标题：团体绘画疗法联合氯氮平治疗慢性精神分裂症疗效观察

      作者：顾文谊，严辉，陈彩虹，凤燕琼    上海市民政第二精神卫生中心精神科，上海 201319

      卷次： 2024年35卷1期

      【摘要】 目的 观察团体绘画疗法联合氯氮平治疗慢性精神分裂症的临床疗效。方法 选取2019年2月至2023年2月上海市民政第二精神卫生中心收治的100例慢性精神分裂症患者作为研究对象，按随机数表法均分为对照组和观察组各50例。对照组患者采用氯氮平治疗，观察组患者在对照组治疗的基础上联合团体绘画疗法治疗。两组患者均持续治疗 6周，于治疗结束后比较两组患者的临床疗效，以及治疗前后的阳性和阴性症状量表(PANSS)、精神分裂症患者生活质量量表(SQLS)和住院精神患者社会功能评定量表(SSPI)评分，同时比较两组患者的不良反应发生情况。结果 观察组患者的治疗总有效率为84.00%，明显高于对照组的66.00%，差异有统计学意义(P<0.05)；治疗后，观察组患者的阳性因子评分、阴性因子评分、一般精神病理评分和总分明显低于对照组，差异均有统计学意义(P<0.05)；治疗后，观察组患者的心理社会、精力与动力、症状及副反应评分和总分明显低于对照组，差异均有统计学意义(P<0.05)；治疗后，观察组患者的日常生活功能、动性及交往情况、社会活动技能评分和总分明显高于对照组，差异均有统计学意义(P<0.05)；治疗期间，观察组患者的不良反应总发生率为14.00%，略低于对照组的18.00%，但差异无统计学意义(P>0.05)。结论 团体绘画疗法联合氯氮平治疗能够改善慢性精神分裂症患者的阳性/阴性症状，提高其生活质量和社会功能，具有疗效好和安全性高等特点，值得临床推广应用。
      【关键词】 慢性精神分裂症；团体绘画疗法；氯氮平；社会功能；生活质量
      【中图分类号】 R749.3 【文献标识码】 A 【文章编号】 1003—6350（2024）01—0067—05

Clinical efficacy of group painting therapy combined with clozapine in the treatment of chronic schizophrenia.GU Wen-yi, YAN Hui, CHEN Cai-hong, FENG Yan-qiong.
Department of Psychiatry, the Second Mental Health Center ofShanghai Civil Affairs Bureau, Shanghai 201319, CHINA
【Abstract】 Objective To observe the clinical efficacy of group painting therapy combined with clozapine inthe treatment of chronic schizophrenia. Methods A total of 100 patients with chronic schizophrenia admitted to the Sec-ond Mental Health Center of Shanghai Civil Affairs Bureau from February 2019 to February 2023 were selected as thestudy subjects. They were randomly divided into a control group and an observation group, with 50 patients in eachgroup. Patients in the control group were treated with clozapine, while those in the observation group were treated withgroup painting therapy on the basis of the treatment in the control group, for 6 weeks. After 6 weeks of treatment, the clini-cal efficacy, Positive and Negative Symptom Scale (PANSS), quality of life scale for schizophrenia patients (SQLS), andScale of Social Function in Psychosis Inpatients (SSPI) scores of hospitalized psychiatric patients were compared betweenthe two groups of patients. The incidence of adverse reactions was also compared between the two groups. Results Thetotal effective rate of treatment in the observation group was 84.00%, significantly higher than 66.00% in the controlgroup (P<0.05). The positive factor score, negative factor score, general psychopathological score, and total score of theobservation group after treatment were significantly lower than those of the control group (P<0.05). After treatment, thescores of psychosocial item, energy and motivation, symptoms and side effects, and total scores of the observation groupwere significantly lower than those of the control group (P<0.05). After treatment, the daily life function, mobility andcommunication status, social activity skill scores, and total scores of the observation group were significantly higher thanthose of the control group (P<0.05). During the treatment period, the total incidence of adverse reactions in the observa-tion group was 14.00%, slightly lower than 18.00% in the control group, but the difference was not statistically signifi-cant (P>0.05). Conclusion The combination of group painting therapy and clozapine can improve the positive/negativesymptoms of chronic schizophrenia patients, improve their quality of life and social function, and has the characteristicsof good efficacy and high safety, which is worthy of clinical promotion and application.
      【Key words】 Chronic schizophrenia; Group painting therapy; Clozapine; Social function; Quality of life