中等强度体能锻炼对精神分裂症患者焦虑抑郁和认知功能的影响及机制研究  

Effect and mechanism of moderate intensity physical exercise on depression,anxiety and cognitive function of schizophrenic patients

作　　者：原富强[1] 浮艳红[1] 张辉 禹磊[1] 张志勇[1] 马振武[1] 徐亚南[1] 赵利芹[1] 杨慧 王旭生[1] Yuan Fuqiang;Fu Yanhong;Zhang Hui;Yu Lei;Zhang Zhiyong;Ma Zhenwu;Xu Yanan;Zhao Liqin;Yang Hui;Wang Xusheng(Psychiatric Department of the Second Affiliated Hospital of Xinxiang Medical University(Henan Psychiatric Hospital,Henan Mental Health Center),Xinxiang 453002,China;Department of Psychiatry,Kaifeng Mental Health Center,Kaifeng 475003,China)

机构地区：[1]新乡医学院第二附属医院(河南省精神病医院,河南省精神卫生中心)精神科,新乡453002 [2]开封市精神卫生中心精神科,开封475003

出　　处：《中华行为医学与脑科学杂志》2022年第6期513-519,共7页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：河南省精神心理疾病临床医学中心开放课题(2020-zxkfkt-008)。

摘　　要：目的探讨中等强度体能锻炼对精神分裂症患者抑郁焦虑、认知功能影响及可能生化机制。方法将2019年3月至2021年3月在新乡医学院第二附属医院住院治疗的148例精神分裂症患者随机分为对照组(n=75)和运动组(n=73)。两组患者均根据临床实际予以药物治疗和常规锻炼,运动组额外增加中等强度体能锻炼。采用焦虑自评量表(self-rating anxiety scale,SAS)和抑郁自评量表(self-rating depression scale,SDS)评价受试者不良心理状态,采用瞬背词语流畅性测验(verbal fluency task,VFT)、数字广度测验(digital span test,DST)、连线试验(trail making test-A,TMT-A)以及阳性和阴性症状量表(positive and negative syndrome,PANSS)评价认知功能,并采用高效液相色谱分析方法测定内源性大麻素(endocannabinoids,eCBs)受体水平,采用酶联免疫吸附法(enzyme-linked immunosorbent assay,ELISA)对患者血清中单胺类神经递质、eCBs含量进行测定。采用SPSS 19.0统计软件对两组间计量资料进行t检验,计数资料进行χ2检验。结果(1)干预后,两组SAS评分、SDS评分、TMT-A分数、PANSS评分均较干预前显著降低,两组干预前后的差值差异有统计学意义(t=6.00,6.52,25.79,17.03,均P<0.01);干预后运动组的SAS评分、SDS评分、TMT-A分数以及PANSS评分均明显低于对照组(t=4.66,20.88,6.61,8.95;均P<0.01)。两组VFT瞬背词个数、DST数目位数均较干预前升高,两组干预前后的差值差异有统计学意义(t=13.78,22.76,均P<0.01)。干预后运动组VFT瞬背词个数及DST数目位数均高于对照组,均差异有统计学意义(t=5.02,5.15,均P<0.01)。(2)干预后,两组血清中单胺类神经递质、eCBs含量均较干预前显著升高,其中干预后运动组的HVA水平[(63.68±6.99)pg/mL]、MHPG水平[(175.90±16.22)pg/mL]、5-HIAA水平[(29.94±4.19)pg/mL]、CBR1水平[(6.70±1.40)μg/L]、2-AG水平[(61.90±5.73)pmol/g]以及AEA水平[(76.48±6.59)pmol/g]均明显高于对照组[(52.97±5.37)pObjective To explore the effect of moderate intensity physical exercise on depression,anxiety and cognitive function of schizophrenic patients and its possible biochemical mechanism.Methods Totally 148 patients with schizophrenia who were hospitalized in hospital from March 2019 to March 2021 were randomly divided into control group(n=75)and exercise group(n=73).The patients of the two groups were given drug treatment and routine exercise according to clinical practice,and the patients in exercise group were given additional medium-intensity physical exercise.Self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were used to evaluate the poor mental state of the subjects.The verbal fluency task(VFT),digital span test(DST),trail making test-A(TMT-A)and the positive and negative symptom scale(PANSS)were used to evaluate cognitive function.The levels of endocannabinoids(eCBs)receptors were detected by high performance liquid chromatography,and the levels of monoamine neurotransmitters and eCBs in the patients'serum were determined by enzyme-linked immunosorbent assay(ELISA).SPSS 19.0 software was used for statistical analysis.The measurement data between the two groups were compared by t-test and the counting data between the two groups were compared byχ2 test.Results(1)After effective intervention,the scores of SAS,SDS,TMT-A and PANSS of the two groups were significantly lower than those before intervention,and the difference before and after intervention between the two groups was statistically significant(t=6.00,6.52,25.79,17.03,all P<0.01).The scores of SAS,SDS,TMT-A and PANSS after intervention in the exercise group were significantly lower than those in the control group(t=4.66,20.88,6.61,8.95;all P<0.01).The number of VFT and DST in the two groups after intervention were significantly higher than those before intervention,and the differences before and after intervention between the two groups were statistically significant(t=13.78,22.76,both P<0.01).After effective intervention,the number of VF

关 键 词：中等强度体能锻炼 精神分裂症 抑郁 焦虑 认知功能 生化机制 

分 类 号：R749.3[医药卫生—神经病学与精神病学]