有氧运动对男性慢性精神分裂症患者认知功能的影响

Effects of aerobic exercise on cognitive function in male patients with chronic schizophrenia

背景精神分裂症的治疗方式以药物治疗及物理治疗为主,但均存在不良反应,影响治疗依从性及疗效。既往研究结果显示,有氧运动有助于改善阿尔茨海默病患者及抑郁障碍患者的认知功能。目前,国内对有氧运动改善精神分裂症患者认知功能的研究存在不足。目的 探讨有氧运动对男性慢性精神分裂症患者认知功能的影响,为精神分裂症患者的治疗提供参考。方法 选取2022年12月—2023年4月在芜湖市第四人民医院住院的76例男性慢性精神分裂症患者为研究对象,采用随机数字表法分为研究组(n=36)和对照组(n=40)。两组均接受常规药物治疗,研究组在此基础上接受为期8周、每周5次、每次60 min的有氧运动干预。于干预前后,采用MATRICS共识认知成套测验(MCCB)和Stroop色词测验(SCWT)分别评定患者的认知功能和执行功能。结果 干预后,研究组MCCB的连线测验用时短于对照组,空间广度测验及迷宫测验评分均高于对照组(Z=-2.070、-2.306、-2.375,P均<0.05),重复测量方差分析结果显示,干预后,两组患者霍普金斯词语学习测验评分的时间主效应有统计学意义(F=39.067,P<0.05),简易视觉空间记忆测验和言语流畅测验评分的时间与组别的交互效应均有统计学意义(F=10.092、9.252,P均<0.05);干预后,研究组简易视觉空间记忆测验和言语流畅测验评分高于对照组(t=6.689、4.249,P均<0.05),研究组简易视觉空间记忆测验和言语流畅测验评分均高于干预前(t=23.746、23.842,P均<0.05)。干预后,研究组SCWT色测验与词测验正确个数均多于对照组(Z=-2.358、-2.771,P均<0.05),两组患者色测验、词测验和色词干扰测验反应时间的时间与组别的交互效应均有统计学意义(F=23.383、19.888、19.662,P均<0.05),干预后,研究组色测验与色词干扰测验的反应时间均短于对照组(t=4.895、6.163,P均<0.05),研究组色测验、词测验、色词干扰测验反应时间均短于干预前(t=54.318、42.425、42.141,P均<0.01)。结论 有氧运动可能有助于改善男性慢性精神分裂症患者的认知功能,包括信息处理加工速度、工作记忆、推理/问题解决能力、词语学习与记忆、视觉学习与记忆和执行功能。

Background The schizophrenia is majorly treated with drug and through physical therapy.However,both treatments would lead to adverse reactions,which could affect therapy adherence and treatment efficacy.Previous studies have shown that aerobic exercise can help alleviate cognitive function in patients with Alzheimer's disease and depressive disorder.At present,little research has been done on such alleviation in schizophrenia patients.Objective To explore the effect of aerobic exercise on cognitive function in male patients with chronic schizophrenia,so as to provide references for relevant treatments.Methods A total of 76 male patients with chronic schizophrenia hospitalized in the Fourth People's Hospital of Wuhu between December 2022 and April 2023 were selected as the study subjects and,in accordance with random number table,divided into study group(n=36)and control group(n=40).Both groups received conventional drug treatment.On this basis,the study group received a 60-minute aerobic exercise 5 times a week for 8 weeks as intervention.Before and after intervention,assessment of cognitive function was performed by using MATRICS Consensus Cognitive Battery(MCCB)and Stroop Color Word Test(SCWT).Result After intervention,compared with the control group,the study group spent less time on finishing the Trail Making Test and scored higher in both the spatial span test and maze test(Z=-2.070,-2.306,-2.375,P<0.05).Repeated measure ANOVA results showed that the time main effect of Hopkins Verbal Learning Test score was statistically significant in the two groups after intervention(F=39.067,P<0.05).So was the interaction effect between the time and group of the Brief Visuospatial Memory Test and Verbal Fluency Test scores(F=10.092,9.252,P<0.05).After intervention,the scores of the Brief Visuospatial Memory Test and Verbal Fluency Test in the study group were higher than those in the control group(t=6.689,4.249,P<0.05).As for the study group itself,the scores were higher than those before intervention(t=23.746,23.842,P<0.05).After intervention,the numbers of correct reading in color test and word test in the study group were more than those in the control group(Z=-2.358,-2.771,P<0.05).The interaction effect between the time and group of the reaction time in color test,word test and color word interference test were statistically significant in both groups(F=23.383,19.888,19.662,P<0.05).After intervention,the reaction time in color test and color word interference test of the study group was shorter than those of the control group(t=4.895,6.163,P<0.05).As for the study group itself,the reaction time were shorter than before intervention(t=54.318,42.425,42.141,P<0.01).Conclusion Aerobic exercise may help alleviate the cognitive problems in male patients with chronic schizophrenia in terms of information processing speed,working memory,reasoning/problem solving ability,word learning and memorizing,visual learning and memorizing,and executive function.