摘要
目的:探讨有氧运动对抑郁症缓解期患者认知功能的改善作用。方法:采用随机数字表法将抑郁症缓解期的出院患者分为运动组(63例)和非运动组(62例),运动组在药物维持治疗的基础上进行有氧运动训练,非运动组单纯药物维持治疗。分别在基线、第8周、第16周时采用神经心理学测验包括韦氏记忆量表中文版的数字广度-顺背(Digit Span-Sequential Order,DS-SO)、数字广度-倒背(Digit Span-Reversed Order,DS-RO)和视觉再生测验、连线测验、持续操作测验(Continuous Performance Task,CPT)、词语流畅性测验(Verbal Fluency Test,VFT)评价患者认知功能情况,采用简单效应分析方法比较不同时间点的组内或组间差异。结果:基线时2组认知功能各项目评分差异均无统计学意义。8周后运动组较非运动组认知功能部分改善,连线测验-A部分(Trail Making Test-A,TMT-A)结果[(51.4±19.1)s与(56.9±21.9)s,t=4.53,P<0.01]、VFT评分[(20.4±5.6)分与(18.7±5.4)分,t=1.73,P=0.09]、连线测验-B部分(Trail Making Test-B,TMT-B)结果[(80.3±37.3)s与(96.6±38.4)s,t=-2.41,P=0.01]差异有统计学意义。16周后运动组较非运动组认知功能显著改善,TMT-A结果[(44.2±16.4)s与(53.4±19.0)s,t=-2.90,P<0.01]、CPT评分[(98.8±10.7)分与(91.4±11.8)分,t=3.67,P<0.01]、VFT评分[(23.1±5.4)分与(19.4±5.2)分,t=3.90,P<0.01]和TMT-B结果[(77.9±30.7)s与(92.9±35.6)s,t=-2.52,P=0.01]差异均具有统计学意义。简单效应分析显示,运动组第8周较基线时TMT-A、CPT、TMT-B评分差异有统计学意义(F=22.46、17.47、32.92,均P<0.01);第16周与基线时相比TMT-A、CPT、DS-RO、视觉再生测验、VFT、TMT-B评分差异均有统计学意义(F=23.31、18.46、4.37、5.58、12.24、28.83,均P<0.01)。干预第8、16周后同一时间点运动组TMT-A、CPT、VFT、TMT-B的分值和变化值以及DS-SO、DS-RO的变化值与非运动组比较差异均有统计学意义。结论:16周有氧运动可有效改善抑郁症缓解期患者的认知功能。
Objective To explore the efficacy of aerobic exercise on the improvement of cognitive function in patients with depression in remission stage.Methods The discharged patients with depression in remission stage were randomly divided into exercise group(n=63)and non-exercise group(n=62).The exercise group received aerobic exercise training on the basis of drug maintenance therapy,and the non-exercise group received drug maintenance therapy only.Neuropsychological tests were used to evaluate participant′s cognitive functions at baseline,8 weeks and 16 weeks by using digital span-antegrade(Digit Span-Sequential Order,DS-SO),digital span-inversion(Digit Span-Reversed Order,DS-RO),visual regeneration(Visual Reproduction,VR)of the Chinese version of the Wechsler memory scale,connection test(Trail Making Test,TMT,continuous performance test(Continuous Performance Task,CPT)and word fluency test(Verbal Fluency Test,VFT).Difference comparisons between the two groups were conducted.Simple effect analysis was used to compare the differences.Results There was no significant difference in the scores of cognitive function between the two groups at baseline.After 8 weeks of aerobic training,the cognitive function of the exercise group was partially improved compared with the non-exercise group,and there were significant differences in TMT-A score((51.4±19.1)s vs.(56.9±21.9)s,t=4.53,P<0.01),VFT score(20.4±5.6 vs.18.7±5.4,t=1.73,P=0.09)and TMT-B score((80.3±37.3)s vs.(96.6±38.4)s,t=-2.41,P=0.01).After 16 weeks of aerobic training,the cognitive function of the exercise group was significantly better than that of the non-exercise group.TMT-A((44.2±16.4)s vs.(53.4±19.0)s,t=-2.90,P<0.01),CPT(98.8±10.7 vs.91.4±11.8,t=3.67,P<0.01),VFT score(23.1±5.4 vs.19.4±5.2,t=3.90,P<0.01),and TMT-B((77.9±30.7)s vs.(92.9±35.6)s,t=-2.52,P=0.01)were significantly better than those of the non-exercise group.Compared with the baseline,simple effect analysis showed that there were significant differences in the scores of TMT-A,CPT and TMT-B at the week-8(F=22.46,17.47,32.92,all P<0.01),and in the scores of TMT-A,CPT,DS-RO,VR,VFT and TMT-B at week-16 in the exercise group(F=23.31,18.46,4.37,5.58,12.24,28.83,all P<0.01).The scores and the changes of TMAT-A,CPT,VFT,TMT-B,DS-SO and DS-RO in the exercise group were significantly different from those in the non-exercise group.Conclusion 16-week aerobic exercise can effectively improve the cognitive function of patients with depression in remission stage.
作者
陈倩倩
许瑞智
汪晓静
陈统献
汤义平
Chen Qianqian;Xu Ruizhi;Wang Xiaojing;Chen Tongxian;Tang Yiping(Department of Psychosomatic Diseases,Taizhou Second People′s Hospital,Taizhou 317200,China)
出处
《中华精神科杂志》
CAS
CSCD
北大核心
2021年第1期25-30,共6页
Chinese Journal of Psychiatry
基金
浙江省医药卫生科技计划项目 (2018KY182)。
关键词
抑郁症
运动疗法
认知
随机对照试验
Depressive disorder
Exercise therapy
Cognition
Randomized controlled trial
