社区技能训练对慢性精神分裂症患者认知功能的影响

Influence of Craftsmanship Training in Community on Cognitive Function on Patients with Chronic Schizophrenia

目的:探讨社区技能训练对慢性精神分裂症患者认知功能的影响。方法:91例慢性精神分裂症康复期患者分为干预组47例和对照组44例,均服用氯氮平维持治疗。干预组同时进行社区技能训练,第1个月为宣传教育、制定具体训练计划阶段,组织患者与人群交流;第2个月正确管理和使用药物,处理药物不良反应;第3个月能识别病情复发的先兆和及时用药,能拒绝饮酒和吸毒等。于入组时及训练3个月后、再干预性指导随访9个月后采用阳性与阴性阴性症状量表(PANSS)评定2组患者的临床症状改善情况;威斯康星卡片分类测验(WCST)和神经心理成套测验(HRB-RC)中的连线测验A和B评定患者的认知功能。结果:与干预前比较,2组患者在干预3个月随访9个月时,PANSS评分均明显降低,干预组明显低于对照组(均P<0.05,0.01)。WCST及HRB-RC的A、B连线测验,干预组干预后各时段均明显降低,并明显低于对照组(P<0.05,P<0.01)。对照组干预前后各时段变化不明显。结论:社区技能训练对慢性精神分裂症患者的社会拔能和认知功能的提高有显著促进作用。

Objective：To explore the effects of craftsmanship training in community on cognitive function of patients with chronic schizophrenia.Methods：100 patients with chronic schizophrenia were randomly divided into intervention group and control group.The patients in both two groups received maintenance treatment of clozapine.Patients in intervention group were treated by antipsychotics combined with craftsmanship training in community,while antipsychotics only for patients in control group for 9 months.Clinical efficacy was evaluated by Positive and Negative Symptoms Scale（PANSS） at baseline,6th and 9th month during a follow-up period.Cognitive function was assessed by Wisconsion Card Sorting Test（WCST） and Trail Making test A and B at baseline,6th month and 9th month during a follow-up period.Results：Patients in intervention group had better performance in cognitive function than in control group（P0.05 or P0.01）.Conclusion：Craftsmanship training in community can improve cognitive function of patients with chronic schizophrenia.