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新森田疗法伍用抗精神病药物改善精神分裂症后抑郁患者的效应 被引量:1

Effect of new Morita therapy plus antipsychotic drugs in ameliorating post-schizophrenia depression
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摘要 目的:应用新森田疗法结合文拉法新与单用文拉法新作对照,观察其在精神分裂症后抑郁治疗过程中的作用及特点。方法:选择2002-01/2004-01在广西壮族自治区龙泉山医院精神科确诊为精神分裂症后抑郁的患者104例,随机分为对照组(52例)和治疗组(52例)。两组患者在年龄、性别、病程及接受教育差异不显著。对照组:住普通病房接受传统治疗,使用抗精神病药物按效价比折氯丙嗪等值量(377.23±92.56)mg/d,文拉法新剂量(130.48±35.23)mg/d。治疗组:住新森田疗法病房,使用抗精神病药物剂量按效价比折氯丙嗪等值量(375.26±94.53)mg/d,文拉法新剂量(128.56±36.74)mg/d。两组抗精神病药物按效价比折氯丙嗪等值量数据相近(t=0.11,P>0.05)。两组文拉法新剂量比较差异均不明显(t=0.27,P>0.05)。新森田疗法为4个期的治疗程序,绝对卧床期:1周,隔离患者,每天由主管医师作短暂查房。轻作业期:4周,由主管医师指导,主要从事轻体力活动。重作业期:4周,基本活动同轻作业期,每增加活动量至1.5~2.0h。社会康复期:3周,做常人日常生活所做的事情。对两组患者治疗结果的评估标准:①采用汉密顿抑郁量表(0~4分的5级评分法:0分为无;1分为轻度;2分为中度;3分为重度;4分为很重)于治疗前及治疗后第4,8,12周末进行抑郁测评。②采用阴性症状量表(6级评分,0分为无,正常或增加;1分为可疑;2分为轻度,程度虽轻但肯定存在;3分为中度;4分为显著;5分为严重)评定阴性症状的严重程度。③采用社会功能缺陷筛选量表(共包括10个项目,0~2分。0分为无异常或仅有不引起抱怨或问题的极轻微缺陷;1分为确有功能缺陷;2分为严重的功能缺陷)评定社会功能缺陷程度。④采用日常生活能力量表(5级评分,0分为正常或从未做过,但能做;1分为困难,但可单独完成或从未做过;2分为需要依赖他人;≥5分为异常)评定日常生活能力;� AIM: To compare new Morita therapy plus venlafaxine with venlafaxine only to observe their role in the treatment of post-schizophrenia depression. METHODS: Totally 104 patients with post-schizophrenia depression, who were selected from the Department of Psychiatry, Longquanshan Hospital of Guangxi Zhuang Autonomous Region between January 2002 and January 2004, were randomly divided into control group (n = 52) and treatment group (n = 52). There were insignificant differences in age, gender, disease course and educational background between the two groups. Patients in the control group and treatment group were treated in common sickroom and new Morita therapy sickroom. The dosages of antipsychotic drugs, which was equal to aminazine according to the ratio of effect to price, in the two groups were (377.23±92.56) and (375.26±94.53) mg per day respectively, and the dosages of venlafaxine were (130.48±35.23) and (128.56±36.74) mg/d per day respectively. There were no obvious differences in the dosages of antipsychotic drugs and venlafaxine between the two groups (t = 0.11, 0.27, P 〉 0.05). New Morita therapy was a 4-period procedure: absolute lying in bed period: one week, the patients were isolated, and the physician-incharge checked shortly every day; light work period: 4 weeks, the patients participated in light physical work under the instruction of the physicianin-charge; heavy work period: 4 weeks, and the basic activities were the same as those at the light work period, and the exercise amount was increased to 1.5-2.0 hours every day; social convalescent period: 3 weeks, the patients participated in the activities of daily life as normal people did. The evaluation standards of the therapeutic results in the two groups:① Before treatment and at the ends of the 4^th, 8^th and 12^th weeks, depression was assessed with Hamilton depression scale (HAMD, the 0-4 points 5-grade scoring method was used: 0 as none; 1 as mild; 2 as moderate; 3 as severe; 4 as very
作者 韦强
出处 《中国临床康复》 CSCD 北大核心 2005年第32期72-75,共4页 Chinese Journal of Clinical Rehabilitation
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