【摘要】：目的精神分裂癥是一種慢性難治性精神疾病,主要包括陽性癥狀、陰性癥狀、認知損害、沖動攻擊、情感癥狀,其中認知功能的損害常常是造成患者日常生活能力下降、社會功能喪失的最主要原因,然而目前藥物治療對認知功能改善仍不理想。本文通過對精神分裂癥患者進行為期6個月的綜合康復治療,評定其對患者認知功能的影響,旨在探討綜合康復治療在改善精神分裂癥患者認知損害的作用效果,為臨床干預提供依據(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知功能的方法。方法依據(jù)精神障礙統(tǒng)計與診斷手冊第4版(DSM-Ⅳ)診斷標準,選取我院長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分為觀察組(藥物治療結(jié)合康復治療)和對照組(藥物治療),每組各30例。入組當天進行全面的病史采集、全面的精神科檢查和體格檢查。在基線和第6個月末分別采用陽性與陰性癥狀量表(PANSS)和精神分裂癥認知功能成套測驗中文版(MCCB)評定每位患者的精神癥狀和認知功能,TESS評估副作用,陰性癥狀評定量表(SANS)評定患者的陰性癥狀�？祻椭委煹膬�(nèi)容包括視頻游戲、拼圖游戲、認知學習、工娛療法、健康教育,統(tǒng)計上采用常用的SPSS軟件16.0進行統(tǒng)計與分析,計數(shù)資料用例數(shù)(百分比)表示,組間的比較采用χ2檢驗。若計量資料符合正態(tài)分布,即采用均數(shù)±標準差來表示,組間的比較使用配對t檢驗的方法,如果計量資料不符合正態(tài)分布,則可以采用中位數(shù)來表示,組間比較可以采用秩和檢驗的方法。結(jié)果綜合康復治療前MCCB,SANS,TESS評分兩組相近,差異無統(tǒng)計學意義;綜合康復治療后觀察組MCCB評分高于對照組,觀察組SANS評分低于對照組,差異有統(tǒng)計學意義。TESS評分兩組相近無統(tǒng)計學意義。MCCB評分兩組均隨時間的延長呈升高趨勢,SANS評分有降低趨勢。結(jié)論綜合康復治療能夠提高精神分裂癥患者的認知功能,說明該措施有利于患者康復和認知功能的恢復和保持,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.
【學位授予單位】：天津醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R749.3
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本文編號：2207610