目的 探讨车祸所致颅脑损伤患者恢复期抑郁及其相关因素.方法 对240例车祸所致颅脑损伤恢复期患者,采用一般情况调查问卷、抑郁自评量表(SDS)、日常生活能力量表(ADL)和社会支持评定量表(SSRS)进行测评,比较分析患者一般资料与SDS、ADL、SSRS评分的关系.结果 240例患者SDS评分＞53分86例,阳性率35.83％;多元回归分析发现,ADL评分、经济状况、赔偿落实、工作恢复、年龄、昏迷时间、SSRS评分和职业8个因素进入SDS逐步回归方程:y=44.456+1.19x1-1.3x2-2.31x3-2.573x4-0.038x5+0.055x6-0.239x7+0.602x8(F=369.848,P=0.000),并能预测SDS评分变异的92.5％(F=5.177,P=0.024).结论 车祸所致颅脑损伤患者在恢复期抑郁的发生率较高,主要与心理、社会因素相关,日常生活能力、经济状况和社会支持较差,年龄较小、职员、昏迷时间较长、未恢复工作、经济赔偿未落实的患者,抑郁发生率相对较高且程度较重.

Objective:To compare the pharmacoeconomics value of domestic olanzapine with imported olanzapine in the treatment of schizophrenia to provide reference for the rational drug use in clinics. Methods:Two hundred patients with schizophrenia were ran-domly divided into group A ( treated with domestic olanzapine ) and group B ( treated with imported olanzapine ) with 100 cases in each. The treatment course was 8 weeks. The patient’ s condition, adverse reactions, social function, quality of life and daily activity in the two groups were evaluated. Meanwhile, cost-efficacy analysis was performed. Results:The scores of PANSS, SDSS, SQLS and ADL after the treatment were all significantly lower than those before the treatment in both groups (P<0. 01). However, there was no significant difference between the two groups (P>0. 05). In the 2nd and 4th weekend after the treatment, the scores of TESS in group A were all significantly higher than those in group B (P<0. 01). The effectiveness of the two groups was similar. The cost in group A was significantly lower than that in group B(P<0. 01). The efficacy-cost ratio in group A was higher than that in group B(P<0. 01). Conclusion:The domestic olanzapine is as effective and safe as imported olanzapine in the treatment of schizophrenia with lower treat-ment cost. Therefore, the pharmacoeconomics value of domestic olanzapine is much better.

Objective To compare the influence of different admission modes on quality of life of patients with chronic schizophrenia.Methods 200 patients with chronic schizophrenia were randomly assigned to discontinuous group and continuous group with 100 cases in each group.All patients were treated with atypical antipsychotic drugs.A discontinuous hospitalization combined with home treatment was given to the discontinuous group and a continuous hospitalization to the continuous group for 1 year.The Positive and Negative Syndrome Scale(PANSS) and the Schizophrenia Quality of Life Scale(SQLS) were respectively used to evaluate the patient's condition and quality of life before and after the intervention.Results The intervention methods on scores of PANSS and SQLS in both groups had a change trend with time.The scores of PANSS and SQLS were significantly lower in the end of 6 months and 1 year after intervention than before in both groups(F=2119.513,390.981,P=0.000).There was a interaction effect between intervention method and time in both groups on the scores of PANSS and SQLS(F=17.660,11.709,P=0.000).There was significant difference between 2 groups on the score of PANSS(F=19.673,P=0.000).The decrease range of those scores was greater in the discontinuous group than in the continuous group(P=0.000).Conclusion A discontinuous hospitalization combined with home treatment is more beneficial than a continuous hospitalization for the patients with chronic schizophrenia in controlling the syndrome and improving or keeping the quality of life.

Objective To analyze the cost-effectiveness of the rehabilitation of intermittent hospitalization combined with home treatment on chronic schizophrenics.Methods 100 patients with chronic schizophrenia were randomly assigned to study group and control group,50 cases in each group.All patients in both groups were treated with atypical antipsychotic drugs.An intermittent hospitalization combined with home treatment was given to the study group and a continuous hospitalization to the control group for a year.Positive and Negative Syndrome Scale(PANSS),Activities of Daily Living Scale(ADL) and Schizophrenia Quality of Life Scale(SQLS) were used to evaluate the patient's condition and activity of daily living and quality of life before and after the intervention.In the meantime,a cost-effectiveness analysis was made.Results The interventions had significant influence on the scores of PANSS,ADL and SQLS in both groups.The scores of PANSS,ADL and SQLS were significantly lower 1 year after the intervention than before in both groups(FB= 540.577,318.148,326.751,all P=0.000).There was a significant interaction effect between intervention method and time in both groups on the scores of PANSS,ADL and SQLS(FAB=13.710,10.918,6.578,P=0.000,0.001,0.012).The decrease value of those scores was significantly greater in the study group than in the control group(t=3.703,3.304,2.565,P=0.000,0.001,0.012).The ratio of cost-effectiveness was larger in the study group than in the control group(t=7.035,P=0.000).Conclusion Intermittent hospitalization combined with home treatment is more beneficial for the patients with chronic schizophrenia in controlling the syndrome,keeping or improving the activity of daily living and the quality of life.Therefore its rehabilitation benefit is better than that of continuous hospitalization.

<正>慢性精神分裂症(chronic schizophrenia,CSP)患者普遍存在着社会功能缺陷[1],随着非典型抗精神病药物不断问世并广泛应用于临床,CSP患者预后有一定改善,但在恢复保持患者社会功能方面仍存在不足。目前在我国,CSP的康复仍然以住院治疗为主,本次研究就不同住院方式对CSP患者社会功

Objective To explore efficacy of cognitive behavior therapy combined with venlafaxine in the treatment of the somatoform pain disorder. Methods All 60 patients with somatoform pain disorder were randomly assigned to study groups (treated with cognitive behavior therapy combined with venlafaxine ) and control group (treated with venlafaxine alone) for 8 weeks. Each had 30 cases. Before the treatment and on the 2, 4 and 8 weekend after the treatment, Simple McGill pain scale (SF-MPQ), Hamilton Depression Scale(HAMD) and Treatment Emergent Side effect Scale(TESS) were used to evaluate the clinical efficacy(degree of pain reducing), degree of depression and adverse effect respectively. Results After 8 weeks, the efficacy in the study group (66.67%) was significantly higher than that in the control group (40.00%)(χ2=4.29,P0.05). The scores of HAMD, total and each factor of SF-MPQ in both groups were lower significantly after treatment than those before treatment. So as the scores in the study group than those in the control group after 4 and 8 weeks (t = 3.04,3.87,2.99,2.90,8.25,2.91,5.18,4.65,6.90,4.67,P 0.05). The incidence of adverse effect had no significant difference between the two groups (χ2=0.08,P0.05). Conclusions Cognitive therapy combined with venlafaxine is more effective than venlafaxine alone in the treatment of the somatoform pain disorder.

Objective It is to approach the therapeutic effect and safety of Jieyu Anshen broth combined with Risperidone in treatment of the chronic schizophrenia.Methods 100 patients with chronic schizophrenia were randomly assigned to study group(treated with Jieyu Anshen broth combined with Risperidone) and control group(treated with Risperidone alone),each had 50 cases,and all treated for 12 weeks.The Positive and Negative Syndrome Scale(PANSS) and Treatment Emergent Side effect Scale(TESS) were used to evaluate the effect and safety respectively.Results After 12 weeks,the clinical effect in the study group was significantly better than that in the control group.The scores of PANSS in the study group were lower significantly than those in the control group and after 4 weeks,so as before treatment.But the scores of TESS had no significant difference between the two groups.Conclusion P Jieyu Anshen broth combined with Risperidone is more effective than Risperidone alone in treatment of the chronic schizophrenia.It is the same safe as Risperidone.

Objective To explore the influence of family environment on relapse of the first episode schizophrenics. Methods 240 recovered patients with first episode schizophrenia were investigated. The Positive and Negative Syndrome Scale (PANSS) and Family Environment Scale (FES) were used to evaluate the relapse of the patients and the family environment in the end of the first year of discharging. Results In the first year of discharging, the relapse rate was 46.67% (112:240). The rate of relapse in the rural group was significantly higher than that in the urban group. It had positive relationship with the scores of PANSS and family population in the moment of discharging and had negative relationship with the admission days and family incomes. Conclusion The family environment has important influence on the first episode schizophrenics relapse. Family intervention can significantly improve the rehabilitation of the first episode schizophrenics and relieve the first episode schizophrenics relapse.

Objective:To explore the influence of doctors' home visiting on the home rehabilitation of the first episode schizophrenia.Methods: All 120 cases of first episode schizophrenia were randomly assigned into the experimental group and the control group(n=60 in each group).The patients in experimental group received doctors' home visiting for one year.The Positive and Negative Syndrome Scale(PANSS) and Social Disability Screening Schedule(SDSS) and Morning Side Rehabilitation State Scale(MRSS) were used to evaluate the efficacy of the patients' rehabilitation.Results: In the end of first year of discharging,the scores of PANSS and SDSS and MRSS in the experimental group were lower significantly than those in the control group and those in the moment of discharging.The re-admission rate was also lower in the experimental group than in the control group.Conclusion: Doctors' home visiting can significantly improve the home rehabilitation of the first episode schizophrenia.

目的评价文拉法辛治疗抑郁症的临床疗效和安全性.方法对符合CCMD-3抑郁症诊断标准的68例抑郁症患者进行文拉法辛和氟西汀的对照研究,其中文拉法辛组34例(75～225mg/d),氟西汀组34例(20～60mg/d),共8周.采用汉密顿抑郁量表(HAMD)评定疗效,副反应量表(TESS)评定不良反应.结果经8周治疗后,文拉法辛与氟西汀疗效相当,没有严重副反应,但能较快控制症状.结论文拉法辛是一种安全、有效的新一代抗抑郁药,适合临床使用.