精神分裂症患者认知功能障碍的治疗

Treatment of cognitive disorder in patients with schizophrenia

目的:认知功能损害进精神分裂症的原发性症状,涉及注意、记忆、抽象思维、信息整合以及执行功能等多方面,主要与额叶、颞叶及海马缺陷相关。资料来源:应用计算机检索Medline1999-01/2004-12期间的与精神分裂症认知障碍相关的文章,检索词“schizophrenia,cognitive”,并限定文章语言种类为English。资料选择:选择与精神分裂症认知障碍有关的随机、对照研究及综述、Meta分析。排除非随机、非对照性研究。资料提炼:共收集到27篇关于精神分裂症认知障碍的随机、对照研究及综述、Meta分析,13篇文献符合纳入标准。排除的14篇文献中,6篇系重复的同一研究,8篇系与精神分裂症认知障碍治疗无关的研究。资料综合:有确凿的证据提示非典型抗精神病药能改善精神分裂症认知功能;α-2受体、M1及M4受体激动剂对精神分裂症的认知功能也有一定的疗效。认知行为治疗作为一种辅助手段,能促进精神分裂症的认知功能的改善。结论:药物与认知行为治疗联合应用,对精神分裂症认知障碍可能有更大的助益。

OBJECTIVE： Cognitive functional damage is a primary symptom of schizophrenia, including multiple aspects of attention, memory, abstract thinking, information integration and performance, it is mainly associated with the defects of frontal lobe, temporal lobe and hippocampus.DATA SOURCES： An online search of Medline was undertaken to identify English articles related to schizophrenic cognitive disorder published from January 1999 and December 2004 by using the keywords of “schizophrenia, cognitive”.STUDY SELECTION： The randomized and controlled study, review and Meta analysis about schizophrenic cognitive disorder were selected; The non-randomized and non-controlled studies were excluded.DATA EXTRACTION： Totally 27 articles of randomized and controlled studies, reviews and Meta analysis about schizophrenic cognitive disorder were collected, and 13 of them were in accordance with the inclusion criteria. Among the 14 deleted ones, 6 were repetitive studies, 8 had no correlation with the treatment of schizophrenic cognitive disorder.DATA SYNTHESIS： There was irrefutable evidence suggested that atypical antipsychotics could improve the cognitive function of schizophrenia. The agitators of alpha-2 receptor, M1 and M4 receptors also had certain curative effect on the cognitive function of schizophrenia. As a consisting method, cognition-behavior therapy could promote the amelioration of the cognitive function of schizophrenia.CONCLUSION： The application of drug combined with cognitionbehaviour therapy may have greater effect on the cognitive disorder of schizophrenia.