多维综合干预对慢性精神分裂症合并代谢综合征的防治效果评价

目的 探讨医疗、药学、护理、营养多维综合干预对慢性精神分裂症合并代谢综合征患者的防治效果.方法 将78例慢性精神分裂症合并代谢综合征患者随机分为干预组和对照组,每组各39例.两组均接受对症治疗,并对干预组实施多维综合干预,为期1年.两组均进行随访,于人组时及出院3、6、12月末对两组患者进行简明精神病评定量表(BPRS)、世界卫生组织(WHO)生存质量评定量表简表(WHOQOL-BREF)、代谢综合征现患率、治疗依从性、复发率和再住院率的评定.结果 入组时干预组与对照组患者的BPRS、WHOQOL评分、代谢综合征现患率及治疗依从性的差异均无统计学意义(P＞0.05).随访12个月末时,干预组患者在WHOQOL的生理领域、心理领域、社会领域、环境领域的评分(分别为11.98±2.26、12.91±2.71、14.91±2.43、13.51±1.94)明显高于对照组(分别为10.24±2.56、11.12±1.21、12.94±2.45、24.3±2.19),治疗依从性(72.2％)明显高于对照组(21.2％),BPRS总分(25.80±5.36)、复发率(11.1％)、再住院率(8.3％)和代谢综合征现患率(27.8％)均低于对照组(分别为29.92±4.55、48.5％、33.3％、75.8％),差异均有统计学意义(P＜0.05,P＜0.01).结论 医疗、药学、护理、营养多维综合干预可提高慢性精神分裂症合并代谢综合征患者维持治疗的依从性,促进患者精神症状和代谢综合征症状的好转,使患者的病情更稳定且生活质量改善,可作为促进患者康复的常用措施.

The Effect of Multidimensional Comprehensive Intervention on Patients with Schizophrenia Complicated with Metabolic Syndrome

Objective To investigate the effect of multidimensional comprehensive intervention on patients with schizophrenia complicated with metabolic syndrome.Methods Seventy-eight cases of patients with schizophrenia complicated with metabolic syndrome were randomly divided into the intervention group and the control group.The both groups received symptomatic treatment but the intervention group also received additional multidimensional comprehensive intervention.The clinical outcome was simultaneously evaluated by BPRS,WHOQOL-BREF,metabolic syndrome,compliance of drug treatment,recurrent rate and rehospitalization rate at 0,3,6 and 12 months following treatment.Results There were no significant differences in BPRS,WHOQOL-BREF,prevalence of metabolic syndrome and medication compliance between the intervention group and the control group before treatment（P0.05）.At end of 12 months follow-up,the treatment compliance and the scores of physiology,psychology and social relations in WHOQOL field as well as the score of environmental field were significantly higher in the intervention group than in the control group（P0.01 or P0.05）,while BPRS,recurrence rate,rehospitalization rate and prevalence of metabolic syndrome were significantly lower in the intervention group than in the control group（P0.01）.Conclusion Multidimensional comprehensive intervention can improve the treatment compliance of the patients,improve the psychiatric symptom and MS,has patient＇s condition more stable,improve their quality of life and can be used as effective means to promote the rehabilitation of the patients.