利培酮、rTMS配合支持性家庭心理治疗对精神分裂症伴言语性幻听患者社会功能及心理健康的影响  

Effects of Risperidone and rTMS Combined with Supportive Family Psychotherapy on Social Function and Mental Health of Patients with Schizophrenia and Verbal Auditory Hallucination

作　　者：鄢传东 王鹏[1,2] 房茂胜 YAN Chuan-dong;WANG Peng;FANG Mao-sheng(Wuhan Mental Health Center,Wuhan 430012,China;Psychological Trauma Word,Wuhan Hospital for Psychotherapy,Wuhan 430012,China)

机构地区：[1]武汉市精神卫生中心,武汉430012 [2]武汉市心理医院心理创伤病区,武汉430012

出　　处：《中国临床心理学杂志》2023年第6期1531-1535,共5页Chinese Journal of Clinical Psychology

基　　金：湖北省卫生健康委员会科研项目(编号:WJ2019M016);国家自然科学基金资助项目(编号:81771445)。

摘　　要：目的:观察利培酮、重复经颅磁刺激(rTMS)配合支持性家庭心理治疗在改善精神分裂症伴言语性幻听患者社会功能、心理健康中的应用效果。方法:将120例精神分裂症伴言语性幻听患者随机分为观察组、对照组各60例,对照组予以利培酮口服及rTMS治疗,观察组在对照组基础上,予以支持性家庭心理治疗,共治疗8周。治疗前、后,采用阳性和阴性症状量表(PANSS)、幻听评定量表(AHRS)、住院精神病人社会功能评定量表(SSPI)、症状自评量表(SCL-90)进行评定。随访1年,统计复发情况。结果:治疗8周后,两组阳性症状、阴性症状、一般症状以及AHRS评分均下降(P<0.05),且观察组低于对照组(P<0.05)。两组SSPI中日常生活能力、动性和交往情况、社会活动技能因子及总分均较治疗前升高,且观察组高于对照组(P<0.05)。随访1年内,观察组复发率6.67%,低于对照组的20.00%。结论:精神分裂症伴言语性幻听患者在利培酮和rTMS治疗基础上,配合支持性家庭心理治疗有助于提高治疗效果,降低复发率。Objective:To observe the application effects of risperidone,repetitive transcranial magnetic stimulation(rTMS)combined with supportive family psychotherapy on improving the social function and mental health of patients with schizophrenia complicated with verbal auditory hallucination.Methods:120 patients with schizophrenia and verbal auditory hallucination were randomly divided into observation group and control group with 60 cases in each group.The control group was given risperidone oral therapy and rTMS,while the observation group was given supportive family psychotherapy in addition to the control group,and both groups were treated for 8 weeks.Before and after treatment,Positive and Negative Symptom Scale(PANSS)and Auditory Hallucination Rating Scale(AHRS)were used to evaluate the clinical symptoms,Scale of Social function in Psychosis Inpatients(SSPI)was adopted to evaluate the social function and Symptom Checklist-90(SCL-90)was used for mental health assessment.The recurrence was counted after 1 year of follow-up.Results:After8 weeks of treatment,the scores of positive symptoms,negative symptoms and general symptoms and score of AHRS in both groups were decreased(P<0.05),and the scores in observation group were lower than those in control group(P<0.05).The scores of factors of daily living ability,mobility and communication and social activity skills and total score of SSPI in both groups were enhanced compared to before treatment,and the scores in observation group were higher compared to control group(P<0.05).Within 1 year of follow-up,the recurrence rate in observation group was 6.67%,which was lower than 20.00% in control group(P<0.05).Conclusion:On the basis of risperidone and rTMS,the combination of supportive family psychotherapy can help to enhance the therapeutic effect and reduce the recurrence rate in patients with schizophrenia and verbal auditory hallucination.

关 键 词：精神分裂症 言语性幻听 支持性家庭心理治疗 

分 类 号：R395.5[哲学宗教—心理学]