infarcts: a review of MRI diagnostic criteria[J].Stroke,2011,42(4):1140-1145.
[7] 庄琦,毛家亮,李春波,等.躯体化症状自评量表的初步编制及信度和效度研究[J].中华行为医学与脑科学杂志,2010,19(9):847-849.
[8] 李晓丽,毛家亮,何奔,等.心脏神经症患者躯体化症状自评量表的临床应用[J].中国误诊学杂志,2008,8(20):4798-4799.
[9] 张明园.精神科评定量表手册[M].长沙:湖南科学技术出版社,1993.
[10] Löwe B,Spitzer RL,Williams JB,et al.Depression,anxiety and somatization in primary care: syndrome overlap and functional impairment[J].Gen Hosp Psychiatry,2008,30(3):191-199.
[11] 吴文源,季建林.综合医院的精神卫生[M].上海:上海科技技术文献出版社,2001:203-212.
[12] 毛家亮.综合医院非专科心理障碍诊治存在的现状,困难及对策[J].医学与哲学,2013,34(2B):9-12.
[13] 杨志寅.现代医学科学发展中的缺憾与思考[J].中华诊断学电子杂志,2013,1(1):1-7.
[14] 毛家亮,何奔.综合医院非心理专科患者心理障碍早期识别及对策[J].中华诊断学电子杂志,2015,3(2):138-142.
[15] 中华医学会神经病学分会神经心理与行为神经病学组.综合医院焦虑,抑郁与躯体化症状诊断治疗的专家共识[J].中华神经科杂志,2016,49(12):908-917.
[16] 姜荣环,党卫民,马弘,等.非精神科医生对抑郁障碍的识别和相关因素[J].中华内科杂志,2010,49(6):477-479.
[17] Barsky AJ,Orav EJ,Bates DW.Somatization increases medical utilization and costs Independent of psychiatric and medical comorbidity[J].Arch Gen Psychiatry,2005,62(8):903-910.
[18] 刘臣,张印.帕罗西汀对躯体形式障碍的疗效观察[J].中国实用医药,2012,7(31):171-172.
[19] Gibiino S,Serretti A.Paroxetine for the treatment of depression: a critical update[J].Expert Opin Pharmacother,2012,13(3):421-431.
[20] Higuchi T,Hong JP,Jung HY,et al.Paroxetine controlled-release formulation in the treatment of major depressive disorder: a randomized,double-blind,placebo-controlled study in Japan and Korea[J].Psychiatry Clin Neurosci,2011,65(7):655-663.
[21] 陈文泽,陈雪芬,张君青,等.躯体化障碍患者的治疗及其神经电生理指标的变化研究[J].浙江医学,2016,38(10):688-690.

更新日期/Last Update: 2018-04-20