CAJ | 학술논문

目的：探讨认知行为治疗（ CBT）联合小剂量利培酮在治疗精神分裂症幻听中的临床效果和安全性。方法采用随机数字表法将80例符合《中国精神障碍分类与诊断标准（第3版）》（ CCMD-3）精神分裂症诊断标准的伴有幻听的患者分为CBT干预组（研究组）与药物治疗组（对照组）各40例，均采用非典型抗精神病药利培酮片治疗，CBT组药物剂量约为对照组的1/3，同时予以CBT干预。分别于入组时、3个月、6个月及随访6个月采用阳性和阴性症状量表（ PANSS）、幻听量表（ AHRS）、副反应量表（ TESS）评定患者的临床疗效及副反应情况。结果治疗3个月、6个月及随访6个月两组的PNASS评分、AHRS评分均较治疗前降低，差异有统计学意义（ P﹤0.05或0.01）；随访6个月时，两组间比较差异有统计学意义（ P﹤0.05）。对照组不良反应发生率高于研究组，差异有统计学意义（χ2＝5.7826，P﹤0.05）。结论 CBT联合小剂量抗精神病药物及足量抗精神病药物治疗精神分裂症幻听均有临床效果，前者疗效的持续性及不良反应发生率可能优于后者，但需要进一步研究。
목적：탐토인지행위치료（ CBT）연합소제량리배동재치료정신분렬증환은중적림상효과화안전성。방법채용수궤수자표법장80례부합《중국정신장애분류여진단표준（제3판）》（ CCMD-3）정신분렬증진단표준적반유환은적환자분위CBT간예조（연구조）여약물치료조（대조조）각40례，균채용비전형항정신병약리배동편치료，CBT조약물제량약위대조조적1/3，동시여이CBT간예。분별우입조시、3개월、6개월급수방6개월채용양성화음성증상량표（ PANSS）、환은량표（ AHRS）、부반응량표（ TESS）평정환자적림상료효급부반응정황。결과치료3개월、6개월급수방6개월량조적PNASS평분、AHRS평분균교치료전강저，차이유통계학의의（ P﹤0.05혹0.01）；수방6개월시，량조간비교차이유통계학의의（ P﹤0.05）。대조조불량반응발생솔고우연구조，차이유통계학의의（χ2＝5.7826，P﹤0.05）。결론 CBT연합소제량항정신병약물급족량항정신병약물치료정신분렬증환은균유림상효과，전자료효적지속성급불량반응발생솔가능우우후자，단수요진일보연구。
Objective To explore the clinical effect and safety of cognitive behavioral therapy( CBT)with small dose risperidone in auditory hallucination of schizophrenia. Methods According to random number table,80 cases chronic schizophrenic patients with au-ditory hallucination in accord with Chinese Classification and Diagnostic Criteria of Mental Disease,third edition(CCMD-3)diagnostic criteria were randomly divided into treatment group and control group. Both groups were treated by atypical antipsychotic risperidone,and the treatment group was given by 1/3 antipsychotic combined with CBT. Clinical efficacy and adverse reactions were evaluated by Positive and Negative Symptoms Scale( PANSS),Auditory Hallucinations Rating Scale( AHRS)and Treatment Emergent Symptom Scale( TESS) before and after treatments 3 months,6 months and 6 months follows-up. Results 3 months,6 months and 6 months follows-up after treatment,the total scores of PANSS and AHRS were reduced significantly as compared with those pretreatment(P﹤0. 05 or 0. 01). fol-low-up of 6 months,the treatment group still has obvious improvement,there was statistically significant difference between groups( P﹤0. 05). The adverse reaction rate in the control group was higher than that in the treatment group,and the difference was statistically sig-nificant(χ2 =5. 7826,P﹤0. 05). Conclusion CBT with small antipsychotic and sufficient antipsychotic treating schizophreniaˊs auditory hallucination have evident clinical efficacy,worthy of promotion and applications. Effect of CBT with small antipsychotic in persisting effects and adverse reactions may be superior to medication,but further studies are needed.