發(fā)布時(shí)間：2018-08-27 14:50

【摘要】：目的精神分裂癥是一種慢性難治性精神疾病,主要包括陽(yáng)性癥狀、陰性癥狀、認(rèn)知損害、沖動(dòng)攻擊、情感癥狀,其中認(rèn)知功能的損害常常是造成患者日常生活能力下降、社會(huì)功能喪失的最主要原因,然而目前藥物治療對(duì)認(rèn)知功能改善仍不理想。本文通過(guò)對(duì)精神分裂癥患者進(jìn)行為期6個(gè)月的綜合康復(fù)治療,評(píng)定其對(duì)患者認(rèn)知功能的影響,旨在探討綜合康復(fù)治療在改善精神分裂癥患者認(rèn)知損害的作用效果,為臨床干預(yù)提供依據(jù)和數(shù)據(jù)支撐,并為有關(guān)精神分裂癥治療的后續(xù)研究提供新視野,從而探索一種輕松,依從性高的治療精神分裂癥認(rèn)知功能的方法。方法依據(jù)精神障礙統(tǒng)計(jì)與診斷手冊(cè)第4版(DSM-Ⅳ)診斷標(biāo)準(zhǔn),選取我院長(zhǎng)期住院的精神分裂癥患者60例,將60例精神分裂癥患者隨機(jī)分為觀察組(藥物治療結(jié)合康復(fù)治療)和對(duì)照組(藥物治療),每組各30例。入組當(dāng)天進(jìn)行全面的病史采集、全面的精神科檢查和體格檢查。在基線和第6個(gè)月末分別采用陽(yáng)性與陰性癥狀量表(PANSS)和精神分裂癥認(rèn)知功能成套測(cè)驗(yàn)中文版(MCCB)評(píng)定每位患者的精神癥狀和認(rèn)知功能,TESS評(píng)估副作用,陰性癥狀評(píng)定量表(SANS)評(píng)定患者的陰性癥狀�？祻�(fù)治療的內(nèi)容包括視頻游戲、拼圖游戲、認(rèn)知學(xué)習(xí)、工娛療法、健康教育,統(tǒng)計(jì)上采用常用的SPSS軟件16.0進(jìn)行統(tǒng)計(jì)與分析,計(jì)數(shù)資料用例數(shù)(百分比)表示,組間的比較采用χ2檢驗(yàn)。若計(jì)量資料符合正態(tài)分布,即采用均數(shù)±標(biāo)準(zhǔn)差來(lái)表示,組間的比較使用配對(duì)t檢驗(yàn)的方法,如果計(jì)量資料不符合正態(tài)分布,則可以采用中位數(shù)來(lái)表示,組間比較可以采用秩和檢驗(yàn)的方法。結(jié)果綜合康復(fù)治療前MCCB,SANS,TESS評(píng)分兩組相近,差異無(wú)統(tǒng)計(jì)學(xué)意義;綜合康復(fù)治療后觀察組MCCB評(píng)分高于對(duì)照組,觀察組SANS評(píng)分低于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義。TESS評(píng)分兩組相近無(wú)統(tǒng)計(jì)學(xué)意義。MCCB評(píng)分兩組均隨時(shí)間的延長(zhǎng)呈升高趨勢(shì),SANS評(píng)分有降低趨勢(shì)。結(jié)論綜合康復(fù)治療能夠提高精神分裂癥患者的認(rèn)知功能,說(shuō)明該措施有利于患者康復(fù)和認(rèn)知功能的恢復(fù)和保持,是一種可行的治療措施。
[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.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R749.3
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本文編號(hào)：2207610