综合康复治疗对精神分裂症患者认知功能的影响及1年随访研究
发布时间：2018-08-27 14:50
【摘要】：目的精神分裂症是一种慢性难治性精神疾病,主要包括阳性症状、阴性症状、认知损害、冲动攻击、情感症状,其中认知功能的损害常常是造成患者日常生活能力下降、社会功能丧失的最主要原因,然而目前药物治疗对认知功能改善仍不理想。本文通过对精神分裂症患者进行为期6个月的综合康复治疗,评定其对患者认知功能的影响,旨在探讨综合康复治疗在改善精神分裂症患者认知损害的作用效果,为临床干预提供依据和数据支撑,并为有关精神分裂症治疗的后续研究提供新视野,从而探索一种轻松,依从性高的治疗精神分裂症认知功能的方法。方法依据精神障碍统计与诊断手册第4版(DSM-Ⅳ)诊断标准,选取我院长期住院的精神分裂症患者60例,将60例精神分裂症患者随机分为观察组(药物治疗结合康复治疗)和对照组(药物治疗),每组各30例。入组当天进行全面的病史采集、全面的精神科检查和体格检查。在基线和第6个月末分别采用阳性与阴性症状量表(PANSS)和精神分裂症认知功能成套测验中文版(MCCB)评定每位患者的精神症状和认知功能,TESS评估副作用,阴性症状评定量表(SANS)评定患者的阴性症状。康复治疗的内容包括视频游戏、拼图游戏、认知学习、工娱疗法、健康教育,统计上采用常用的SPSS软件16.0进行统计与分析,计数资料用例数(百分比)表示,组间的比较采用χ2检验。若计量资料符合正态分布,即采用均数±标准差来表示,组间的比较使用配对t检验的方法,如果计量资料不符合正态分布,则可以采用中位数来表示,组间比较可以采用秩和检验的方法。结果综合康复治疗前MCCB,SANS,TESS评分两组相近,差异无统计学意义;综合康复治疗后观察组MCCB评分高于对照组,观察组SANS评分低于对照组,差异有统计学意义。TESS评分两组相近无统计学意义。MCCB评分两组均随时间的延长呈升高趋势,SANS评分有降低趋势。结论综合康复治疗能够提高精神分裂症患者的认知功能,说明该措施有利于患者康复和认知功能的恢复和保持,是一种可行的治疗措施。
[Abstract]:Objective Schizophrenia is a chronic and refractory psychiatric disorder, which mainly includes positive symptoms, negative symptoms, cognitive impairment, impulsive aggression, and emotional symptoms. The impairment of cognitive function is often the main reason for the decline of daily living ability and loss of social function. However, the improvement of cognitive function is still ignored by drug treatment. The purpose of this study is to explore the effect of comprehensive rehabilitation therapy on improving cognitive impairment in schizophrenic patients, to provide evidence for clinical intervention and data support, and to provide follow-up research on the treatment of schizophrenia. Methods According to the diagnostic criteria of DSM-IV, 60 schizophrenic patients who had been hospitalized for a long time in our hospital were selected and randomly divided into observation group (combination of medication) and observation group (combination of medication). Rehabilitation therapy and control group (medication) were administered with 30 patients in each group. All patients were given comprehensive medical history, psychiatric examination and physical examination on the same day. Cognitive function, TESS assessment of side effects, negative symptom rating scale (SANS) assessment of patients with negative symptoms. Rehabilitation treatment includes video games, jigsaw puzzles, cognitive learning, recreational therapy, health education, statistics and analysis using commonly used SPSS software 16.0, counting data use cases (percentage) expressed, the comparison between groups. _2 test was used. If the measurement data accorded with normal distribution, that is to say, the mean (+ standard deviation) was used to express the comparison between groups. If the measurement data did not accord with normal distribution, the paired t test was used. If the measurement data did not accord with normal distribution, the median value could be used to express, and the rank sum test could be used to compare between groups. The scores of MCCB in the observation group were higher than those in the control group, and the scores of SANS in the observation group were lower than those in the control group. There was no significant difference in TESS between the two groups. It can improve the cognitive function of schizophrenic patients, indicating that this measure is conducive to the recovery and maintenance of cognitive function, and is a feasible treatment.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R749.3
，
本文编号：2207610
[Abstract]:Objective Schizophrenia is a chronic and refractory psychiatric disorder, which mainly includes positive symptoms, negative symptoms, cognitive impairment, impulsive aggression, and emotional symptoms. The impairment of cognitive function is often the main reason for the decline of daily living ability and loss of social function. However, the improvement of cognitive function is still ignored by drug treatment. The purpose of this study is to explore the effect of comprehensive rehabilitation therapy on improving cognitive impairment in schizophrenic patients, to provide evidence for clinical intervention and data support, and to provide follow-up research on the treatment of schizophrenia. Methods According to the diagnostic criteria of DSM-IV, 60 schizophrenic patients who had been hospitalized for a long time in our hospital were selected and randomly divided into observation group (combination of medication) and observation group (combination of medication). Rehabilitation therapy and control group (medication) were administered with 30 patients in each group. All patients were given comprehensive medical history, psychiatric examination and physical examination on the same day. Cognitive function, TESS assessment of side effects, negative symptom rating scale (SANS) assessment of patients with negative symptoms. Rehabilitation treatment includes video games, jigsaw puzzles, cognitive learning, recreational therapy, health education, statistics and analysis using commonly used SPSS software 16.0, counting data use cases (percentage) expressed, the comparison between groups. _2 test was used. If the measurement data accorded with normal distribution, that is to say, the mean (+ standard deviation) was used to express the comparison between groups. If the measurement data did not accord with normal distribution, the paired t test was used. If the measurement data did not accord with normal distribution, the median value could be used to express, and the rank sum test could be used to compare between groups. The scores of MCCB in the observation group were higher than those in the control group, and the scores of SANS in the observation group were lower than those in the control group. There was no significant difference in TESS between the two groups. It can improve the cognitive function of schizophrenic patients, indicating that this measure is conducive to the recovery and maintenance of cognitive function, and is a feasible treatment.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R749.3
，
本文编号：2207610
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