CAJ | 학술논문

目的：观察认知行为治疗( CBT)对首发偏执型精神分裂症的早期疗效和预后观察。方法：选取首发偏执型精神分裂症患者60例,随机分为研究组和对照组,研究组( CBT合并奥氮平组)和对照组(奥氮平组)各30例,研究组在口服奥氮平基础上,进行为期12周的CBT治疗,随访6个月。采用阳性与阴性症状量表(PANSS)评价疗效,社会功能缺陷量表(SDSS)评定社会功能,副反应量表(TESS)评定不良反应。结果：治疗12周末及随访结束时,研究组与对照组同期对比,PANSS各项评分显著降低(P<0.05或P<0.01)。半年随访时,研究组SDSS大部分项目评分显著低于对照组(P<0.01)；研究组与对照组复发率分别为23.3%和51.7%,研究组与对照组停药率分别为6.7%和31.0%,均有显著性差异(P<0.05)。结论：CBT合用奥氮平治疗首发偏执型精神分裂症,比单一药物治疗更具有优越性,近期疗效更明显,治疗依从性更好,复发率明显降低。
목적：관찰인지행위치료( CBT)대수발편집형정신분렬증적조기료효화예후관찰。방법：선취수발편집형정신분렬증환자60례,수궤분위연구조화대조조,연구조( CBT합병오담평조)화대조조(오담평조)각30례,연구조재구복오담평기출상,진행위기12주적CBT치료,수방6개월。채용양성여음성증상량표(PANSS)평개료효,사회공능결함량표(SDSS)평정사회공능,부반응량표(TESS)평정불량반응。결과：치료12주말급수방결속시,연구조여대조조동기대비,PANSS각항평분현저강저(P<0.05혹P<0.01)。반년수방시,연구조SDSS대부분항목평분현저저우대조조(P<0.01)；연구조여대조조복발솔분별위23.3%화51.7%,연구조여대조조정약솔분별위6.7%화31.0%,균유현저성차이(P<0.05)。결론：CBT합용오담평치료수발편집형정신분렬증,비단일약물치료경구유우월성,근기료효경명현,치료의종성경호,복발솔명현강저。
Objective:To observe early curative effects and prognosis of cognitive behavior therapy ( CBT ) on first-episode paranoid schizophrenia. Methods:60 cases of first episode paranoid schizophrenia were randomly divided into study group (30 cases, CBT combined with olanzapine group) and control group (30 cases, olanzapine group). The cases in study group were treated by CBT combined with olanzapine for 12 weeks whereas those in control group were only treated by olanzapine, and they were all followed up for 6 months. Positive and negative symptoms scale ( PANSS) was used to assess the efficacy, social function defect scale ( SDSS) was used to evaluate the social function, and treatment emergent symptom scale ( TESS) was used to assess the adverse reactions. Results:12 weeks after the treatment and at the end of the follow-up, the PANSS scores of study group and control group in the same period de-creased significantly (P<0. 05 or P<0. 01). When the six-month follow-up was performed, the SDSS score of study group was signifi-cantly lower than that of control group (P<0. 01). The recurrence rate of study group and control group were 23. 3% and 51. 7%, the drug-withdrawal rates of study group and control group were 6. 7% and 31. 0%, and there were both significant differences ( P<0. 05 ) . Conclusions:CBT combined with olanzapine in the treatment of first episode paranoid schizophrenia has more advantages than the single drug, treatment, and has more obvious short-term effects, better treatment compliance, and lower recurrence rate.