正念睡眠认知疗法对中青年精神分裂症伴失眠患者睡眠质量、认知及学习记忆能力的影响  

Effects of Mindfulness-based Sleep Cognitive Therapy on Sleep Quality,Cognition,Learning and Memory Ability of Young and Middle-aged Schizophrenic Patients with Insomnia

作　　者：何兰英 徐曼华[1] 李平[1] 赵栋 孙岩 HE Lanying;XU Manhua;LI Ping;ZHAO Dong;SUN Yan(Physical Therapy Center,the Eighth Hospital of Shijiazhuang City,Shijiazhuang 050000,China;Department of Public Health,Shijiazhuang Hospital of Traditional Chinese Medicine,Shijiazhuang 050000,China)

机构地区：[1]石家庄市第八医院物理治疗中心,石家庄050000 [2]石家庄市中医院公共卫生科,石家庄050000

出　　处：《临床误诊误治》2024年第3期58-64,共7页Clinical Misdiagnosis & Mistherapy

基　　金：河北省卫生健康委员会医学科学研究项目(20231700)。

摘　　要：目的 探讨正念睡眠认知疗法对中青年精神分裂症伴失眠患者睡眠质量、认知及学习记忆能力的影响。方法 选取2022年1月—2023年4月收治的中青年精神分裂症伴失眠108例,采用随机数字表法分为2组各54例,对照组采取常规药物治疗,观察组在上述治疗基础上联合正念睡眠认知疗法治疗。观察2组临床疗效,治疗前后睡眠质量[匹兹堡睡眠质量指数量表(PSQI)评分]、精神状态[简明精神病量表(BPRS)评分]、认知及学习记忆能力[霍普金斯词语学习测验修订版(HVLT-R)、简易视觉空间记忆测验修订版(BVMT-R)评分]、认知损害因子[半乳糖凝集素-3(Galectin-3)、神经细胞黏附分子(NCAM)、胰岛素样生长因子-1(IGF-1)]、血清细胞因子[白细胞介素-1(IL-1)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]及皮质醇变化。结果 治疗4周、8周,观察组PSQI、BPRS各维度评分均低于对照组(P<0.05);治疗4周、8周2组PSQI、BPRS各维度评分较治疗前呈逐渐降低趋势(P<0.05)。观察组总有效率为96.30%(52/54)高于对照组的81.48%(44/54)(P<0.05)。治疗8周,观察组HVLT-R、BVMT-R评分高于对照组(P<0.05);治疗4周、8周,观察组血清NCAM、IGF-1水平高于对照组,Galectin-3、IL-1、IL-6、TNF-α、皮质醇水平低于对照组(P<0.05)。结论 相比单纯药物治疗,联合应用正念睡眠认知疗法可明显改善中青年精神分裂症伴失眠患者睡眠质量,减轻精神症状,降低认知功能损害及慢性炎症反应程度。Objective To investigate the effects of mindfulness-based sleep cognitive therapy on sleep quality,cognition,learning and memory ability of young and middle-aged schizophrenic patients with insomnia.Methods A total of 108 middle-aged and young adults with schizophrenia and insomnia were selected from January 2022 to April 2023 and divided into two groups with 54 cases in each group by random number table method.The control group received conventional drug treatment,and the observation group was treated with mindfulness-based sleep cognitive therapy on the basis of the above treatment.The clinical effect of the two groups was observed.Before and after treatment,changes in sleep quality [Pittsburgh Sleep Quality Index Scale(PSQI) score],mental status [Brief Psychiatric Rating Scale(BPRS) score],cognitive and learning memory ability [Hopkins Verbal Learning Test-Revised(HVLT-R),Brief Visuospatial Memory Test-Revised(BVMT-R) score],cognitive impairment factor [Galectin-3,nerve cell adhesion molecule(NCAM),insulin-like growth factor-1(IGF-1)],serum cytokines [interleukin-1(IL-1),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)] and cortisol were observed.Results At 4 and 8 weeks after treatment,the scores of PSQI and BPRS in observation group were lower than those in control group(P<0.05).At 4 weeks and 8 weeks after treatment,the scores of PSQI and BPRS in the two groups were gradually decreased compared with those before treatment(P<0.05).The total effective rate of the observation group was 96.30%(52/54),which was higher than that of the control group [81.48%(44/54)](P<0.05).At 8 weeks after treatment,HVLT-R and BVMT-R scores in observation group were higher than those in control group(P<0.05).At 4 and 8 weeks after treatment,the serum levels of NCAM and IGF-1 in observation group were higher than those in control group,while the levels of Galectin-3,IL-1,IL-6,TNF-α and cortisol in observation group were lower than those in control group(P<0.05).Conclusion Compared with drug therapy alone,the combined applicat

关 键 词：精神分裂症 失眠 中青年 正念睡眠认知疗法 睡眠质量 学习记忆能力 认知损害 皮质醇 

分 类 号：R749.3[医药卫生—神经病学与精神病学]