柴胡桃仁汤对迟发性运动障碍模型大鼠的治疗作用

目的观察柴胡桃仁汤对迟发性运动障碍(tardive dyskinesia,TD)大鼠模型行为及血清超氧化物歧化酶(superoxide dismutase,SOD)活力、脂质过氧化代谢物丙二醛水平变化,探讨TD可能的病理生理机制.方法将24只雄性Sprague-Dawley(SD)大鼠随机分为空白、模型、治疗四组,每组8只,分别予腹腔注射生理盐水+第5周始灌胃生理盐水、腹腔注射氟哌啶醇+第5周始灌胃生理盐水、腹腔注射氟哌啶醇+第5周始灌胃柴胡桃仁汤处理,共9周;每周末观察大鼠口部异常运动,进行评分.研究结束时取静脉血,分离血清,测定血清超SOD活力、及丙二醛水平.结果腹腔注射氟哌啶醇使SD大鼠口部异常运动增加明显,第5周达峰值;柴胡桃仁汤可使TD模型大鼠口周异常运动评分下降,减分为12.0±9.9,与TD组(0.6+4.2)相比,差异有显著性(u=5.0,P＜0.05);TD组大鼠血清SOD活力(kat/L)明显降低(5.4±0.7),丙二醛水平(kat/L)显著升高(20.4±6.0),柴胡桃仁汤可缓解这一改变(SOD6.5±0.3,丙二醛7.7±3.2),而且差异均有显著性(P＜0.01).可用于制作TD动物模型;而可使这些行为异常显著缓解(P＜0.05);与模型组比较,治疗组血清SOD活力升高,丙二醛水平下降,差异有显著性意义(P＜0.01).结论柴胡桃仁汤通过阻制氧化损伤,有效缓解TD模型大鼠口周异常运动,氧化应激在TD发生过程中起重要作用.     

抑郁症患者烟酸皮肤潮红反应与认知功能的关联分析

目的:探讨抑郁症患者烟酸皮肤潮红反应敏感度与认知功能的关系。方法:本研究为横断面研究,纳入2018年7月至2019年8月在驻马店市第二人民医院门诊或住院的符合DSM-Ⅳ诊断标准的抑郁症患者40例（抑郁症组）,以及与抑郁症组性别和受教育程度相匹配的健康对照者32名（对照组）。收集一般人口学和临床资料。采用可重复的成套神经...     

入院诊断为急性短暂精神病性障碍患者的转归及其预测因素

目的:调查入院诊断为急性短暂精神病性障碍(acute and transient psychotic disorders,ATPD)患者的最后转归,研究转归的预测因素。方法:采用回顾性随访研究,收集以ATPD(依据ICD-10诊断标准)序贯入院的患者112名,于首次入院诊断后1.0～4.5年内,由2名高年资精神科主治医师利用各种医疗及社区康复资料,判断患者最近的转归,探索与转归有关的预测因素。结果:(1)73.2%(82/122)的患者更改为其他诊断,主要改诊为精神分裂症65.2%(73/122);还有26.8%的患者短期患病后恢复正常,仍维持原来的诊断即ATPD;(2)将转归为精神分裂症及仍为ATPD的患者分组[2组占全部患者92.0%(103/112)]比较,发现家族史阳性患者几乎全来自精神分裂症组,精神分裂症组较ATPD组入院前病程更长[(9.8±5.8)d vs.(7.2±5.8)d,P0.05],而病前人格方面2组均存在较高比例的内向性人格(分别为50/73和18/28);(3)对2组中测查过MMPI的患者进行分析,发现其中精神病态量表分(Pd)在精神分裂症组明显升高[(59.8±11.1)vs.(52.1±10.7),P0.01]。结论:入院诊断为急性短暂精神病性障碍的患者大部分转归为精神分裂症,其中有精神分裂症谱系障碍阳性家族史,入院前病程偏长,MMPI精神病态量表分高者,转归为精神分裂症的可能性更大。     

重复性成套神经心理状态测验在北京地区正常人群中的应用

目的:使用重复性成套神经心理状态测验(The Repeatable Battery for the Assessment of Neuropsychological Status,RBANS)中文版作为测查工具,对北京地区代表性正常人进行测量,并分析主要人口学因素对测量结果的影响。方法:依据北京地区人口学统计资料,分层选取城镇社区/乡村村庄作为抽样点,分别从6个年龄组(18~29、30~39、40~49、50~59、60~69、70~79岁)各抽取代表性被试60名,进行RBANS中文版的测量,获得各分测验原始分,经过数学变换转换为5大因子量表分及全量表分(使用100±15表示)。使用多因素方差分析考察性别、年龄、受教育程度对测量结果的影响。结果:(1)被试RBANS各量表分在不同年龄组间分布等齐[如,全量表分:30~39岁组(100.8±15.3),60~69岁组(100.1±15.3)];(2)除线条定位得分男性高于女性[(15.4±3.3)vs.(13.6±3.9),P0.001]外,其他分测验原始分和所有量表分性别差异均无统计学意义;(3)除图画命名、语义流畅性分测验外,其他分测验原始分均随年龄的增大而下降[如,"编码"分测验:6个年龄组(从小到大)原始分分别为54、46、38、33、25、17分,均P0.001];(4)所有量表分随受教育程度的上升而升高(如,全量表分:初中97分,高中102分,P=0.008)。结论:获取了重复性成套神经心理状态测验(RBANS)中文版北京样本数据,数据表明性别、年龄、受教育程度中,后二者对RBANS得分有明显影响。     

吸烟对精神分裂症男性患者精神病理症状的影响

Objective To compare the differences of psychopathologic symptoms between smokers and non-smokers in chronic and first-episode,drug-nalve schizophrenics.then it was attempted to explain the reasons why there is higher rate of smoking behavior in schizophrenia.Methods In all.427 male chronic schizophrenic patients(332 smokers and 95 non-smokers)and 63 male first-episode drug-naive patients with schizophrenia(22 smokers and 41 non-smokers)were collected.All patients were assessed with the Positive and Negative Syndrome Scale(PANSS).Results In chronic patients.the item scores of poor rapport and passive/apathetic social withdrawal of PANSS negative subscale were significantly lower in smokers than non-smokers(3.9 ±1.5 vs.4.4±1.7;3.6±1.6 vs.4.0±1.7.respectively,P＜0.05),and so was the total scores of PANSS negative subscale(24.0±8.2 vs.26.3±9.5).In first-episode.drug-ndive patients.the itern scores of emotional withdrawal and passive/apathetic social withdrawal of PANSS negative subscale were significant lower in smokers than non-smokers(2.7±1.3 vs.3.5±1.3:2.7±1.3 vs.3.5±1.4,respectively,P＜0.05).Conclusion It is suggested there are positive effects of cigarette smoking on the psychopathological symptoms of patients with schizophrenia,which misht be one of the mechanisms for higher rates of smoking behavior in schizophrenia.     

精神卫生从业人员的社会安全保障现状及对策

中国是一个以精神疾病低治疗率为特点的精神卫生资源匮乏的发展中国家.根据卫生部的统计数据[1],中国13亿人口中,患有严重精神疾病的患者达1600多万,患有不同程度精神或心理障碍需要专业人员干预的达到1.9亿人.     

慢性精神分裂症与脑肿瘤患者认知状况比较分析

目的　探讨慢性精神分裂症患者脑功能缺陷与不同脑叶损伤间的关系。方法　运用威斯康星卡片分类测验、词汇流畅性测验、Stroop测验,对30名正常人、39例精神分裂症及88例脑肿瘤患者(其中左、右额叶各2 4例、颞叶2 0例、顶枕叶2 0例)进行测试。结果　精神分裂症患者与脑肿瘤患者均存在不同程度、不同特征的认知损伤,其中阴性症状为主的精神分裂症与右额叶脑肿瘤患者损伤类似,除完成分类数、总词汇数外,本研究所采用的测查其余指标差异无显著性(P >0 . 0 5)。结论　阴性症状为主的慢性精神分裂症患者右侧额叶功能受损明显,精神分裂症起病的器质性因素可能涉及右额叶。     

吸烟对精神分裂症男性患者精神病理症状的影响

Objective To compare the differences of psychopathologic symptoms between smokers and non-smokers in chronic and first-episode,drug-nalve schizophrenics.then it was attempted to explain the reasons why there is higher rate of smoking behavior in schizophrenia.Methods In all.427 male chronic schizophrenic patients(332 smokers and 95 non-smokers)and 63 male first-episode drug-naive patients with schizophrenia(22 smokers and 41 non-smokers)were collected.All patients were assessed with the Positive and Negative Syndrome Scale(PANSS).Results In chronic patients.the item scores of poor rapport and passive/apathetic social withdrawal of PANSS negative subscale were significantly lower in smokers than non-smokers(3.9 ±1.5 vs.4.4±1.7;3.6±1.6 vs.4.0±1.7.respectively,P＜0.05),and so was the total scores of PANSS negative subscale(24.0±8.2 vs.26.3±9.5).In first-episode.drug-ndive patients.the itern scores of emotional withdrawal and passive/apathetic social withdrawal of PANSS negative subscale were significant lower in smokers than non-smokers(2.7±1.3 vs.3.5±1.3:2.7±1.3 vs.3.5±1.4,respectively,P＜0.05).Conclusion It is suggested there are positive effects of cigarette smoking on the psychopathological symptoms of patients with schizophrenia,which misht be one of the mechanisms for higher rates of smoking behavior in schizophrenia.     

吸烟对精神分裂症男性患者精神病理症状的影响

Objective To compare the differences of psychopathologic symptoms between smokers and non-smokers in chronic and first-episode,drug-nalve schizophrenics.then it was attempted to explain the reasons why there is higher rate of smoking behavior in schizophrenia.Methods In all.427 male chronic schizophrenic patients(332 smokers and 95 non-smokers)and 63 male first-episode drug-naive patients with schizophrenia(22 smokers and 41 non-smokers)were collected.All patients were assessed with the Positive and Negative Syndrome Scale(PANSS).Results In chronic patients.the item scores of poor rapport and passive/apathetic social withdrawal of PANSS negative subscale were significantly lower in smokers than non-smokers(3.9 ±1.5 vs.4.4±1.7;3.6±1.6 vs.4.0±1.7.respectively,P＜0.05),and so was the total scores of PANSS negative subscale(24.0±8.2 vs.26.3±9.5).In first-episode.drug-ndive patients.the itern scores of emotional withdrawal and passive/apathetic social withdrawal of PANSS negative subscale were significant lower in smokers than non-smokers(2.7±1.3 vs.3.5±1.3:2.7±1.3 vs.3.5±1.4,respectively,P＜0.05).Conclusion It is suggested there are positive effects of cigarette smoking on the psychopathological symptoms of patients with schizophrenia,which misht be one of the mechanisms for higher rates of smoking behavior in schizophrenia.     

阿立哌唑治疗急性复发精神分裂症29例

目的:探讨新型抗精神病药物阿立哌唑治疗急性复发精神分裂症的有效性和安全性。方法:随机入组症状急性恶化或复发的精神分裂症患者30例(脱落1例),纳入分析29例(男15例,女14例),采用阿立哌唑治疗,剂量为(14．4±9．2)mg·d-1,临床观察6周。采用阳性症状与阴性症状量表(PANSS)评定疗效,用不良反应症状量表(TESS)、血生化指标和心电图的改变评价治疗的安全性。结果:①治疗1周后,PANSS阳性、阴性症状分和总分均显著下降(P<0．05);治疗6周后PANSS各分值(阳性症状分为15．5±6．1,阴性症状分为15．1±7．0,总分为60．4±18．1)与基线水平(阳性症状分为26．8±7．1,阴性症状分为22．1±8．4,总分为96．4±21．0)差异显著(P<0．01)。②经6周治疗,基本痊愈6例(20．7％),好转共12例(41．4％),症状无显著变化11例(37．9％),1例患者病情有恶化。③治疗过程中,所有患者TESS总分平均值(2．0±2．3),其中12例患者评分一直为0;主要表现为失眠、静坐不能、食欲减退、便秘、视物模糊。6周的观察中未发现阿立哌唑导致的体重显著增加和心电图的明显改变。结论:阿立哌唑对急性复发的精神分裂症有良好的疗效,而且不良反应较小。