针灸推拿对精神分裂症患者阴性症状及认知功能的影响研究
A Study on the Effects of Acupuncture and Massage on Negative Symptoms and Cognitive Function in Patients with Schizophrenia
DOI: 10.12677/ijpn.2025.144010, PDF,    科研立项经费支持
作者: 应珊珊：象山县第三人民医院中医精神科，浙江 宁波；蒋达平, 叶 琪, 易鹏程*：象山县第三人民医院普通精神科，浙江 宁波；戴天刚：象山县中医医院睡眠障碍科，浙江 宁波
关键词: 精神分裂症；阴性症状；认知功能；针灸；阿立哌唑；Schizophrenia； Negative Symptoms； Cognitive Function； Acupuncture； Aripiprazole
摘要: 目的：探讨针灸联合阿立哌唑对精神分裂症患者阴性症状及认知功能的改善作用。方法：选取象山县中医医院医疗健康集团三院院区符合诊断标准的精神分裂症患者93例(研究组46例、对照组47例)。研究组在阿立哌唑药物治疗基础上给予针灸干预，对照组仅接受阿立哌唑药物治疗。经过12周的治疗，比较两组的阴性症状评定量表(SANS)和精神分裂症认知功能成套测验(MCCB)得分的差异。结果：治疗12周后，研究组阴性症状和认知功能整体改善情况均优于对照组(P < 0.05)；SANS中，情感淡漠、迟钝意志缺乏和注意障碍维度评分差异具有统计学意义(P < 0.05)。MCCB中，工作记忆与处理速度评分差异具有统计学意义(P < 0.05)。两组不良反应发生率差异无统计学意义(P > 0.05)。结论：针灸联合阿立哌唑治疗可减轻精神分裂症阴性症状并改善认知功能，且安全性良好。
Abstract: Objective: To investigate the therapeutic effect of acupuncture combined with aripiprazole on negative symptoms and cognitive function in patients with schizophrenia. Methods: Ninety-three patients with schizophrenia who met the diagnostic criteria were selected from the Third Hospital Campus Affiliated to Xiangshan County Traditional Chinese Medicine Hospital Healthcare Group (46 in the study group and 47 in the control group). The study group received acupuncture intervention in addition to aripiprazole medication, while the control group received aripiprazole medication only. After 12 weeks of treatment, the differences in scores on the Scale for the Assessment of Negative Symptoms (SANS) and the MATRICS Consensus Cognitive Battery (MCCB) were compared between the two groups. Results: After 12 weeks of treatment, the overall improvement in negative symptoms and cognitive function in the study group was superior to that of the control group (P < 0.05). Specifically, within the SANS scale, the differences in the scores for the dimensions of avolition-apathy, anhedonia-asociality, and attention impairment were statistically significant (P < 0.05). Within the MCCB, the differences in the scores for working memory and processing speed were statistically significant (P < 0.05). However, there was no statistically significant difference in the incidence of adverse reactions between the two groups (P > 0.05). Conclusion: Acupuncture combined with aripiprazole can alleviate negative symptoms and improve cognitive function in patients with schizophrenia, with a good safety profile.
文章引用：应珊珊, 蒋达平, 叶琪, 戴天刚, 易鹏程. 针灸推拿对精神分裂症患者阴性症状及认知功能的影响研究[J]. 国际神经精神科学杂志, 2025, 14(4): 76-82. https://doi.org/10.12677/ijpn.2025.144010

参考文献

[1] Galderisi, S., Mucci, A., Buchanan, R.W. and Arango, C. (2018) Negative Symptoms of Schizophrenia: New Developments and Unanswered Research Questions. The Lancet Psychiatry, 5, 664-677. [Google Scholar] [CrossRef] [PubMed]
[2] Wang, D., Schneider-Thoma, J., Siafis, S., Qin, M., Wu, H., Zhu, Y., et al. (2024) Efficacy, Acceptability and Side-Effects of Oral versus Long-Acting-Injectables Antipsychotics: Systematic Review and Network Meta-Analysis. European Neuropsychopharmacology, 83, 11-18. [Google Scholar] [CrossRef] [PubMed]
[3] Tu, C., MacDonald, I. and Chen, Y. (2019) The Effects of Acupuncture on Glutamatergic Neurotransmission in Depression, Anxiety, Schizophrenia, and Alzheimer’s Disease: A Review of the Literature. Frontiers in Psychiatry, 10, Article 14. [Google Scholar] [CrossRef] [PubMed]
[4] Huang, C., Zhang, P., Dong, Y., Chang, R., Lao, J., Li, Z., et al. (2023) A Meta-Analysis on the Efficacy of Acupuncture as an Adjuvant Therapy for Schizophrenia. Neuropsychiatric Disease and Treatment, 19, 2381-2400. [Google Scholar] [CrossRef] [PubMed]
[5] Qin, S., Zhang, Z., Zhao, Y., Liu, J., Qiu, J., Gong, Y., et al. (2022) The Impact of Acupuncture on Neuroplasticity after Ischemic Stroke: A Literature Review and Perspectives. Frontiers in Cellular Neuroscience, 16, Article 817732. [Google Scholar] [CrossRef] [PubMed]
[6] Levine, S.Z. and Leucht, S. (2013) Identifying Clinically Meaningful Symptom Response Cut-Off Values on the SANS in Predominant Negative Symptoms. Schizophrenia Research, 145, 125-127. [Google Scholar] [CrossRef] [PubMed]
[7] Gray, B.E., McMahon, R.P., Green, M.F., Seidman, L.J., Mesholam-Gately, R.I., Kern, R.S., et al. (2014) Detecting Reliable Cognitive Change in Individual Patients with the MATRICS Consensus Cognitive Battery. Schizophrenia Research, 159, 182-187. [Google Scholar] [CrossRef] [PubMed]
[8] 路广义, 付继勇, 孟月兰, 等. 残留型精神分裂症社会功能状态及其与阴性症状、认知功能的关系[J]. 国际精神病学杂志, 2025, 52(4): 1037-1040.
[9] Faris, P., Pischedda, D., Palesi, F. and D’Angelo, E. (2024) New Clues for the Role of Cerebellum in Schizophrenia and the Associated Cognitive Impairment. Frontiers in Cellular Neuroscience, 18, Article 1386583. [Google Scholar] [CrossRef] [PubMed]
[10] Tsapakis, E.M., Treiber, M., Mitkani, C., Drakaki, Z., Cholevas, A., Spanaki, C., et al. (2024) Pharmacological Treatments of Negative Symptoms in Schizophrenia—An Update. Journal of Clinical Medicine, 13, Article 5637. [Google Scholar] [CrossRef] [PubMed]
[11] Wang, X., Wang, J., Han, R., Yu, C. and Shen, F. (2024) Neural Circuit Mechanisms of Acupuncture Effect: Where Are We Now? Frontiers in Neurology, 15, Article 1399925. [Google Scholar] [CrossRef] [PubMed]
[12] 崔哲, 王晓琳, 田勇. 认知康复治疗对精神分裂症患者认知功能障碍及社会功能的影响研究[J]. 心理月刊, 2024, 19(5): 55-57.
[13] 罗诗蕾, 詹松华, 陈义磊, 等. 基于ReHo方法探究针刺百会穴脑效应的性别差异[J]. 中国中西医结合影像学杂志2019, 18(1): 3-7, 21.
[14] Li, J., Wu, X., Yan, S., Shen, J., Tong, T., Aslam, M.S., et al. (2024) Understanding the Antidepressant Mechanisms of Acupuncture: Targeting Hippocampal Neuroinflammation, Oxidative Stress, Neuroplasticity, and Apoptosis in CUMS Rats. Molecular Neurobiology, 62, 4221-4236. [Google Scholar] [CrossRef] [PubMed]
[15] Sun, Z., Liu, J., Guo, W., Jiang, T., Ma, C., Li, W., et al. (2016) Serum Brain-Derived Neurotrophic Factor Levels Associate with Cognitive Improvement in Patients with Schizophrenia Treated with Electroacupuncture. Psychiatry Research, 244, 370-375. [Google Scholar] [CrossRef] [PubMed]