首发精神分裂症利培酮合并认知治疗的自知力、用药依从性及社会功能改善效果分析  

Analysis of the Improvement Effect of Risperidone Combined with Cognitive Therapy on First-episode Schizophrenia on Insight, Medication Compliance and Social Function

作　　者：黎勇航[1] 黄史青[1] 郭华贵[1] 朱进才[1] LI Yong-hang;HUANG Shi-qing;GUO Hua-gui(Department of Psychiatry,Foshan Third People's Hospital,Foshan,Guangdong,528000,China)

机构地区：[1]佛山市第三人民医院,广东佛山528000

出　　处：《黑龙江医学》2022年第9期1037-1040,共4页Heilongjiang Medical Journal

基　　金：佛山市十三五医学特色专科(FSTSZK002)。

摘　　要：目的:探讨首发精神分裂症利培酮合并认知治疗的自知力、用药依从性及社会功能改善效果。方法:回顾性分析2018年1月—2019年6月佛山市第三人民医院进行利培酮维持治疗8周合并认知治疗治疗8周的50例首发精神分裂症患者(研究组)临床资料,并以同期行利培酮维持治疗8周的49例患者为对照组。治疗前、治疗后(治疗8周)采用阳性和阴性症状量表(PANSS)评定比较两组患者精神症状,同期采用自知力评定量表(SAI)评价比较患者两组患者自知力评价比较两组患者用药依从性。统计两组患者震颤、焦虑、静坐不能、失眠、体重增加、便秘、视物模糊等不良反应发生率。两组患者出院1个月和出院1年均采用个人和社会功能量表(PSP评分)评价比较社会功能变化。统计两组患者治疗后1年内复发率。结果:两组患者治疗前后PANSS总评分比较差异无统计学意义(t=0.020、1.886,P>0.05)。与同组治疗前比较,两组患者治疗后PANSS总评分均降低而同期SAI评分则升高,差异无统计学意义(t=1.886、3.381,P>0.05)。研究组用药依从性、治疗后SAI评分、出院1个月和出院1年的PSP评分均高于对照组,治疗后1年复发率则低于对照组,差异有统计学意义(χ^(2)=5.771,t=2.807,t=17.917,χ^(2)=11.880,P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(χ^(2)=0.089,P>0.05)。结论:首发精神分裂症利培酮合并认知治疗可有效改善患者的精神症状、自知力、用药依从性及社会功能,且安全可靠。Objective:To investigate the improvement effect of risperidone combined with cognitive therapy on insight,medication compliance and social function in first-episode schizophrenia.Methods:The clinical data of 50 first-episode schizophrenic patients(study group)treated with risperidone maintenance therapy for 8 weeks and cognitive therapy for 8 weeks in the hospital from January 2018 to June 2019 were retrospectively analyzed.And 49 patients who underwent risperidone maintenance treatment for 8 weeks in the same period were taken as the control group.The positive and Negative Syndrome Scale(PANSS)was used to evaluate the mental symptoms of the two groups before and after treatment(8 weeks of treatment),and the insight of the two groups was evaluated by the insight Rating Scale(SAI)at the same time.The medication compliance of the two groups was evaluated and compared.The occurrence rates of tremor,anxiety,inability to sit still,insomnia,weight gain,constipation,blurred vision and other adverse reactions between the two groups were compared.The changes of social function in the two groups were evaluated by the personal and social function scale(PSP score)1 month and 1 year after discharge.The recurrence rate within 1 year after treatment between the two groups was statistically compared.Results:There was no statistically significant difference in PANSS score between the two groups before and after treatment(t=0.020,1.886,P>0.05).Compared with the same group before treatment,the PANSS total score in both groups decreased after treatment,while the SAI score increased in the same period,the difference was not statistically significant(t=1.886,3.381,P>0.05).The medication compliance,SAI score after treatment,PSP score at 1 month after discharge and 1 year after discharge in the study group were higher than those in the control group,and the recurrence rate at1 year after treatment was lower than that in the control group,the difference was statistically significant(χ^(2)=5.771,t=2.807,t=17.917,χ^(2)=11.880,P<0.05).The

关 键 词：首发精神分裂症 利培酮 认知治疗 自知力 用药依从性 社会功能 

分 类 号：R749.3[医药卫生—神经病学与精神病学]