【摘要】 目的了解药物结合康复工疗对慢性精神分裂症患者阴性症状、认知功能和社会功能改善的作用。方法将温州康宁医院精神科病房的300例慢性精神分裂症患者随机分为研究组(药物治疗结合康复工疗)和对照组(药物治疗),每组各150例。患者在入组时、入组后12周及随访半年时应用阴性症状量表(SANS)、韦氏成人智力测验(WAIS)、个人和社会功能量表(PSP)进行评估。康复工疗前后计量资料采用配对样本t检验进行统计;组间计量资料采用独立样本t检验;计数资料应用卡方检验,随访资料采用重复测量的方差分析。结果 (1)治疗12周及随访半年时,研究组SANS总分与入组时比较差异有统计学意义(t=7.74,F=11.32,P均<0.01);对照组SANS差异无统计学意义(P均>0.05)。研究组和对照组SANS评分的组间比较:入组时评分比较差异无统计学意义(t=1.76,P>0.05);治疗12周及随访半年时两组比较差异有统计学意义(t=6.76,t=8.12,P均<0.01)。(2)治疗12周及随访半年时,研究组WAIS总分增加,认知功能改善,差异有统计学意义(t=5.31,P<0.05;F=8.17,P<0.01)。对照组WAIS总分增加不明显,差异无统计学意义(P均>0.05)。两组的组间比较:入组时两组WAIS评分比较差异无统计学意义(t=2.05,P>0.05),两组具有可比性;治疗12周及随访半年时两组比较差异有统计学意义(t=3.87,t=5.23,P均<0.05)。(3)经过12周的康复工疗,在入组后12周及随访半年时,研究组PSP总分增加,社会功能改善,差异有统计学意义(t=4.81,P<0.05;F=10.54,P<0.01)。对照组PSP总分增加不明显,差异无统计学意义(P均>0.05)。两组组间比较:入组时两组PSP评分比较差异无统计学意义(t=1.24,P>0.05);治疗12周及随访半年时两组比较差异有统计学意义(t=5.37,P<0.05;t=9.36,P<0.01)。结论药物治疗结合康复工疗的模式可使慢性精神分裂症患者的阴性症状减少,认知功能和社会功能较治疗前提高。更多还原

【Abstract】 Objective To be aware of the medicine with work therapy’ s influence to chronic schizophrenia’s negative syndrome,cognitive function and social function.Methods Three hundred patients with chronic schizophrenia from Wenzhou Kangning Hospital were divided into two groups:study group( medicine with work therapy) and control group( medicine).There were 150 cases in each group.The scale assessment of negative syndrome( SANS),Wechscler adult intelligence scale( WAIS) and personal and social performance scale( PSP) were tested at the beginning,12 weeks later and half year after follow up.The differences of the two groups were compared by paired samples t test,independent sample t test or chi-square test,follow-up data between the two groups were compared by repeated measures analysis of variance.Results( 1) After treatment for 12 weeks and half year after follow up,there were statistical significance of SANS total scores in study group compared with the beginning( t = 7.74,F = 11.32,all P < 0.01);in control group,there was no statistical significance in SANS total scores compared with at the beginning( all P >0.05).The scores of SANS showed no difference between two groups before treatment( t = 1.76,P > 0.05).The scores of SANS had significant difference between study group and control group after treatment for 12 weeks and half year after follow up( t = 6.76,t = 8.12,all P < 0.01).( 2) After treatment for 12 weeks and half year after follow up,WAIS total scores increased,cognitive function was improved in study group,there were statistical significance between the two groups( t = 5.31,P < 0.05;F = 8.17,P < 0.01).The increasing of WAIS total scores was not obvious in control group,there was no statistical significance between the two groups( all P > 0.05).The scores of WAIS showed no difference between two groups before treatment( P >0.05).The scores of WAIS were significant different between study group and control group after treatment for 12 weeks and half year after follow up( t = 3.87,t = 5.23,all P < 0.05).( 3) After treatment for 12 weeks and half year after follow up,the treatment effect of social function,study group PSP total scores increased,social function improved,there were statistical significance compared with the beginning( t = 4.81,P < 0.05;F = 10.54,P < 0.01).In control group,the growth of PSP total scores was not obvious,there was no statistical difference compared with the beginning( all P > 0.05).The scores of PSP showed no difference between two groups before treatment( t = 1.24,P > 0.05).The scores of PSP had significant difference between study group and control group after treatment for 12 weeks and half year after follow up( t = 5.37,P < 0.05;t =9.36,P < 0.01).Conclusion Medicine with work therapy can make chronic schizophrenia patient’ s negative symptoms cut down,cognitive function and social function enhance compared with before treatment.更多还原