药物干预与长期随访对慢性精神分裂症患者生活质量和康复影响的研究

Study on the effect of drug intervention and long-term follow-up on the quality of life and rehabilitation division of patients with chronic schiz ophrenia

目的 探讨药物干预和长期随访对慢性精神分裂症患者生活质量和康复效果的影响，为优化本病的干预策略提供参考。方法 选取2011年3月～2013年3月在金华市第二医院门诊就诊的慢性精神分裂症患者156例，随机分为观察组和对照组，每组各78例。两组患者均给予氯丙嗪治疗，对照组给予单纯药物干预，观察组在药物干预的基础上，通过长期随访对患者进行心理干预、家庭干预、康复训练和药物指导。干预12个月后，对比两组患者暴力行为发生率；同时对比两组患者干预前后简明精神病评定量表、生活质量综合评定问卷-74和自知力与治疗态度问卷的评估结果 。结果 两组患者干预前暴力行为发生率比较，差异无统计学意义（P〉0．05）；观察组干预后暴力行为发生率为23．08％，显著低于对照组（38．46％），差异有统计学意义（P〈0．05）。干预第9个月时，观察组简明精神病评定量表评估结果 为（41．28±8．54）分，干预第12个月时评估结果 为（34．59±9．83）分，均显著低于对照组（均P〈0．05）。干预第12个月时，观察组心理健康评估结果 为（49．59±3．71）分，社会功能评估结果 为（47．19±5．47）分，显著高于本组干预前和同时间对照组评估结果 （均P〈0．05）。干预第12个月时，观察组自知力与治疗态度问卷评估结果 为（17．85±4．48）分，显著高于对照组（P〈0．05）。结论 药物干预和长期随访能够提高慢性精神分裂症患者的康复效果，改善患者的生活质量，值得进一步推广。

Objective To investigate the effect of drug intervention and long-term follow-up on the quality of life and rehabilitation efficacy of patients with chronic schizophrenia, and to provide the reference for the optimization of the disease intervention strategies. Methods 156 patients with chronic schizophrenia in the Second Hospital of Jinhua City from March 2011 to March 2013 were selected randomly divided into observation group and control group, with 78 cases in each group. All the patients were treated with Chlorpromazine. The control group was given only drug intervention; on the basis of drug intervention, the observation group was given the long-term follow-up of patients witb psychological intervention, family intervention, rehabilitation training and guidance of drug. 12 months after the intervention, the incidence of violence was compared between both groups. The brief psychiatric rating scale, general quality of life inventory-74 and insight and treatment attitude questionnaire assessment results were compared as well. Results The difference of intervention violence incidence rate was not statistically significant between both groups （P 〉 0.05）. The violence rate was 23.08% in the observation group after the intervention, which significantly lower than the control group （38.46%）, the difference was statistically significant （P 〈 0.05）. After 9 months, the brief psychiatric rating scale evaluation results in observation group was （41.28±8.54） scores, the brief psychiatric rating scale evaluation results in observation group was （34.59±9.83） scores at the 12 months, they were significantly lower than those in the control group, the differences were statistically significant （P 〈 0.05）. After 12 months, the mental health assessment results in observation group was （49.59±3.71） scores, the social function assessment results was （47.19±5.47） scores, they were all higher than those in the control group and the same group before the intervention, the differences were statistically sig- nificant （P 〈 0.05）. After 12 months, insight and treatment attitude questionnaire assessment results in observation group was （17.85±4.48） scores, it was higher than that in control group （P 〈 0.05）. Conclusion Drug intervention and long-term follow-up can improve chronic mental rehabilitation of schizophrenia patients, improve the quality of life of patients, is worthy of further promotion.