中医运动疗法对精神分裂症患者阴性症状改善的系统评价

向婷婷 罗尧岳 蒋小剑 刘娟 肖美慧

〔摘要〕 目的 系统性评价中医运动疗法对精神分裂症患者阴性症状改善的疗效，并比较不同中医运动方式、运动频率之间的效果差异。方法 通过检索中国知网、万方、维普、PubMed、Embase数据库，严格按纳入、排除标准筛选中医运动疗法干预精神分裂症患者的随机对照试验，检索建库至2020年11月。评价纳入文献偏倚风险后，采用RevMan 5.3进行Meta分析。结果 共纳入9项研究，893例患者，中医运动组的阴性症状量表（scale for the assessment of negative symptoms， SANS）、阳性与阴性症状量表评分均高于对照组（P<0.05）。但采取不同运动形式、运动频率的患者，SANS评分比较，差异无统计学意义（P>0.05）。结论 中医运动疗法在改善精神分裂症患者阴性症状方面具有明显疗效，值得临床推广。

〔关键词〕 精神分裂症;中医运动疗法;阴性症状;系统评价

〔中图分类号〕R277.7       〔文献标志码〕A        〔文章编号〕doi：10.3969/j.issn.1674-070X.2021.12.018

Systematic Review of Traditional Chinese Medicine Exercise Therapy on Improvement of

Negative Symptoms in Treating Schizophrenic Patients

XIANG Tingting1， LUO Yaoyue1， JIANG Xiaojian1*， LIU Juan2， XIAO Meihui1

（1. School of Nursing， Hunan University of Chinese Medicine， Changsha， Hunan 410208， China;

2. Ningxia Medical University， Yinchuan， Ningxia 750004， China）

〔Abstract〕 Objective To systematically evaluate the efficacy of traditional Chinese medicine （TCM） exercise therapy in the improvement of negative symptoms in patients with schizophrenia， and to compare the appilication difference in TCM exercise modes and exercise frequencies. Methods The databases of CNKI， Wanfang， VIP， PubMed， Embase were searched， and randomized controlled trials of TCM exercise therapy intervention in schizophrenia were screened strictly in accordance with the inclusion and exclusion criteria， the retrieval limit time was set up until November 2020. After the risk of bias in the included literature was evaluated， Meta analysis was conducted by RevMan 5.3 software. Results A total of 9 studies were included， including 893 patients. The scores of the negative symptom scale （SANS） and positive and negative symptom scale in the TCM exercise group were higher than those in the conventional group （P<0.05）. However， there was no statistical significance in SANS scores of patients with different exercise forms and frequency （P>0.05）. Conclusion TCM exercise therapy has obvious efficacy in improving negative symptoms of schizophrenia patients， and is worthy of clinical promotion.

〔Keywords〕 schizophrenia; TCM exercise therapy; negative symptoms; systematic review

精神分裂症是一种慢性、重型精神疾病，全球患病率为0.33%～0.75%[1]，由于精神分裂症的高复发率和高致残率，对社会和家庭造成沉重负担，已成为一项重大公共卫生问题[2]。目前，精神分裂症仍以药物治疗为主。但是，研究[3]表明，药物治疗仅能控制患者的阳性症状，对阴性症状的改善作用有限。若阴性症状的发展得不到有效控制，患者将会出现严重的社会功能衰退[4]。为寻找解决措施，临床开展了大量研究，发现一定强度的运动训练能够改善精神分裂症患者的阴性症状[5-6]。中医运动疗法是有氧运动与冥想运动的结合，强调身心融合与放松，常见的有太极拳、八段锦、易筋经、六字诀、五禽戏等[7]，虽然这些方法在用于改善精神分裂症患者阴性症状方面已有研究，但无系统综述对其总体疗效进行评价。……