{"id":119449,"date":"2026-10-29T17:56:44","date_gmt":"2026-10-29T09:56:44","guid":{"rendered":"https:\/\/www.wsisp.com\/helps\/119449.html"},"modified":"2026-10-29T17:56:44","modified_gmt":"2026-10-29T09:56:44","slug":"%e6%b4%97%e6%89%8b%e6%b4%97%e5%88%b0%e8%84%b1%e7%9a%ae%e3%80%81%e6%a3%80%e6%9f%a5%e9%97%a8%e9%94%81%e5%88%b0%e5%b4%a9%e6%ba%83%ef%bc%9a%e5%bc%ba%e8%bf%ab%e7%97%87%e4%b8%ba%e4%bb%80%e4%b9%88%e8%bf%99","status":"publish","type":"post","link":"https:\/\/www.wsisp.com\/helps\/119449.html","title":{"rendered":"\u6d17\u624b\u6d17\u5230\u8131\u76ae\u3001\u68c0\u67e5\u95e8\u9501\u5230\u5d29\u6e83\uff1a\u5f3a\u8feb\u75c7\u4e3a\u4ec0\u4e48\u8fd9\u4e48\u96be\u597d\uff1f| Info X Med\u6587\u732e\u6df1\u5ea6\u89e3\u8bfb"},"content":{"rendered":"

\u6587\u732e\u6765\u6e90：Info X Med\u671f\u520a\u300aThe BMJ\u300b（State of the Art Review）<\/p>\n

DOI：10.1136\/bmj-2024-083443<\/p>\n

\u7ed3\u8bba\u5148\u884c： \u5f3a\u8feb\u75c7\u4e0d\u662f\u201c\u60f3\u592a\u591a\u201d，\u800c\u662f\u4e00\u5957\u88ab\u201c\u77ed\u6682\u5b89\u5fc3\u201d\u4e0d\u65ad\u5f3a\u5316\u7684\u6076\u6027\u5faa\u73af\u3002\u66b4\u9732\u4e0e\u53cd\u5e94\u963b\u6b62（ERP）\u81f3\u4eca\u4ecd\u662f\u4e00\u7ebf\u6cbb\u7597，\u575a\u6301\u5b8c\u6210\u8005 Y-BOCS \u5e73\u5747\u4e0b\u964d 50%\u201370%；\u800c SSRI \u53ea\u5e26\u6765 30%\u201340% \u7684\u6539\u5584，\u4e14\u7ea6\u4e00\u534a\u4eba\u9996\u6b21\u7528\u836f\u65e0\u6548\u3002\u66f4\u503c\u5f97\u6ce8\u610f\u7684\u662f：\u836f\u7269\u52a0 ERP \u5e76\u4e0d\u4f18\u4e8e\u5355\u7528 ERP，\u4f46\u660e\u663e\u4f18\u4e8e\u5355\u7528\u836f\u7269\u2014\u2014\u6362\u53e5\u8bdd\u8bf4，\u201c\u53ea\u5f00\u836f\u201d\u662f\u6700\u5e38\u89c1\u3001\u4e5f\u6700\u6602\u8d35\u7684\u6cbb\u7597\u4e0d\u8db3\u3002\u96be\u6cbb\u75c5\u4f8b\u53ef\u52a0\u7528\u8c37\u6c28\u9178\u8c03\u8282\u5242\u6216\u7279\u5b9a\u6297\u7cbe\u795e\u75c5\u836f；rTMS\u3001DBS\u3001\u88f8\u76d6\u83c7\u7d20\u4e0e\u6c2f\u80fa\u916e\u4ecd\u5728\u8bc1\u636e\u79ef\u7d2f\u9636\u6bb5\u3002<\/p>\n

\u4e00\u3001\u5148\u8ba4\u6e05\u5bf9\u624b：\u5f3a\u8feb\u75c7\u5230\u5e95\u662f\u4ec0\u4e48<\/span><\/span><\/h3>\n
    \n
  • \u60a3\u75c5\u7387：\u6210\u4eba\u4e00\u5e74\u60a3\u75c5\u7387 1.2%，\u7ec8\u751f\u60a3\u75c5\u7387 2.3%（\u7ea6\u6bcf 40 \u4eba\u4e2d\u6709 1 \u4eba）；\u5973\u6027\u7565\u591a，\u5e73\u5747\u8d77\u75c5\u5e74\u9f84\u7ea6 19 \u5c81（\u7537\u6027\u66f4\u65e9）\u3002<\/li>\n
  • \u5373\u4f7f\u5728\u533b\u7597\u4f53\u7cfb\u53d1\u8fbe\u7684\u56fd\u5bb6，\u4ece\u75c7\u72b6\u51fa\u73b0\u5230\u88ab\u8bc6\u522b，\u5e38\u5e38\u8981\u62d6 10 \u5e74\u4ee5\u4e0a；\u5728\u5f88\u591a\u5730\u533a，\u60a3\u8005\u6839\u672c\u5f97\u4e0d\u5230\u89c4\u8303\u8bc4\u4f30\u3002<\/li>\n
  • \u6838\u5fc3\u75c7\u72b6\u4e09\u8054：\u4fb5\u5165\u6027\u601d\u7ef4（obsessions）\u3001\u91cd\u590d\u884c\u4e3a\u6216\u5fc3\u7406\u4eea\u5f0f（compulsions）\u3001\u4ee5\u53ca\u4e3a\u4e86\u56de\u907f\u89e6\u53d1\u60c5\u5883\u800c\u505a\u7684\u56de\u907f\u884c\u4e3a\u3002<\/li>\n
  • \u5e38\u89c1\u4e3b\u9898：\u6c61\u67d3\u4e0e\u6d01\u51c0\u3001\u4f24\u5bb3\u4e0e\u72af\u9519\u7684\u8d23\u4efb\u3001\u5bf9\u79f0\u4e0e\u7cbe\u786e\u3001\u4ee5\u53ca\u6027\u3001\u9053\u5fb7\u3001\u66b4\u529b\u76f8\u5173\u7684\u7981\u5fcc\u5ff5\u5934\u3002<\/li>\n
  • \u75c5\u7a0b：\u81ea\u53d1\u7f13\u89e3\u7387\u4f4e，\u4e0d\u6cbb\u7597\u591a\u5448\u6162\u6027\u5e76\u9010\u6e10\u6076\u5316，\u75c7\u72b6\u5e38\u968f\u5fc3\u7406\u793e\u4f1a\u538b\u529b\u8d77\u4f0f\u3002<\/li>\n
  • \u88ab\u6f0f\u8bca\u7684\u4e09\u4e2a\u539f\u56e0：\u60a3\u8005\u7f9e\u4e8e\u542f\u9f7f\u3001\u533b\u751f\u5728\u5e38\u89c4\u95ee\u8bca\u4e2d\u4e0d\u7b5b\u67e5\u3001\u4e0e\u7126\u8651\u75c7\/\u6291\u90c1\/\u62bd\u52a8\u7b49\u9274\u522b\u56f0\u96be\u3002<\/li>\n
  • \u7814\u7a76\u5c42\u9762\u7684\u5c34\u5c2c：\u81f3\u4eca\u6ca1\u6709\u4efb\u4f55\u795e\u7ecf\u751f\u5316\u3001\u5f71\u50cf\u6216\u9057\u4f20\u6807\u5fd7\u7269，\u654f\u611f\u6027\u4e0e\u7279\u5f02\u6027\u8db3\u4ee5\u7528\u4e8e\u8bca\u65ad\u2014\u2014\u201c\u751f\u7269\u5b66\u6807\u8bb0\u201d\u8fd9\u6761\u8def\u4ecd\u7a7a\u7740\u3002<\/li>\n
  • \u5927\u767d\u8bdd：\u5f88\u591a\u4eba\u4ee5\u4e3a\u5f3a\u8feb\u75c7\u662f\u201c\u7231\u5e72\u51c0\u201d\u201c\u8ffd\u6c42\u5b8c\u7f8e\u201d，\u5176\u5b9e\u6838\u5fc3\u662f\u201c\u6015\u201d\u2014\u2014\u6015\u81ea\u5df1\u60f3\u7684\u4f1a\u6210\u771f，\u4e8e\u662f\u7528\u6d17\u624b\u3001\u68c0\u67e5\u3001\u9ed8\u5ff5\u6362\u51e0\u5206\u949f\u5b89\u5fc3\u3002\u5b89\u5fc3\u662f\u501f\u6765\u7684，\u5229\u606f\u8d8a\u6eda\u8d8a\u9ad8：\u4eea\u5f0f\u505a\u5f97\u8d8a\u591a，\u8d8a\u76f8\u4fe1\u201c\u4e0d\u505a\u5c31\u4f1a\u51fa\u4e8b\u201d\u3002<\/li>\n<\/ul>\n

    \u4e8c\u3001\u4e00\u7ebf\u7597\u6cd5：ERP \u5230\u5e95\u600e\u4e48\u505a\u3001\u80fd\u505a\u5230\u4ec0\u4e48\u7a0b\u5ea6<\/span><\/span><\/h3>\n
      \n
    • \u6a21\u578b（\u56fe1）：\u4eba\u4eba\u90fd\u4f1a\u6709\u95ef\u5165\u6027\u7684\u602a\u5ff5\u5934；\u5f3a\u8feb\u75c7\u60a3\u8005\u628a\u5b83\u8bef\u8bfb\u4e3a\u201c\u6211\u771f\u7684\u5f88\u5371\u9669\/\u6211\u8fd9\u4e2a\u4eba\u6709\u95ee\u9898\u201d（\u9ad8\u4f30\u98ce\u9669），\u4e8e\u662f\u7126\u8651\u3001\u5185\u759a，\u8fdb\u800c\u7528\u4eea\u5f0f\u4e0e\u56de\u907f\u53bb\u6d88\u9664\u5a01\u80c1，\u6362\u6765\u77ed\u6682\u7f13\u89e3，\u53c8\u53cd\u8fc7\u6765\u5f3a\u5316\u4e86\u8bef\u8bfb\u3002<\/li>\n
    • ERP \u7684\u4e24\u4e2a\u52a8\u4f5c：\u66b4\u9732（\u9010\u6b65\u63a5\u8fd1\u5bb3\u6015\u7684\u60c5\u5883\u4e0e\u5ff5\u5934）+ \u53cd\u5e94\u963b\u6b62（\u4e0d\u505a\u4eea\u5f0f\u3001\u4e0d\u5bfb\u6c42\u4fdd\u8bc1）；\u6807\u51c6\u7597\u7a0b\u7ea6 10\u201320 \u6b21\u4f1a\u8c08，\u7b2c\u4e00\u6b21\u662f\u5fc3\u7406\u6559\u80b2\u4e0e\u539f\u7406\u8bf4\u660e\u3002<\/li>\n
    • \u7597\u6548：\u5b8c\u6210\u6cbb\u7597\u8005 Y-BOCS \u5e73\u5747\u4e0b\u964d 50%\u201370%，\u8d85\u8fc7 35% \u5373\u89c6\u4e3a\u4e34\u5e8a\u663e\u8457；\u4e00\u9879 RCT \u4e2d\u57fa\u7ebf 25.3 \u5206\u964d\u5230 11.4 \u5206，6 \u4e2a\u6708\u968f\u8bbf\u4ecd\u7ef4\u6301 10.9 \u5206\u3002<\/li>\n
    • \u5143\u5206\u6790：30 \u9879\u7814\u7a76（1793 \u4eba）\u663e\u793a ERP \u76f8\u5bf9\u5b89\u6170\u5242\u6761\u4ef6\u6548\u5e94\u91cf g=0.97；\u76f8\u5bf9\u4e3b\u52a8\u5bf9\u7167（\u5982\u538b\u529b\u7ba1\u7406）g=0.37\u2014\u2014\u8bf4\u660e\u7597\u6548\u6765\u81ea ERP \u7684\u7279\u5f02\u6210\u5206，\u800c\u4e0d\u662f\u201c\u6709\u4eba\u966a\u7740\u804a\u201d\u3002<\/li>\n
    • \u5c40\u9650：\u7ea6 20% \u7684\u60a3\u8005\u65e0\u53cd\u5e94；21 \u9879 RCT \u7684\u52a0\u6743\u8131\u843d\u7387\u7ea6 14.7%，\u82e5\u628a\u62d2\u7edd\u6cbb\u7597\u8005\u7b97\u8fdb\u53bb\u8fbe 18.7%\u3002<\/li>\n
    • \u9884\u540e\u56e0\u7d20：\u57fa\u7ebf\u4e25\u91cd\u5ea6\u9ad8\u3001\u81ea\u77e5\u529b\u5dee\u3001\u8ba4\u77e5\u50f5\u5316\u3001\u5171\u75c5\u6291\u90c1\/\u5f3a\u8feb\u578b\u4eba\u683c\/\u5b64\u72ec\u75c7\u8c31\u7cfb\u3001\u5bb6\u5c5e\u8fc7\u5ea6\u53c2\u4e0e\u4eea\u5f0f\u3001\u751f\u6d3b\u8d28\u91cf\u5dee；\u800c\u201c\u662f\u5426\u771f\u7684\u7167\u7740\u505a（\u963b\u6b62\u53cd\u5e94）\u201d\u662f\u6700\u5f3a\u7684\u9884\u6d4b\u56e0\u5b50\u4e4b\u4e00\u3002<\/li>\n
    • \u5927\u767d\u8bdd：ERP \u6709\u70b9\u50cf\u201c\u6545\u610f\u4e0d\u9501\u95e8\u7136\u540e\u51fa\u95e8\u201d\u2014\u2014\u4e0d\u662f\u8ba9\u4f60\u4e0d\u6015，\u800c\u662f\u8ba9\u4f60\u4eb2\u81ea\u9a8c\u8bc1\u201c\u6015\u7684\u4e8b\u5e76\u6ca1\u6709\u53d1\u751f\u201d\u3002\u5b83\u4e0d\u9760\u8bb2\u9053\u7406，\u9760\u7ecf\u9a8c\u6539\u5199\u9884\u671f\u3002\u4e5f\u6b63\u56e0\u4e3a\u8981\u76f4\u9762\u6050\u60e7，\u8131\u843d\u7387\u9ad8\u5f97\u60ca\u4eba\u2014\u2014\u8fd9\u89e3\u91ca\u4e86\u4e3a\u4ec0\u4e48\u201c\u7597\u6cd5\u6709\u6548\u201d\u548c\u201c\u75c5\u4eba\u771f\u7684\u597d\u4e86\u201d\u662f\u4e24\u4ef6\u4e0d\u540c\u7684\u4e8b\u3002<\/li>\n<\/ul>\n

      \"\"<\/p>\n

      \u56fe1\u3000\u5f3a\u8feb\u75c7\u7684\u8ba4\u77e5\u884c\u4e3a\u6a21\u578b：\u4fb5\u5165\u6027\u5ff5\u5934\u5982\u4f55\u88ab\u201c\u8bef\u8bfb\u201d\u6210\u707e\u96be（\u539f\u6587 Fig 1）<\/span><\/p>\n

      （\u8bfb\u56fe：\u4ece\u4e0a\u5230\u4e0b\u662f\u201c\u4eba\u4eba\u90fd\u4f1a\u6709\u7684\u602a\u5ff5\u5934\u2192\u5938\u5927\u4fe1\u5ff5\u7684\u8bef\u8bfb\u2192\u7126\u8651\/\u5185\u759a\u2192\u5f3a\u8feb\u4e0e\u56de\u907f\u2192\u77ed\u6682\u7f13\u89e3\u201d，\u53f3\u4fa7\u90a3\u6761\u5411\u4e0a\u7684\u7c97\u7bad\u5934\u5c31\u662f\u201c\u8d1f\u5f3a\u5316\u201d\u56de\u8def\u2014\u2014\u6bcf\u4e00\u6b21\u5b89\u5fc3，\u90fd\u5728\u7ed9\u4e0b\u4e00\u6b21\u5f3a\u8feb\u6295\u7968\u3002）<\/p>\n

      \"\"<\/p>\n

      \u56fe2\u3000Y-BOCS \u603b\u5206\u4e0e\u4e34\u5e8a\u5206\u7ea7（\u539f\u6587 Fig 2）<\/span><\/p>\n

      （\u8bfb\u56fe：Y-BOCS \u5171 10 \u4e2a\u6761\u76ee，\u603b\u5206 0\u201340；0\u201313 \u4e3a\u4e9a\u4e34\u5e8a\u300114\u201325 \u8f7b\u5ea6\u300126\u201334 \u4e2d\u5ea6\u300135\u201340 \u91cd\u5ea6\u3002\u5b83\u662f\u4e34\u5e8a\u8bd5\u9a8c\u91cc\u6700\u5e38\u7528\u7684\u201c\u6807\u5c3a\u201d，\u4e5f\u662f\u5224\u65ad\u201c\u6709\u6ca1\u6709\u6548\u201d\u7684\u5206\u754c\u7ebf\u3002）<\/p>\n

      \u4e09\u3001\u836f\u7269：\u4e3a\u4ec0\u4e48 SSRI \u8981\u201c\u9ad8\u5242\u91cf\u3001\u957f\u7597\u7a0b\u201d<\/span><\/span><\/h3>\n
        \n
      • \u603b\u4f53\u6548\u5e94：SSRI \u901a\u5e38\u5e26\u6765 30%\u201340% \u7684\u75c7\u72b6\u6539\u5584，\u7ea6\u4e00\u534a\u60a3\u8005\u5bf9\u9996\u6b21\u7528\u836f\u65e0\u53cd\u5e94\u3002<\/li>\n
      • 11 \u9879 RCT（2372 \u4eba，10\u201313 \u5468）\u7684\u5143\u5206\u6790：SSRI \u4ec5\u6bd4\u5b89\u6170\u5242\u591a\u964d 2.65 \u5206（95%CI 1.85\u20133.46），\u6548\u5e94\u91cf g=0.33（\u5c0f）；\u4f46\u8fbe\u5230\u5e94\u7b54（Y-BOCS \u964d\u226535%）\u7684\u6bd4\u503c\u6bd4\u4e3a 2.21\u3002<\/li>\n
      • 21 \u9879\u7814\u7a76（4102 \u4eba）\u7684\u66f4\u5927\u5143\u5206\u6790：g=\u22120.59（\u4e2d\u7b49\u6548\u5e94），\u7ea6\u5408\u6bd4\u5b89\u6170\u5242\u591a\u964d 4.2 \u5206\u3002<\/li>\n
      • \u6c2f\u7c73\u5e15\u660e\u7565\u5f3a\u4e8e SSRI：5 \u9879 RCT（739 \u4eba）\u663e\u793a\u591a\u964d\u7ea6 3.1 \u5206（g \u5dee\u503c \u22120.43）；\u4f46\u5b83\u526f\u4f5c\u7528\u66f4\u5927，\u4e14\u65e9\u671f\u8bd5\u9a8c\u591a\u5728\u9884\u6ce8\u518c\u65f6\u4ee3\u5b8c\u6210\u3001\u6837\u672c\u66f4\u201c\u521d\u6cbb\u201d\u3001\u53cc\u76f2\u66f4\u6613\u88ab\u8bc6\u7834，\u4f18\u52bf\u53ef\u80fd\u88ab\u9ad8\u4f30\u3002<\/li>\n
      • \u5242\u91cf-\u53cd\u5e94：11 \u9879\u8bd5\u9a8c（2322 \u4eba）\u663e\u793a\u7597\u6548\u968f\u5242\u91cf\u5347\u9ad8，\u5230\u7ea6 40 mg \u6c1f\u897f\u6c40\u5f53\u91cf\u540e\u8fdb\u5165\u5e73\u53f0；\u800c\u526f\u4f5c\u7528\u5bfc\u81f4\u7684\u8131\u843d\u968f\u5242\u91cf\u4e0a\u5347（40 mg \u65f6\u76f8\u5bf9\u98ce\u9669 1.81，83.7 mg \u65f6 1.96）\u3002<\/li>\n
      • \u589e\u6548：5 \u9879 RCT \u7684\u6297\u7cbe\u795e\u75c5\u836f\u589e\u6548\u6548\u5e94\u91cf d=0.4（\u5e73\u5747\u591a\u964d 2.34 \u5206），\u5176\u4e2d\u5229\u57f9\u916e d=0.53（3.89 \u5206）\u3001\u963f\u7acb\u54cc\u5511 d=1.11（6.29 \u5206），\u800c\u5965\u6c2e\u5e73\u3001\u55b9\u786b\u5e73\u672a\u8fbe\u7edf\u8ba1\u663e\u8457\u3002\u8c37\u6c28\u9178\u8c03\u8282\u5242（\u7f8e\u91d1\u521a\u3001\u5229\u9c81\u5511\u7b49）\u5728 17 \u9879 RCT（759 \u4eba）\u4e2d\u5e73\u5747\u591a\u964d 3.81 \u5206\u3002<\/li>\n
      • \u8054\u5408\u6cbb\u7597\u7684\u5173\u952e\u6570\u5b57：12 \u9879\u7814\u7a76（698 \u4eba）\u4e2d，ERP+\u836f\u7269 \u5bf9\u6bd4 \u5355\u7528 ERP，\u4ec5\u591a\u964d 0.08 \u5206（\u65e0\u7edf\u8ba1\u5b66\u610f\u4e49）；\u800c 9 \u9879\u7814\u7a76（415 \u4eba）\u4e2d，ERP+\u836f\u7269 \u5bf9\u6bd4 \u5355\u7528\u836f\u7269，\u591a\u964d 6.60 \u5206\u3002<\/li>\n
      • \u5927\u767d\u8bdd：\u95e8\u8bca\u6700\u5e38\u89c1\u7684\u573a\u666f\u662f\u201c\u5f00\u4e86 SSRI，\u968f\u8bbf\u4e24\u6b21，\u8bf4\u6ca1\u6548\u5c31\u6362\u836f\u201d\u3002\u8fd9\u7ec4\u6570\u5b57\u8bf4\u660e\u4e24\u4ef6\u4e8b：\u7b2c\u4e00，SSRI \u7684\u6548\u5e94\u91cf\u672c\u6765\u5c31\u5c0f，\u8d77\u6548\u8981\u7b49 10\u201313 \u5468\u3001\u5242\u91cf\u8981\u591f，\u6025\u7740\u6362\u836f\u7b49\u4e8e\u6ca1\u7ed9\u5b83\u673a\u4f1a；\u7b2c\u4e8c，\u771f\u6b63\u88ab\u4f4e\u4f30\u7684\u662f ERP\u2014\u2014\u52a0\u4e0a\u836f\u7269\u5e76\u4e0d\u6bd4\u5355\u7528 ERP \u66f4\u597d，\u4f46\u660e\u663e\u597d\u8fc7\u53ea\u5403\u836f\u3002\u53ea\u5f00\u836f，\u7b49\u4e8e\u4e3b\u52a8\u653e\u5f03\u4e86\u6548\u679c\u6700\u597d\u7684\u90a3\u4e00\u534a\u3002<\/li>\n<\/ul>\n

        \u56db\u3001\u5fc3\u7406\u6cbb\u7597\u7684\u5347\u7ea7：\u4ece\u201c\u4e60\u60ef\u5316\u201d\u5230\u201c\u9884\u671f\u8fdd\u80cc\u201d<\/span><\/span><\/h3>\n
          \n
        • \u8001\u89e3\u91ca：ERP \u4e4b\u6240\u4ee5\u6709\u6548，\u662f\u56e0\u4e3a\u53cd\u590d\u66b4\u9732\u8ba9\u7126\u8651\u201c\u4e60\u60ef\u5316\u201d\u800c\u81ea\u7136\u4e0b\u964d\u3002<\/li>\n
        • \u65b0\u89e3\u91ca（\u6291\u5236\u6027\u5b66\u4e60）：\u6050\u60e7\u8bb0\u5fc6\u4e0d\u4f1a\u88ab\u62b9\u6389，\u800c\u662f\u5728\u65c1\u8fb9\u957f\u51fa\u4e00\u5c42\u201c\u5b89\u5168\u5b66\u4e60\u201d；\u6cbb\u7597\u76ee\u6807\u662f\u8ba9\u5b89\u5168\u5b66\u4e60\u538b\u8fc7\u5a01\u80c1\u5b66\u4e60\u3002<\/li>\n
        • \u64cd\u4f5c\u4e0a\u7684\u53d8\u5316：\u660e\u786e\u8bbe\u8ba1\u201c\u8fdd\u80cc\u8d1f\u6027\u9884\u671f\u201d\u7684\u7ec3\u4e60\u3001\u5728\u4e0d\u540c\u60c5\u5883\u4e2d\u6cdb\u5316\u3001\u53d8\u5316\u7ec3\u4e60\u53c2\u6570\u2014\u2014\u800c\u4e0d\u662f\u5355\u7eaf\u201c\u91cd\u590d\u5230\u4e0d\u7126\u8651\u4e3a\u6b62\u201d\u3002<\/li>\n
        • \u63a5\u7eb3\u4e0e\u627f\u8bfa\u7597\u6cd5（ACT）：\u4e0d\u4ee5\u6d88\u9664\u75c7\u72b6\u4e3a\u552f\u4e00\u76ee\u6807，\u5f3a\u8c03\u201c\u613f\u610f\u4f53\u9a8c\u4e0d\u9002 + \u671d\u4e2a\u4eba\u4ef7\u503c\u884c\u52a8\u201d；8 \u9879 RCT（366 \u4eba）\u663e\u793a\u5927\u6548\u5e94\u91cf（d=1.19），\u5fc3\u7406\u7075\u6d3b\u6027\u662f\u7597\u6548\u7684\u7a33\u5b9a\u8c03\u8282\u56e0\u7d20\u3002<\/li>\n
        • \u63a8\u7406\u578b\u8ba4\u77e5\u884c\u4e3a\u6cbb\u7597（I-CBT）：\u628a\u5f3a\u8feb\u75c7\u7406\u89e3\u4e3a\u201c\u63a8\u7406\u6df7\u4e71\u201d\u2014\u2014\u5206\u4e0d\u6e05\u201c\u60f3\u5230\u4e86\u201d\u4e0e\u201c\u53d1\u751f\u4e86\u201d；\u4e00\u9879 111 \u4eba\u7684 RCT \u5c06\u5176\u4e0e\u4f20\u7edf\u8ba4\u77e5\u6cbb\u7597\u3001\u6b63\u5ff5\u8bad\u7ec3\u505a\u4e86\u6bd4\u8f83，\u521d\u6b65\u8bc1\u636e\u652f\u6301\u5176\u7597\u6548，\u5c24\u5176\u9002\u5408\u81ea\u77e5\u529b\u5dee\u7684\u60a3\u8005\u3002<\/li>\n
        • \u8fdc\u7a0b\u4e0e\u6570\u5b57\u7597\u6cd5：\u4e00\u9879 RCT \u4e2d\u89c6\u9891 ERP \u964d 9.06 \u5206\u3001\u9762\u5bf9\u9762\u964d 8.52 \u5206，\u7597\u6548\u76f8\u5f53；\u6e38\u620f\u5316 App \u80fd\u63d0\u5347\u4f9d\u4ece\u6027，\u4f46\u9690\u79c1\u3001\u76d1\u7ba1\u4e0e\u6570\u5b57\u7d20\u517b\u662f\u73b0\u5b9e\u969c\u788d\u3002<\/li>\n
        • \u5927\u767d\u8bdd：\u8fc7\u53bb\u4ee5\u4e3a\u201c\u7ec3\u5230\u4e0d\u7126\u8651\u201d\u624d\u7b97\u6210\u529f；\u73b0\u5728\u66f4\u5f3a\u8c03\u201c\u6211\u9884\u671f\u7684\u707e\u96be\u6ca1\u53d1\u751f\u201d\u3002\u8fd9\u4e2a\u8f6c\u53d8\u5f88\u5b9e\u7528\u2014\u2014\u4f60\u4e0d\u5fc5\u7b49\u7126\u8651\u6d88\u5931\u624d\u80fd\u7ed3\u675f\u7ec3\u4e60，\u53ea\u8981\u8ba9\u5927\u8111\u62ff\u5230\u4e00\u6761\u201c\u548c\u9884\u671f\u4e0d\u7b26\u201d\u7684\u8bc1\u636e，\u5b83\u5c31\u5f97\u5206\u3002<\/li>\n<\/ul>\n

          \u4e94\u3001\u96be\u6cbb\u4e0e\u524d\u6cbf：\u836f\u7269\u4e4b\u5916\u8fd8\u6709\u4ec0\u4e48<\/span><\/span><\/h3>\n
            \n
          • \u7f8e\u91d1\u521a：8 \u5468 RCT（42 \u4eba）\u4e2d，\u7f8e\u91d1\u521a\u7ec4 100% \u8fbe\u5230\u90e8\u5206\u5e94\u7b54（\u226525% \u4e0b\u964d），\u5b89\u6170\u5242\u7ec4 32%；\u7f13\u89e3\u7387 89% \u5bf9 32%；4 \u9879\u53cc\u76f2 RCT \u7684\u5143\u5206\u6790\u663e\u793a\u5e94\u7b54\u53ef\u80fd\u6027\u4e3a\u5b89\u6170\u5242\u7684 3.61 \u500d\u3002<\/li>\n
          • \u5229\u9c81\u5511：38 \u4f8b\u81f3\u5c11\u4e00\u79cd SSRI \u65e0\u6548\u8005\u7684 12 \u5468 RCT，Y-BOCS \u964d\u5e45 15% \u5bf9 11%，\u672a\u8fbe\u7edf\u8ba1\u5b66\u5dee\u5f02\u3002<\/li>\n
          • N-\u4e59\u9170\u534a\u80f1\u6c28\u9178（NAC）：5 \u9879\u589e\u6548 RCT（195 \u4eba）\u6700\u5927\u6539\u5584\u4e0d\u8db3 3 \u5206，\u4f4e\u4e8e\u201c\u90e8\u5206\u5e94\u7b54\u201d\u901a\u5e38\u8981\u6c42\u7684 25%\u3002<\/li>\n
          • rTMS：12 \u9879\u4ec5\u7eb3\u5165 RCT \u7684\u5143\u5206\u6790（282\u2013791 \u4eba）\u6548\u5e94\u91cf g=0.29\u20130.49（\u5c0f\u5230\u4e2d\u7b49），\u9776\u70b9\u4ee5\u8f85\u52a9\u8fd0\u52a8\u533a\u3001\u80cc\u5916\u4fa7\u524d\u989d\u53f6\u3001\u7736\u989d\u76ae\u8d28\u4e3a\u4e3b；\u4e00\u9879 61 \u4eba\u7684 RCT \u628a rTMS \u653e\u5728 ERP \u4e4b\u524d，\u7ed3\u679c\u4e0e\u4f2a\u523a\u6fc0\u65e0\u5dee\u5f02\u3002<\/li>\n
          • tDCS：6 \u9879 RCT（147 \u4eba）\u7ec4\u95f4\u5dee \u22121.13 \u5206（95%CI \u22125.35 \u81f3 3.10），\u672a\u89c1\u4f18\u52bf\u3002<\/li>\n
          • DBS：\u9776\u70b9\u5305\u62ec\u8179\u4fa7\u56ca\/\u8179\u4fa7\u7eb9\u72b6\u4f53\u3001\u4f0f\u9694\u6838\u3001\u4e18\u8111\u5e95\u6838\u7b49；\u7814\u7a76\u591a\u4e3a\u5f00\u653e\u3001\u975e\u76f2\u3001\u5c0f\u6837\u672c，\u4f46\u5bf9\u6781\u91cd\u5ea6\u96be\u6cbb\u8005\u6548\u5e94\u8f83\u5927\u2014\u2014\u4ee3\u4ef7\u662f\u4fb5\u5165\u6027\u3001\u8d39\u7528\u4e0e\u4e13\u79d1\u4e2d\u5fc3\u95e8\u69db\u3002<\/li>\n
          • \u88f8\u76d6\u83c7\u7d20：\u76ee\u524d\u552f\u4e00\u5df2\u53d1\u8868\u7684\u7814\u7a76\u4ec5 9 \u4eba\u3001\u5f00\u653e\u6807\u7b7e，Y-BOCS \u4e0b\u964d\u5e45\u5ea6 23%\u2013100%；\u6570\u9879\u4e8c\u671f RCT \u6b63\u5728\u8fdb\u884c（25 mg \u4e0e 30 mg\u3001\u95f4\u9694\u4e00\u5468）\u3002\u6c2f\u80fa\u916e 0.5 \u4e0e 1.0 mg\/kg \u9759\u8109\u7ed9\u836f\u53ef\u5728\u6570\u5c0f\u65f6\u5185\u8d77\u6548\u3001\u7ef4\u6301\u7ea6\u4e00\u5468；MDMA \u5219\u53ef\u80fd\u901a\u8fc7\u589e\u5f3a\u60c5\u611f\u5f00\u653e\u4e0e\u6050\u60e7\u6d88\u9000\u6765\u8f85\u52a9 ERP\u3002<\/li>\n
          • \u5171\u540c\u7684\u8f6f\u808b：\u81f4\u5e7b\u6548\u5e94\u592a\u201c\u663e\u773c\u201d，\u53cc\u76f2\u51e0\u4e4e\u4e0d\u53ef\u80fd\u7ef4\u6301，\u5b89\u6170\u5242\u6548\u5e94\u96be\u4ee5\u6392\u9664\u3002<\/li>\n
          • \u5927\u767d\u8bdd：\u8fd9\u4e9b\u624b\u6bb5\u7684\u5171\u540c\u70b9\u662f\u201c\u8bc1\u636e\u7b49\u7ea7\u8fd8\u4e0d\u591f\u201d\u3002DBS \u6548\u5e94\u5927，\u4f46\u4e3b\u8981\u662f\u5f00\u653e\u7814\u7a76；\u88f8\u76d6\u83c7\u7d20\u7684\u6570\u636e\u6765\u81ea 9 \u4e2a\u4eba；rTMS \u6548\u5e94\u91cf\u5c0f\u3001\u65b9\u6848\u4e94\u82b1\u516b\u95e8\u3002\u5b83\u4eec\u4e0d\u662f\u201c\u65b0\u5e0c\u671b\u201d，\u800c\u662f\u201c\u5f85\u9a8c\u8bc1\u7684\u5047\u8bbe\u201d\u2014\u2014\u5c24\u5176\u5728\u88ab\u793e\u4ea4\u5a92\u4f53\u653e\u5927\u65f6，\u66f4\u9700\u8981\u8fd9\u53e5\u8bdd\u3002<\/li>\n<\/ul>\n

            \u516d\u3001\u843d\u5230\u5177\u4f53\u7684\u4eba：\u5206\u7ea7\u3001\u6587\u5316\u4e0e\u201c\u6b63\u4e49\u53d6\u5411\u201d\u7684 ERP<\/span><\/span><\/h3>\n
              \n
            • \u5206\u7ea7\u6cbb\u7597（stepped care）：\u4e00\u7ebf\u4e3a ERP\u3001SSRI \u6216\u4e24\u8005\u8054\u5408；\u4e0d\u8db3\u5219\u8003\u8651\u6c2f\u7c73\u5e15\u660e\u3001\u6297\u7cbe\u795e\u75c5\u836f\u589e\u6548，\u4ee5\u53ca ACT\u3001\u8ba4\u77e5\u6cbb\u7597\u3001I-CBT \u7b49\u4e8c\u7ebf\u5fc3\u7406\u6cbb\u7597；\u518d\u4e0d\u8db3\u53ef\u8003\u8651 rTMS\u3001DBS；\u6c2f\u80fa\u916e\u4e0e\u81f4\u5e7b\u5242\u76ee\u524d\u53ea\u5728\u7814\u7a76\u573a\u666f\u4e2d\u4f7f\u7528\u3002<\/li>\n
            • \u6587\u5316\u4f1a\u6539\u5199\u75c7\u72b6\u5185\u5bb9：\u62c9\u7f8e\u88d4\u4eba\u7fa4\u4e2d\u6c61\u67d3\u4e0e\u653b\u51fb\u4e3b\u9898\u66f4\u591a；\u5357\u4e9a\u4eba\u7fa4\u4e2d\u6c61\u67d3\u4e0e\u75c5\u7406\u6027\u6000\u7591\u5e38\u89c1，\u4e14\u6027\u522b\u5f71\u54cd\u8868\u73b0\u5f62\u5f0f；\u4e2d\u56fd\u4eba\u5bf9\u79f0\u75c7\u72b6\u66f4\u591a；\u65e5\u672c\u4eba\u6c61\u67d3\u4e0e\u653b\u51fb\u4e3b\u9898\u66f4\u591a\u3002<\/li>\n
            • \u5b97\u6559\u5f3a\u8feb（scrupulosity）：\u6cbb\u7597\u5e08\u8981\u533a\u5206\u201c\u4fe1\u4ef0\u5b9e\u8df5\u201d\u4e0e\u201c\u5f3a\u8feb\u4eea\u5f0f\u201d\u3002\u4f8b\u5982\u9762\u5bf9\u7a46\u65af\u6797\u60a3\u8005\u7684\u6d01\u51c0\u5f3a\u8feb，\u4e0d\u662f\u53bb\u6311\u6218\u5b97\u6559\u6d17\u624b（wudu），\u800c\u662f\u5e2e\u4ed6\u5206\u6e05\u201c\u6559\u4e49\u8981\u6c42\u201d\u4e0e\u201c\u5f3a\u8feb\u9a71\u52a8\u201d\u3002<\/li>\n
            • \u8eab\u4efd\u76f8\u5173\u75c7\u72b6：\u5bf9\u6027\u53d6\u5411\u3001\u79cd\u65cf\u8fb1\u9a82\u5ff5\u5934\u7b49\u7684\u5f3a\u8feb\u6027\u6000\u7591，\u6cbb\u7597\u76ee\u6807\u662f\u201c\u5bf9\u5931\u63a7\u7684\u6050\u60e7\u201d，\u800c\u4e0d\u662f\u5426\u5b9a\u60a3\u8005\u7684\u8eab\u4efd；\u8fd9\u7c7b\u201c\u6b63\u4e49\u53d6\u5411\u7684 ERP\u201d\u8981\u6c42\u6cbb\u7597\u5e08\u683c\u5916\u8c28\u614e\u3002<\/li>\n
            • \u516c\u5e73\u6027\u95ee\u9898：\u975e\u6d32\u4eba\u7fa4\u7684\u7814\u7a76\u4ecd\u7136\u7a00\u5c11；\u73b0\u6709\u5c11\u91cf\u8bc1\u636e\u663e\u793a，\u5c11\u6570\u7fa4\u4f53\u7684\u6cbb\u7597\u6548\u679c\u4e0e\u591a\u6570\u7fa4\u4f53\u5e76\u65e0\u663e\u8457\u5dee\u5f02，\u4f46\u201c\u5c11\u6570\u7fa4\u4f53\u538b\u529b\u662f\u5426\u53c2\u4e0e\u81f4\u75c5\u201d\u4ecd\u5f85\u7814\u7a76\u3002<\/li>\n
            • \u6587\u7ae0\u5217\u51fa\u7684\u672a\u6765\u95ee\u9898：\u5982\u4f55\u628a ACT\u3001I-CBT\u3001\u6291\u5236\u6027\u5b66\u4e60\u7248 ERP \u6574\u5408\u8fdb\u6807\u51c6\u6d41\u7a0b？\u81f4\u5e7b\u5242\u7684\u4f5c\u7528\u673a\u5236\u662f\u4ec0\u4e48\u3001\u5982\u4f55\u4e0e\u5fc3\u7406\u6cbb\u7597\u914d\u5408？\u54ea\u4e9b\u60a3\u8005\u7279\u5f81\u80fd\u9884\u6d4b\u5dee\u5f02\u5316\u53cd\u5e94？\u5bb6\u5c5e\u53c2\u4e0e\u662f\u5426\u52a0\u5206？\u8fdc\u7a0b\u4e0e VR \u5982\u4f55\u63d0\u9ad8\u53ef\u53ca\u6027？<\/li>\n
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              \u4e03\u3001\u4e00\u53e5\u8bdd\u603b\u7ed3<\/span><\/span><\/h3>\n

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              \u5728Info X Med\u5373\u53ef\u67e5\u770b\u539f\u6587\u732e<\/p>\n

              \u6807\u7b7e： `#\u5f3a\u8feb\u75c7` `#OCD` `#ERP` `#\u66b4\u9732\u4e0e\u53cd\u5e94\u963b\u6b62` `#SSRI` `#Y-BOCS` `#\u88f8\u76d6\u83c7\u7d20` `#\u8111\u6df1\u90e8\u7535\u523a\u6fc0` `#\u6587\u732e\u89e3\u8bfb`<\/p>\n","protected":false},"excerpt":{"rendered":"

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