药物结合心理行为治疗精神分裂症伴代谢综合征的效果分析

The effective analysis of schizophrenia complicated with metabolic syndrome treated by medication and psycho-behavior therapy

目的探讨以药物结合心理行为的综合干预措施治疗精神分裂症伴代谢综合征的临床效果。方法将100例精神分裂症伴代谢综合征的患者随机分为干预组和对照组各50例。2组均给予齐拉西酮抗精神病治疗,干预组在此基础上加用二甲双胍结合心理行为的综合干预措施,随访6个月。采用阳性与阴性症状量表(PANSS)评估疗效,生活质量综合评定问卷(GQOLI-74)评估生活质量,同时比较2组患者代谢综合征的各项指标、复发率和再入院率。结果 2组患者入组时PANSS评分、GQOLI-74评分和代谢指标异常比较差异均无统计学意义(P>0.05),随访6个月时2组PANSS各项评分较治疗前均有明显改善,且组间比较差异有统计学意义(P<0.05);2组GQOLI-74躯体功能、心理功能及社会功能评分均较治疗前明显提高,差异有统计学意义(P<0.05),其中干预组躯体功能、心理功能指标明显高于对照组,差异有统计学意义(P<0.05);2组代谢综合征相关指标异常比例均降低,其中干预组各项指标异常比例明显低于对照组,差异有统计学意义(P<0.05或P<0.01);6个月内干预组复发率10.00%(5例),再住院率8.00%(4例),明显低于对照组的复发率26.00%(13例)和再住院率22.00%(11例),差异有统计学意义(χ2=4.33、3.84,P<0.05)。结论药物结合心理行为的综合性干预措施治疗精神分裂症伴代谢综合征患者,可明显提高治疗效果,并明显改善代谢综合征各项指标,提高生活质量,降低复发率和再入院率。

Objective To explore the effects of medication and psycho-behavior therapy on schizophrenia complicated with metabolic syndrome.Methods One hundred schizophrenia Patients complicated with metabolic syndrome were randomly divided into intervention group and control group,50 cases in each group.In addition to ziprasidone antipsychotic medication for both groups,the intervention group received psycho-behavior therapy for 6months.The positive and negative symptom scale（PANSS）was performed to assess curative effect,and general quality of life inventory（GQOLI-74）was used to evaluate physical function,psychological function and social function.At the same time,the rate of recurrence and readmission was comparatively analyzed between two groups.Results There was no significant difference between two groups before treatment in terms of PANSS scores,GQOLI-74 scores and abnormal metabolic scores（P〈0.05）,all of which were obviously improved after 6-month therapy in both groups（P〈0.05）;Furthermore,after therapy,and the intervention group got the higher scores of physical function and psychological function,higher PANSS scores and less abnormal metabolic scores compared with control group（all P〈0.05）.The rate of recurrence and rate of readmission observed within 6months in intervention group were 10%（5cases）and 8%（4cases）,which were significantly lower than 26%（13cases）,22%（11cases）observed in the control group with statistically significant differences（!2=4.33,3.84;P〈0.05）.Conclusion The therapy of medication combined with psycho-behavior therapy can significantly improve the therapeutic effects and metabolic indicators to improve the quality of life and reduce the rate of recurrence and readmission in schizophrenia patients complicated with metabolic syndrome.