团体归因训练与氯氮平联合治疗对难治性精神分裂症患者阴性症状及生活质量的作用  

Effect of group attribution training combined with clozapine on negative symptoms and quality of life in refractory schizophrenia patients

作　　者：由炜[1] 丁宁 李智强[1] 刘增训[1] You Wei;Ding Ning;Li Zhiqiang;Liu Zengxun(Shandong Mental Health Center, Jinan 250014, China;Qingdao Mental Health Center, Qingdao 266034,China)

机构地区：[1]山东省精神卫生中心,济南250014 [2]青岛市精神卫生中心,266034

出　　处：《中华行为医学与脑科学杂志》2019年第6期538-542,共5页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：山东省医药卫生科技发展计划项目(2017WSB06).

摘　　要：目的探讨团体归因治疗(attributional retraining group therapy,ARGT)联合氯氮平治疗对难治性精神分裂症患者的阴性症状及生活质量的作用。方法采用ARGT联合氯氮平治疗与单独使用氯氮平治疗进行临床对照研究,分为ARGT联合氯氮平治疗(研究组,n=56)和单独使用氯氮平治疗(对照组,n=54)。采用阳性与阴性症状量表(PANSS)在治疗基线和8周后分别对患者精神症状进行评估,采用生活质量综合评定问卷(GQOLI-74)在治疗基线和8周后分别对患者生活质量进行评估,采用副反应量表(TESS)评定药物副反应。采用SPSS18.0对数据进行统计分析。结果基线时,两组患者的PANSS评分差异无统计学意义(P>0.05)。8周后,研究组患者的PANSS量表总分为(79.41±11.64)分,阴性症状评分为(28.68±2.74)分,与对照组患者的PANSS量表总分[(83.06±11.58)分]及阴性症状评分[(30.61±2.12)分]比较,差异具有统计学意义(t=7.68,7.10,P<0.05)。研究组阳性症状、认知症状、情感症状及攻击症状评分与对照组相比,均差异无统计学意义(均P>0.05)。基线时两组GQOLI-74量表中物质生活、心理健康、躯体健康和社会功能量表评分比较差异无统计学意义(均P>0.05);8周后研究组GQOLI-74量表总分为(206.37±14.37)分,其中物质生活评分为(48.69±6.35)分,躯体健康评分为(52.83±7.32)分,心理健康评分为(51.66±4.63)分,社会功能评分为(53.62±6.17)分,与对照组[(182.00±12.56)分,(44.62±6.11)分,(48.52±5.52)分,(45.26±4.66)分,(46.18±5.32)分]比较,差异具有统计学意义(t=4.67,5.26,3.26,4.92,3.25,均P<0.05)。两组TESS评分差异无统计学意义(P>0.05)。结论ARGT联合氯氮平治疗能够更好地改善难治性精神分裂症的阴性症状,进一步提高难治性精神分裂症患者的生活质量。Objective To investigate the effect of attributional retraining group therapy(ARGT) combined with closabine on the negative symptoms and quality of life in refractory schizophrenia patients. Methods The refractory schizophrenia patients were divided into ARGT combined with clozapine therapy group(study group, n=56) and clozapine alone group(control group, n=54). The positive and negative syndrome scale(PANSS) was used to assess the symptoms of all patients at baseline and 8 weeks later.The quality of life(QOL) of the patients was assessed by GQOLI-74 at baseline and 8 weeks after treatment.The side effects were evaluated by treatment emergent symptom scale(TESS) before and after treatment.SPSS18.0 was used for statistical analysis. Results At baseline, there was no significant difference in PANSS score between the two groups.After 8 weeks, the total score of PANSS (79.41±11.64) and the score of negative symptoms (28.68 ±2.74) in the study group were lower that those of control group(83.06±11.58, 30.61±2.12), and the differences were statistically significant(t=7.68, 7.10, both P<0.05). The scores of positive symptoms, cognitive symptoms, emotional symptoms and aggression symptoms in the study group had no statistical differences compared with the control group (all P>0.05). There were no significant differences in the scores of material life, mental health, physical health and social function between the two groups at baseline (P>0.05). After 8 weeks, the total score of GQOLI- 74 (206.37±14.37), material life score (48.69±6.35), body health score (52.83±7.32), mental health score (51.66±4.63) and social function score (53.62±6.17) of the study group were higher than those of control group((182.00±12.56),(44.62±6.11),(48.52±5.52),(45.26±4.66),(46.18±5.32))(t=4.67, 5.26, 3.26, 4.92, 3.25, all P<0.05). There was no significant difference in TESS score between the two groups(P<0.05). Conclusion ARGT combined with clozapine can improve the negative symptoms and the quality of life of patients with refrac

关 键 词：团体归因治疗 精神分裂症 阴性症状 生活质量 氯氮平 

分 类 号：R749.3[医药卫生—神经病学与精神病学]