体卫融合视域下易筋经对稳定期精神分裂症患者症状的改善作用  

The Rehabilitation Effect of Yijinjing on Patients with Stable Schizophrenia from the Perspective of Integration of Sports and Health

作　　者：高慧[1] 涂斯婧 陆如平 蒋琳娜 乔惠君 瞿林[1] 李宁宁[4] 罗超 陈剑华[4] Gao Hui;Tu Sijing;Lu Ruping;Jiang Linna;Qiao Huijun;Qu Lin;Li Ningning;Luo Chao;Chen Jianhua(Shanghai No.1 Mental Health Center of Civil Administration,Shanghai 201105,China;School of Public Health,Hangzhou Normal University,Hangzhou 311121,China;School of Public Health and Management,Guangxi University of Chinese Medicine,Nanning 530200,China;Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine,Shanghai Institute of Traditional Chinese Medicine for Mental Health,Shanghai Clinical Research Center for Mental Health,Shanghai Key Laboratory of Psychotic Disorders,Shanghai 200030,China)

机构地区：[1]上海市民政第一精神卫生中心,上海201105 [2]杭州师范大学公共卫生学院,杭州311121 [3]广西中医药大学公共卫生与管理学院,南宁530200 [4]上海交通大学医学院附属精神卫生中心,上海市中医神志病研究所,上海市重性精神病重点实验室,上海200030

出　　处：《世界科学技术-中医药现代化》2022年第8期3167-3173,共7页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：上海市闵行区卫生健康委员会科研课题(2020MW55):传统功法“以意引气”易筋经对稳定期精神分裂症患者阴性症状及认知功能的影响,负责人:高慧;上海市闵行区科学技术委员会/闵行区财政局自然科学研究课题(2022MHZ059):中国传统功法易筋经对长期住院精神分裂症患者社会功能康复的效果观察,负责人:高慧;上海市卫生健康委员会/上海市中医药管理局进一步加快中医药传承创新发展三年行动计划(2021年-2023年)(ZY(2021-2023)-0207-01):精神分裂症阴性症状及药物不良反应的中西医结合诊疗方案研究,负责人:陈剑华

摘　　要：目的基于“体卫融合”视域下,观察易筋经对稳定期精神分裂症患者阴性症状和认知功能等慢性症状的改善作用。方法采用横断面研究法,于2021年1-5月招募在上海市民政第一精神卫生中心住院的稳定期精神分裂症患者(病程≥20年)。按照随机数字法,将患者分为对照组和易筋经组,对照组采用常规治疗方式处理和适当活动;易筋经组在常规治疗方式处理的基础上,进行易筋经锻炼,每次锻炼40 min,每周2次,共计12周。采用阳性和阴性症状量表(PANSS)、重复性神经心理状态评定量表(RBANS)和卡尔加里精神分裂症抑郁量表(CDSS)评价患者症状改善情况;检测血液中人脑源性神经营养因子(BDNF)、白介素6(IL-6)和肿瘤坏死因子(TNF-α)水平辅助评价患者症状改善情况。结果最终对照组和易筋经组各20例,入组时2组性别、年龄、病程、受教育年限和抗精神病药物使用量之间均无统计学差异。锻炼12周末,易筋经组PANSS评分降低,阴性症状、一般性症状和总分与锻炼前有显著性差异(P<0.001),与对照组相比,仅阴性症状评分有显著差异(t=2.953,P=0.005);易筋经组RBANS量表各项评分较锻炼前均显著升高(P<0.05),相比于对照组也均较高(P<0.05);易筋经组CDSS量表评分较锻炼前显著降低(t=5.802,P<0.001),但较对照组无统计学差异。锻炼12周末,易筋经组BDNF水平较锻炼前有所升高,但未达到统计学差异;IL-6(t=2.627,P=0.017)和TNF-α(t=5.549,P<0.001)水平均显著降低。结论传统功法易筋经可以改善稳定期精神分裂症患者的阴性症状和认知功能。本研究为中国特色“体卫融合”的实践积累了经验,也为进一步向其他基层精神卫生机构推广该方法提供了依据。Objective To observe the rehabilitation effect of Yijinjing on negative symptoms and cognitive function of patients with stable schizophrenia under the perspective of"sports and health integration".Methods A cross-sectional study was conducted to recruit patients with stable schizophrenia(disease course≥20 years)from the No.1 Mental Health Center of Shanghai Municipal Administration between January and May 2021.According to the random number method,the patients were divided into the control group and the Yijinjing group.The control group was treated with conventional rehabilitation and appropriate activities.Besides conventional rehabilitation treatment,the Yijinjing group received Yijinjing exercise for 40 min each time,twice a week,12 weeks.Positive and Negative Symptoms Scale(PANSS),Repeatable Battery for the Assessment of Neuropsychological Status(RBANS),and Calgary Depression Scale for Schizophrenia(CDSS)were used to evaluate symptoms of schizophrenia.The brain-derived neurotrophic factor(BDNF),interleukin-6(IL-6)and tumor necrosis factor-alpha(TNF-α)were detected to assist in evaluating the symptom of schizophrenia.Results Finally,there were 20 patients in the control group and 20 patients in the Yijinjing group,and no statistical differences in gender,age,disease course,education years and dose of antipsychotic drugs between the two groups at the time of enrollment.After 12 weeks of exercise,the PANSS score decreased in the Yijinjing group,the scores of negative symptoms,general symptoms and the total score were significantly decreased than did before exercise(P<0.001),compared with the control group,only negative symptom scores have significant difference(t=2.953,P=0.005);each score of RBANS in the Yijinjing group were significantly increased than did before exercise(P<0.05)and higher than the control group(P<0.05);the score of CDSS in Yijinjing group was significantly lower than did before exercise(t=5.802,P<0.001),but there was no statistical difference compared with the control group.After12 weeks o

关 键 词：体卫融合 易筋经 精神分裂症 阴性症状 认知功能 

分 类 号：R749.3[医药卫生—神经病学与精神病学]