奥氮平联合认知治疗对精神分裂症的疗效  

Efficacy of olanzapine combined with cognitive therapy for schizophrenia

作　　者：田建华[1] 王云香[1] 刘德敏[1] 

机构地区：[1]石河子绿洲医院,新疆石河子832000

出　　处：《四川精神卫生》2017年第2期132-135,共4页Sichuan Mental Health

基　　金：新疆兵团卫生科技项目(2015YL03)

摘　　要：目的探讨奥氮平联合认知治疗对精神分裂症患者的疗效及对认知功能的影响,为临床治疗精神分裂症提供参考。方法以2012年12月-2014年8月在石河子绿洲医院就诊的符合《国际疾病分类(第10版)》(ICD-10)诊断标准的住院精神分裂症患者为研究对象,共94例,采用随机数字表法分为观察组和对照组各47例。对照组给予奥氮平单一治疗,观察组在奥氮平治疗的基础上联合认知治疗,两组均治疗10周。治疗前及治疗8周末,采用阳性和阴性症状量表(PANSS)评价临床疗效,采用加拿大Stellate-64导无纸数字化脑电诱发电位仪进行事件相关电位(ERPs)P300检测,评估患者认知功能。结果治疗8周末,两组PANSS总评分及各分量表评分均较治疗前低(P<0.05或0.01),观察组PANSS总评分及各分量表评分均低于对照组(P均<0.05);观察组靶刺激潜伏期P3和N2均较治疗前短,对照组靶刺激潜伏期P3较治疗前短,差异均有统计学意义(P均<0.01);观察组P300靶刺激波幅P3较治疗前高,差异有统计学意义(P<0.05);观察组P300靶刺激潜伏期N2和P3均短于对照组,差异均有统计学意义(P均<0.05)。结论单用奥氮平与奥氮平联合认知治疗均能改善精神分裂症患者的精神症状和认知功能,但联合治疗的效果可能优于单用药物治疗。Objective To explore the curative effect and the influence to cognitive function of olanzapine combined with cognitive psychotherapy in patients with schizophrenia,and to provide reference for clinical treatment of schizophrenia.Methods A total of 94 hospitalized patients with schizophrenia who met the International Classification of Diseases,tenth edition （ICD-10） in Shihezi Lvzhou Hospital from December 2012 to August 2014 were selected.All cases were divided into observation group （ n=47） and control group （n=47） according to random number table method.The control group was given olanzapine single treatment,the observation group was treated with olanzapine combined with cognitive psychotherapy.Both two groups were treated for 10weeks.Before and after 8 weeks treatment,Positive and Negative Symptoms Scale （PANSS） was used to evaluate the clinical curative effect,the Canada Stellate -64 guide paperless digital eeg evoked potentiometer was used to test Event Related Potentials （ ERPs） P300to assess cognitive function.Results After treatment for 8 weeks,PANSS total score and all subscales scores in two groups were lower than before treatment （ P〈0.05 or 0.01）,the PANSS total score and each subscale score of observation group were lower than control group （all P〈0.05 ）.P300latency period P3 and N2 were shortened than before treatment in observation group,and only P300latency period P3 was shortened than before treatment in control group （ all P〈0.01）.P300target stimulus amplitude P3 was elevated （P〈0.05） in observation group.P300latency period P3 and N2 of observation group were shorter than the control group （all P〈0.05 ）.Conclusion Both olanzapine single treatment and olanzapine combined cognitive psychotherapy can improve mental symptoms and cognitive function in patients with schizophrenia,but the effects of combination therapy may be superior to drug therapy alone.

关 键 词：精神分裂症 奥氮平 认知治疗 疗效 事件相关电位P300 

分 类 号：R749.3[医药卫生—神经病学与精神病学]