目的 探究五行音乐疗法联合碳酸锂治疗双相情感障碍的临床疗效及其对抑郁躁狂情绪的影响.方法 选择双相障碍患者80例,根据治疗方式不同分为研究组和对照组各40例.对照组采用碳酸锂治疗,研究组在对照组基础上加以五行音乐疗法,对比两组临床治疗效果、《中医五态情志问卷》评分,贝克-拉范森躁狂量表(BRMS)评分、汉密尔顿抑郁(HAMD)量表评分、症状自评量表(SCL-90)中各因子评分及不良反应发生率.结果 治疗后,观察组治疗总有效率显著高于对照组(P<0.05);观察组情绪五因子除喜外,其他4项评分均显著低于对照组(P<0.05);两组BRMS和HAMD评分差异显著(P<0.05);观察组SCL-90各维度评分显著低于对照组(P<0.05).结论 五行音乐疗法联合碳酸锂治疗能有效缓解双相情感障碍患者抑郁、躁狂等不良情绪,增强患者依从性,降低炎症水平,具有较好的临床疗效且不良反应少,安全性高.

Objective:To investigate the clinical efficacy of five-element music therapy in the treatment of bipolar disorder.Methods:Eighty patients with bipolar disorder admitted to Shandong Mental Health Center from January 2018 to December 2019 were included in this study. They were randomly divided into a study group and a control group ( n = 40/group). The control group was treated with conventional drug treatment. The study group was treated with five-element music therapy based on conventional drug treatment. Before, during and after treatment, mania and depression were evaluated. Symptom self-evaluation scale and the Traditional Chinese Medicine Five State Emotion Questionnaire were completed to evaluate the curative effect. Patients were followed up by telephone call. Recurrence at 3, 6 and 12 months was recorded. Results:Before treatment, there were no significant differences in the scores of the Bech-Rafaelsen Mania Rating Scale (BRMs), Hamilton Depression Rating Scale (HAMD), Traditional Chinese Medicine Five State Emotion Questionnaire, Symptom Checklist-90 (SCL-90) between the two groups (all P > 0.05). During and after treatment, BRMs, HAMD, Traditional Chinese Medicine Five State Emotion Questionnaire, and SCL-90 scores were significantly decreased in each group compared with before treatment [Control group: BRMs score during and after treatment: (11.52 ± 1.57) points, (9.43 ± 1.05) points; HAMD score during and after treatment: (16.75 ± 3.05) points, (13.61 ± 2.51) points; Traditional Chinese Medicine Five State Emotion Questionnaire: emotional vocabulary (67.25 ± 5.7) points, (56.38 ± 4.97) points, physical symptoms (29.52 ± 3.94) points, (24.19 ± 3.05) points, SCL-90 score: (100.52 ± 10.26) points, (68.85 ± 7.33) points. Study group: BRMs score during and after treatment: (9.33 ± 1.09) points, (7.85 ± 0.82) points; HAMD score: (13.74 ± 2.54) points, (10.17 ± 1.97) points; Traditional Chinese Medicine Five State Emotion Questionnaire: emotional vocabulary: (58.19 ± 5.06) points, (46.85 ± 4.06) points, physical symptoms (25.14 ± 3.54) points, (20.11 ± 2.57) points; SCL-90 scores: (90.85 ± 8.97) points, (56.87 ± 5.81) points]. During and after treatment, scores of BRMs, HAMD, Traditional Chinese Medicine Five State Emotion Questionnaire and SCL-90 in the study group were significantly lower than those in the control group ( t = 3.77, 7.01, 4.48, 6.99, 8.78, 4.89, 6.05, 4.19, 7.57, all P < 0.05). Total response rate in the study group was significantly higher than that in the control group (90.0% vs. 72.5%, χ2 = 4.02, P < 0.05). At 3, 6 and 12 months after treatment, recurrence rate in the study group was 2.5%, 15.0% and 30.0%, respectively, which were significantly lower than 17.5%, 35.0%, and 52.5% in the control group ( χ2 = 5.00, 4.26, 4.17, all P < 0.05). Conclusion:Five-element music therapy for the treatment of bipolar disorder can markedly alleviate depression and mania, restore patient's emotional state, improve clinical efficacy, and decrease recurrence rate.

目的 分析不同部位重复经颅磁刺激(rTMS)治疗慢性失眠的疗效及对患者认知功能的改善作用.方法 选取160例慢性失眠患者,分为假刺激组、Cz组、左侧组、右侧组各40例.假刺激组做rTMS假刺激治疗,左侧组、右侧组、Cz组分别在左侧前额叶背外侧(DLPFC)、右侧DLPFC、Cz点后1 cm三个不同部位行rTMS治疗.观察不同部位rTMS治疗慢性失眠的疗效.采用匹兹堡睡眠质量指数(PSQI)、睡眠个人信念和态度量表(DBAS)、蒙特利尔认知评估量表(MoCA)、符号数字转换测验(SDMT)、听觉诱发事件相关电位(ERPs)评价患者认知功能的改善作用.结果 治疗后Cz组、左侧组、右侧组DBAS总分及各分量表评分、SDMT、MoCA评分均较治疗前升高(P<0.05).治疗后,Cz组、左侧组、右侧组PSQI评分均低于假刺激组,DBAS总分及各分量表评分、SDMT、MoCA评分均高于假刺激组(P<0.05);左侧组、右侧组PSQI、DBAS后果分量表评分均低于Cz组,DBAS总分及除后果分量表外其他各分量表评分、MoCA、SDMT评分均高于Cz组(P<0.05);右侧组DBAS期望、控制和预测分量表评分均高于左侧组(P<0.05).治疗后Cz组、左侧组、右侧组ERPs P3峰潜伏期均较治疗前缩短,P3波幅均较治疗前升高(P<0.05).治疗后,与假刺激组比较,Cz组、左侧组、右侧组ERPs P3峰潜伏期均缩短,P3波幅均升高(P<0.05);与Cz组比较,左侧组、右侧组ERPs P3峰潜伏期均缩短,P3波幅均升高(P<0.05).治疗后Cz组、左侧组、右侧组治疗总有效率均高于假刺激组(P<0.05);左侧组、右侧组治疗总有效率均高于Cz组(P<0.05);左侧组、右侧组治疗总有效率差异无统计学意义(P>0.05).结论 rTMS治疗部位在左侧DLPFC、右侧DLPFC治疗慢性失眠疗效优于其他区域,可明显改善患者睡眠质量、睡眠信念和态度、认知功能.

目的:对抑郁障碍患者的疗效进行开放性、前瞻性研究,以期为临床早诊断提供筛查依据.方法:选取专科医院住院的符合ICD-10诊断标准诊断为抑郁障碍的患者.出院前1天进行自制一般情况调查表、汉密顿抑郁量表(HAMD)、心境障碍问卷(MDQ)评定.将MDQ量表评分≥7分定义为筛查阳性,视为高危组,其余视为低危组.出院后1年对两组患者进行随访,内容包括症状评估、社会功能状况、是否更改诊断为双相情感障碍等.结果:共入组168例患者,出院后1年共脱落3例,脱落率1.7％.高危组入组年龄、首次发病年龄均小于低危组(t=-4.28,-6.02;P＜0.05).低危组1年临床疗效优于高危组(x2=2.11,P＜0.05).高危组更改为双相障碍诊断例数显著高于低危组(x2=17.00,P＜0.05).出院1年疗效与首次发病年龄(P=0.047,OR=0.89,B=0.12)、更改诊断(P =-0.063,OR=0.91,B=0.16)、MDQ评分(P=-0.037,OR=0.78,B=0.11)关系密切.更改诊断与首次发病年龄(P=0.067,OR=0.91,B=0.12)、MDQ评分(P=-0.077,OR=0.81,B=0.19)关系密切.结论:首次发病年龄越早远期疗效越差.MDQ量表在抑郁障碍早期应用作为常规筛查工具值得在临床中推广使用.

目的 分析盐酸多奈哌齐联合胞磷胆碱注射液对阿尔茨海默症患者的血清因子 、神经认知功能及临床疗效的影响.方法 选择2013年6月-2017年6月山东省精神卫生中心收治的96例阿尔茨海默症患者,并按照随机数字法均分为对照组和观察组,每组各48例.对照组采用胞磷胆碱注射液治疗,观察组在对照组治疗的基础上增加盐酸多奈哌齐.统计患者治疗的有效率,比较2组患者血清因子白细胞介素-6(IL-6)、白细胞介素1β(IL-1β)、人内皮素-1(ET-1)、基质金属蛋白酶9(MMP-9)水平和日常生活活动量表(ADL)、阿尔茨海默病评估量表(ADAS-cog)、简易精神状态量表(MMSE)、神经精神科问卷(NPI)评分结果 .结果 观察组有效率为84.44％(41/48),明显高于对照组有效率68.89％(34/48),差异具有统计学意义(P<0.05).治疗后,2组患者的血清因子均明显下降,但观察组的IL-6、IL-1β 、ET-1及MM P-9水平均明显低于对照组IL-6、IL-1β 、ET-1及MM P-9,差异均具有统计学意义(P均<0.05).观察组的ADL、ADAS-cog、MMSE及NPI评分明显优于对照组,差异具有统计学意义(P均<0.05).对照组不良反应发生率为10.42％,观察组为12.50％,2组不良反应发生率差异无统计学意义(P>0.05).结论 盐酸多奈哌齐联合胞磷胆碱注射液治疗阿尔茨海默症,能改善患者的神经认知功能,调节患者的血清因子,提高临床治疗有效率,值得临床推广应用.

Objective To explore the efficacy and safety of Shugan Jieyu capsule combined with small dose olanzapine in treating of post-stroke depression with. Methods A total of 130 patients with post-stroke depression were selected, they were randomly divided into Shugan Jieyu capsule group and combination group, there were 65 patientes in each group, Shugan Jieyu capsule group were only treated with shuganjieyu capsule, combination group were treated with Shugan Jieyu capsule and small dose olanzapine, the HAMD score, clinical efficacy and adverse reactions of patients before treatment, or at four weeks, at eight weeks were compared in two groups. Results The HAMD scores in two groups at four weeks, eight weeks after treatment was significantly lower than that before treatment, the difference was statistically significant (P<0.05); the HAMD scores in combination group at four weeks, eight weeks after treatment was significantly lower than that in Shugan Jieyu capsule group,the difference was statistically significant (P<0.05);the total effective rate in combination group was significantly higher than that in Shugan Jieyu capsule group;the inci-dence of adverse reaction had no significant differences between two groups (P=0.144). Conclusion Treating post-stroke depression with Shugan jieyu capsule combined with small dose olanzapine can significantly improve patient's HAMD score, improve clinical efficacy, it has a high security, it is worthy of clinical application.

Objective To explore the correlation between the personality traits and social behavior mode of schizophrenic patients in remission stage.Methods 111 patients with schizophrenia in remission stage (study group)and 125 healthy subjects (control group)were assessed with NEO Personality Inventory-Revised edition (NEO-PI-R),Interpersonal Trust Scale (ITS)and Security Questionnaire (SQ).The correlation of big five personality traits with interpersonal trust and sense of security were analyzed between the two groups.Results Score of C dimension of NEO-PI-R in study group was significantly lower than that in control group (P <0.05).In study group,score of N dimension of NEO-PI-R was significantly positively correlated with factor score of special trust of ITS (P =0.031),while score of A dimension was significantly negatively correlated with factor score of special trust (P =0.001 ).Scores of O dimension and A dimension of NEO-PI-R in study group were significantly positively correlated with factor score of universal trust of ITS (P <0.05 ).Factor score of interpersonal safety of SQ was significantly negatively correlated with N dimension (P =0.000)and was significantly positively correlated with A and C dimensions (P <0.05 )of NEO-PI-R in study group.Factor score of determine control of SQ was significantly negatively correlated with N dimension (P =0.000)and was significantly positively correlated with O,A,C dimensions of NEO-PI-R (P <0.05).Conclusion The personality characteristics of schizophrenic patients in remission stage is related to their social behavior mode.

本文从临床应用的角度出发,对近年来有关曲唑酮的文献作一综述,通过本文的回顾,可见曲唑酮作为一种5-羟色胺阻滞和再摄取抑制剂,适用于伴有焦虑、激越、睡眠以及性功能障碍的抑郁患者。其作用与三环类抗抑郁剂、选择性五羟色胺抑制剂等药物疗效相当,并且具有抗焦虑、较快改善睡眠、安全性能高的优势。

OBJECTIVE To explore the efficacy of paliperidone extended-release tablets in the improvement of social functions in schizophrenics. METHODS A total of 81 schizophrenics were randomly divided into study group with paliperidone extended-release tablets and control group with risperidone for a 12-week treatment. They were assessed and analyzed by positive and negative symptoms scales (PANSS), social disability screening schedule (SDSS) and treatment emergent symptom scale (TESS) at baseline, 6(th) weekend and 12(th) weekend. RESULTS In study group, the factors and total scores of PANSS in the 12(th) weekend of treatment [(12.0 ± 2.8), (12.1 ± 3.6), (26.2 ± 5.0), (50.2 ± 8.7)] were all significantly lower than those at baseline [(24.7 ± 5.3), (23.8 ± 3.6), (45.0 ± 2.9), (93.5 ± 6.8)] (t = 9.60-16.78, P < 0.05). In study group, the positive factor, negative factor and total scores of PANSS in the 12(th) weekend of treatment [(12.0 ± 2.8), (12.1 ± 3.6), (50.2 ± 8.7)] were all significantly lower than those in the 6(th) weekend of treatment [(14.2 ± 1.8), (14.6 ± 2.4), (56.5 ± 6.4)] (t = 2.58-4.26, P < 0.05). In the 12(th) weekend of treatment, the factors and total scores of PANSS in study group [(12.0 ± 2.8), (12.1 ± 3.6), (26.2 ± 5.0), (50.2 ± 8.7)] were all significantly lower than those in control group [(16.9 ± 4.9), (18.7 ± 5.3), (32.5 ± 5.1), (68.1 ± 13.0)] (t = -4.28--5.67, P < 0.05). In study group, the total scores of SDSS in the 12(th) weekend of treatment (5.93 ± 2.78) were significantly lower than those at baseline (13.9 ± 3.4) (t = 10.83, P < 0.05). In study group, the total scores of SDSS in the 12(th) weekend of treatment (5.9 ± 2.8) were significantly lower than those in the 6(th) weekend of treatment (7.6 ± 2.9) (t = 5.21, P < 0.05). But there was no significant improvement in control group (t = 1.88, P > 0.05). In the 12(th) weekend of treatment, the total scores of SDSS in study group (5.9 ± 2.8) were significantly lower than those in control group (8.8 ± 2.9) (t = -4.49, P < 0.05). No severe adverse effect was reported in either group. CONCLUSION Paliperidone extended-release tablets are effective to improve social functions and psychiatric symptoms of schizophrenics.

思瑞康是一种新型抗精神病药物,与氯氮平同属第二代抗精神病药物.本研究对接受思瑞康治疗的精神分裂症患者的临床心电图进行分析,以探讨其对心脏的影响.

在美国,Holzman从1974年起从事平稳眼跟踪(SPEM)研究,认为SPEM很可能是精神分裂症的生物标志[1].1 972年以后,小岛卓也等也开始研究探查性眼球活动(SEM),取得较好结果,认为SEM可以作为精神分裂症的生物标志[2].之后我国也相继开展了有关眼球活动的研究.