认知矫正治疗慢性精神分裂症患者认知功能缺陷的临床效果研究

目的探讨研究认知矫正治疗对精神分裂症患者认知功能缺陷的治疗效果。方法2012年10月至2015年12月期间收治的165例精神分裂症患者在去掉17例脱落的患者后按照随机数字表法随机分成计算机化的认知矫正（CCRT组，52例）、认知矫正（CRT组，49例）、普通工娱治疗对照组（WAT组，47例）。CCRT组以自主研发的计算机认知矫正治疗系统进行治疗，CRT组以神经认知矫正手册的汉化版作为治疗工具进行治疗，WAT组接受相同时间的工娱治疗。比较三组患者治疗前、治疗3个月后以及随访的第3个月时认知功能和临床症状的改善情况。结果治疗结束后和随访的第3个月时，CRT组和CCRT组在改善连线测验、WCST完成分数和空间广度等指标方面明显优于WAT纽，差异有统计学意义（P〈O．05）。改善空间广度方面CCRT纽较CRT纽更优，而改善符号编码方面CRT纽患者较CCRT纽更优，差异均有统计学意义（P〈0．05）。CCRT组、CRT组和WAT组患者的临床症状在治疗后和随访期间均无明显变化（P〉0．05）。结论使用CCRT和CRT治疗均能有明显改善精神分裂症患者的认知功能缺陷情况，且CCRT治疗方法相对于CRT改善患者空间记忆更优，而CRT治疗方法改善精神运动方面更优。

Objective To study the clinical effect of cognitive deficits for cognitive remediation therapy of chronic schizophrenia. Methods A total of 165 cases of chronic schizophrenia patients were divided into CCRT group, CRT group and WAT group according to random number table during October 2012 to December 2015, 17 patients left and CCRT group （ 52 cases ） were received computerized cognitive remediation therapy, CRT group （ 49 cases ） received Chinese version of manual cognitive remediation therapy and Work and Amusement Therapy （ WAT ） group （ 47 cases ） received three months＇ operative musical therapy and dancing training. Cognitive function and clinical symptoms were compared between the three groups before treatment, 3 months after therapy and 3-monthfollow-up. Results After three months treatment, there were significant improvements revealed in categories of trail A （F=4.372, P=0.000 ） , WCST test （ F=3.579, P=0.026 ） and spatial span （ F=3.102, P=0.016 ） both in CCRT group and CRT groupl There was a significant advantage （ P〈0.05 ） in spatial span in CCRT group when compared to CRT group while there was a significant advantage （ P〈0.05 ） in symbol coding in CRT group comparing to CCRT group. There was no significant changes （ P〉0.05 ） in clinical symptoms neither at posttreatment nor at follow up among three groups. Conclusions Both CCRT and CRT can improve cognitive functions of schizophrenia patients significantly, and CCRT has an advantage in improving spatial memory than CRT while CRT is better in the improvement of psychomotor speed than CCRT.