基于中医症型辨证施护对精神分裂症(癫症)患者精神症状及社会功能的影响
Effects of Traditional Chinese Medicine Syndrome-Based Nursing Care on Psychiatric Symptoms and Social Function in Patients with Schizophrenia (Dian Syndrome)
DOI: 10.12677/ns.2026.159284, PDF,    科研立项经费支持
作者: 吴邢超, 李 可, 周春芬, 樊丽琴, 易鹏程*：象山县第三人民医院精神科，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；癫症；中医症型；辨证施护；阴性症状；Schizophrenia； Dian Syndrome； TCM Syndrome Types； Syndrome-Based Nursing； Negative Symptoms
摘要: 目的：探讨基于中医症型辨证施护对精神分裂症(癫症)患者精神症状、阴性症状、日常生活能力及中医证候的改善效果。方法：选取2025年6月至2026年5月在本院住院的以阴性症状为主的精神分裂症患者150例，采用区组随机化方法，按住院顺序编号，以1:4比例随机抽取30例为对照组(接受精神科常规护理)，120例为研究组，根据中医辨证分为心脾两虚证、痰气郁结证、肝气犯脾证、脾肾阳虚证四型，分别给予对应的中医辨证护理方案。干预时间8周。比较两组干预前后阳性与阴性症状量表(PANSS)、阴性症状量表(SANS)、日常生活能力量表(ADL)及中医证候积分变化。结果：干预后，研究组PANSS总分、SANS总分、ADL评分及中医证候积分改善均显著优于对照组(P < 0.05)，效应量Cohen’s d值分别为0.68、0.74、0.62和0.71。其中，心脾两虚证和脾肾阳虚证患者在阴性症状及日常生活能力方面的改善最为明显。结论：基于中医症型的辨证施护方案可有效改善癫症患者的精神症状、阴性症状及日常生活能力，降低中医证候积分，具有一定的临床推广应用价值。
Abstract: Objective: To explore the effects of syndrome-based nursing care on psychiatric symptoms, negative symptoms, daily living ability, and Traditional Chinese Medicine (TCM) syndromes in patients with schizophrenia (Dian syndrome). Methods: A total of 150 inpatients with predominantly negative symptoms of schizophrenia from June 2025 to May 2026 were enrolled. Using a block randomization method with a 1:4 ratio, 30 patients were assigned to the control group (receiving routine psychiatric care) and 120 to the study group. The study group was further divided into four TCM syndrome types: Heart-Spleen Deficiency, Phlegm-Qi Stagnation, Liver-Qi Invading Spleen, and Spleen-Kidney Yang Deficiency, each receiving corresponding syndrome-based nursing protocols for 8 weeks. Changes in the Positive and Negative Syndrome Scale (PANSS), Scale for the Assessment of Negative Symptoms (SANS), Activities of Daily Living (ADL) scale, and TCM syndrome scores were compared between the two groups before and after intervention. Results: After intervention, the study group showed significantly greater improvements in PANSS total score, SANS total score, ADL score, and TCM syndrome scores compared to the control group (P < 0.05), with Cohen’s d effect sizes of 0.68, 0.74, 0.62, and 0.71, respectively. Patients with Heart-Spleen Deficiency and Spleen-Kidney Yang Deficiency exhibited the most prominent improvements in negative symptoms and daily living ability. Conclusion: The syndrome-based nursing protocol can effectively improve psychiatric symptoms, negative symptoms, and daily living ability, and reduce TCM syndrome scores in patients with Dian syndrome, demonstrating potential for clinical application.
文章引用：吴邢超, 李可, 周春芬, 樊丽琴, 戴天刚, 易鹏程. 基于中医症型辨证施护对精神分裂症(癫症)患者精神症状及社会功能的影响[J]. 护理学, 2026, 15(9): 18-26. https://doi.org/10.12677/ns.2026.159284

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