认知康复综合训练改善苯丙胺类依赖者认知功能的随机对照试验  

Combined cognitive rehabilitation training on treating cognitive function disorder caused by amphetamine-type stimulant: A randomised controlled study

作　　者：李传威 江海峰[1] 徐定 钱峰 张炜 杜江[1] 赵燕 赵敏[1] 

机构地区：[1]上海交通大学医学院附属精神卫生中心,上海200030 [2]上海市戒毒管理局,上海200080

出　　处：《中国心理卫生杂志》2015年第7期528-532,共5页Chinese Mental Health Journal

基　　金：上海市禁毒基金;科技支撑计划(2012BAI01B07);上海市卫生计生委(XBR2011015;2013SY011)

摘　　要：目的:评估认知康复综合训练对改善苯丙胺类兴奋剂(ATS)依赖者认知功能障碍的疗效。方法:在强制戒毒机构招募符合精神障碍诊断与统计手册第4版(DSM-IV)苯丙胺类兴奋剂依赖者,随机分为干预组(30例)和对照组(26例)。对照组仅接受常规教育,干预组除接受常规教育外还接受24周的认知康复综合训练,主要包括心理康复与躯体康复。采用中文版Cog State量表(CSB)在干预前(基线)及干预24周末评估两组受试者的认知功能。结果:两组干预前的CSB各维度得分无统计学差异。在24周末干预结束时,干预组在单卡学习任务[(0.06±0.12)vs.(-0.03±0.14),P<0.05]、Tw o-Back任务[(0.12±0.15)vs.(0.01±0.19),P<0.05]、连续配对学习任务[(-0.46±0.35)vs.(-0.15±0.49),P<0.05]三个维度得分改善优于对照组。两组其余5个维度得分变化即检出任务、识别任务、国际购物清单任务、Groton迷宫任务、社会情绪识别任务无统计学差异(均P>0.05)。结论:认知康复综合训练可以改善苯丙胺类依赖者的视觉学习记忆、工作记忆和空间工作记忆,而对其他方面认知功能无明显改善。Objective： To assess the effect of combined cognitive rehabilitation training on improving cognitive dysfunction in amphetamine-type stimulant dependent patients. Methods： Subjects who met the clinical diagnosis of ATS dependence by DSM-IV in compulsory isolation detoxification institute were randomly assigned into intervention group （ n = 30） and control group （ n = 26）. Control group received a regular education. Intervention group also received a combined cognitive rehabilitation training besides regular education, including psychological and physical rehabilitation for 24 weeks. The Chinese version of CogState Battery （CSB） was used to assess cognitive function at baseline and 24 weeks after the intervention. Results： No significant difference was found on all subscales scores of CogState Battery between two groups at baseline. At 24 weeks after the intervention, compared to control group, the intervention group had more improvements in three sub-scale scores, i. e., One Card Learning Task [ （0. 06 ±0. 12） vs. （ - 0.03 ± 0. 14）, P 〈 0. 05], Two-back Task [ （0. 12 ± 0. 15） vs. （0. 01 ± 0. 19）, P 〈 0. 05] and Continuous Paired Association Learning Task [ （ - 0. 46 ± 0. 35） vs. （ - 0. 15 ±0. 49）, P 〈 0.05]. No difference was found on improvements in the rest 5 sub-scale scores, i. e., Detection Task, Identification Task, International Shopping List Task, Groton Maze Learning Task and Social Emotional Cognition Task （P 〉 0. 05） . Conclusion： The combined cognitive rehabilitation training could improve amphetamine-type stimulant dependent patients＂ visual learning and memory, working memory and spatial working memory, while have no significant improvement on other cognitive functions.

关 键 词：苯丙胺类兴奋剂 认知康复综合训练 认知功能 临床试验 

分 类 号：R749.61[医药卫生—神经病学与精神病学] R749.059[医药卫生—临床医学]