贫困精神分裂症病人免费服药3年临床分析

A clinical analysis on schizophrenic patients in poverty with free medication policy for three years

目的评估免费服药对社区贫困精神分裂症病人的效果。方法通过对119例社区贫困精神分裂症病人随访，比较免费服药治疗3年前后，病人在服药依从性、病情稳定性、社会功能性、住院频繁性、社会破环性方面的变化，分析实行免费服药治疗的疗效。结果119例贫困精神分裂症病人能遵医服药者从免费治疗前39例提高到108例，增加了63.9%；同时间断服药者从45例减少到9例，减少了80.0%；不服药者从35例减少到2例，下降了94.3%。病情的稳定好转率从27.7%提高到94.2%。社会功能得到改善，不能自理生活者从48例下降到9例，下降了81.3%。再住院次数及攻击行为明显减少，未住院病人从15例增加到106例，增加了85.8%；无冲动行为者从48例增加到98例，增加了51.0%。结论贫困精神分裂症病人需要正规系统治疗，免费服药是病人的康复途径之一，提高了病人的生活质量，减轻了经济负担，获得了治安稳定的社会效益。

Objective To evaluate the effect of free medication policy on patients with schizophrenia in poverty communities. Methods 119 patients with schizophrenia from poverty communities were enrolled in this study and the changes in therapy compliance, state of the illness, function of the society, frequency of hospitalization and social aggression were compared before and after three-year free medication policy, and the effectiveness of the policy was eveluated. Results The study showed that patients who followed doctor＇s prescription increased from 39 cases to 108 cases by 63.9 % ; whereas patients who discontinued treatment decreased from 45 to 9 by 80.0%; and patients with treatment refusal decreased from 35 to 2 by 94.3%. At the same time, improvement rate for the condition increased from 27.7% to 94.2%. Social function had been improved. No self-care patients decreased from 48 to 9 by 81.3%. Re - hospitalization frequency and aggressive behavior were significantly reduced. Patients without hospitalization increased from 15 to 106 by 85.8% ; patients without impulsive behavior increased from 48 to 98 by 51.0%. Conclusions Schizophrenic patients need standard and systemic medication treatment in poverty communities. Free medication policy is one of the rehabilitative ways for patients with psychotic disorders to improve the quality of life, relieve economic burden, gain social profit for security stability.