• P311

  Abstract withdrawn

• P312
  道家 认知治疗的临床应用 - Daoistic Cognitive Therapy: Review of Clinical Applications
  金富 朱 1
  1 新 乡医学院 , 心理学系 , 新 乡市 , Chinese Mainland
  
  Daoistic Cognitive Psychotherapy has been developed and applied for one decade in China . A group of therapists have carried out this indigenous therapy for Chinese patents suffering from various kinds of psychiatric disorders, such as: anxiety disorders, depression and coronary heart diseases. Based on the clinical experiences it has illustrated clearly that the Doistic cognitive therapy is particularly useful for the patients who are suffering from psychosomatic disorders, particularly of coronary heart disease. In general, the therapy works better for the patients who are in the middle age or older, have higher education, and less severe emotional symptoms of anxiety or depression. It is effective for patients who are suffering from burden of overwork or overanxious for achievement. In contrast, it is not effective for young patients who are thriving for their success in their personal career and persons who are less educated and do not appreciated the philosophical concepts of Daoism. Clinical experiences also show that the effectiveness of the therapy will be better if the course of therapy last at least for about ten sessions within the period of one to three months. If it is necessary, medication can be applied to enhance the improvement. Finally, the patient's cognitive ability to comprehend and accept the main point of the philosophical thought of Daoism is the key for the success of the Daoistic cognitive psychotherapy.
   
  

• P313
  中 药配合心理疗法治疗妇女更年期不寐 129 例 临床研究 - Clinical Study on Treatment based on Effects of Chinese Traditional Medicine and Psychotherapy in 129 Cases of women' Menopause Insomnia
  丽丽 张 1 , 1
  1 河北工程大学医学院中医系教研室 , 邯 郸 , Chinese Mainland
  
  目的 : 观察中药 配合心理 疗法治疗妇女更年期不寐的临床疗效。
  方法 : 129 例更年期女性失眠患者随机分 为两组。治疗组 76 例采用中 药葆神驭寐饮为基本方辨证施药 ， 配合心理行为疗法 ； 对照组 53 例 单用西药舒乐安定 2mg 。以 临床综合疗效、中医证候疗效及睡眠质量改善情况为指标进行临床疗效对照观察。
  结果： 治 疗组综合临床疗效明显优于对照组。（ P<0.05 ）
  结论 : 中 药配合心理疗法能明显提高妇女更年期不寐的临床疗效。
  主 题词 妇女更年期不寐 / 中 药配合心理疗法 @ 葆神 驭寐饮
  
  Abstract goal: The observation Chinese native medicine coordination psychotherapy treats the clinical curative effect which the woman menopause does not sleep.
  Method: 129 example menopause female loses sleep the patient to divide into two groups stochastically. The treatment group 76 examples use the Chinese native medicine dialectically to execute the medicine for base we, the coordinate psychology behavior therapy; The control group 53 examples only use the western medicine to extend stabilize 2mg happy. Take the clinical synthesis curative effect, the Chinese medicine card period of five days curative effect and the sleep quality improvement situation carries on the clinical curative effect comparison observation as the target. （ P<0.05 ）
  Conclusion: The Chinese native medicine coordination psychotherapy can obviously enhance the clinical curative effect which the woman menopause does not sleep.
   
  

• P314
  认知行为疗法对首发精神分裂症患者治疗依从性的影响 - The Effects of Cognitive Behavior Therapy (CBT) in Therapeutic Compliance of First-Episode Schizophrenics
  Zhenwu Ma 1 , Meixiang Li 1 , Yuxin Wan 1
  1 Henan Mental Hospital, Henan Xinxiang, Chinese Mainland
  
  摘要 : 目的 : 探 讨认知行为疗法对首发精神分裂症患者治疗依从性的影响。
  方法 ： 将首 发精神分裂症患者 80 例 , 随机分 为两组 ， 认知行为治疗组和对照组 ， 两组均采用利培酮治疗。用简明精神病评定量表 (BPRS) 评定疗效 ， 以及副反应量表 (TESS) 评定副反应。比较两者的服药依从性。经 6 个月、 1 年的随 访观察 , 分 别对两组的复发率进行比较。
  结果： 治 疗 8 周后 2 组疗效无显著性差异。认知行为治疗组完全依从（占 67.5% ）， 显著高于对照组（ 40% ）；不依从（占 2.5% ）， 则显著低于对照组（占 22.5% ）； 6 个月、 1 年后 认知行为治疗组复发率低于对照组 (P<0.05~0.01) 。
  结论 : 认知行为疗法能明显提高首发精神分裂症患者的治疗依从性 ， 减少疾病的复发率。
  关键词 : 认知行为疗法 ; 首 发精神分裂症 ； 治疗依从性
  
  Objective: To explore the effects of Cognitive Behavior Therapy(CBT) in therapeutic compliance of first-episode schizophrenics.
  Methods: 80 first-episode schizophrenics were randomly divided into CBT group and control group,and risperidone was used in two groups individually.Brief Psychiatric Rating Scale(BPRS) and Treatment Emergent Symptoms Scale(TESS) were used to evaluate efficacy and adverse reaction.Recurrent rate of two groups were compared after 6 months and 12 months.
  Results: After 8 weeks,there was not significant difference in efficacy between two groups,complete compliance of CBT group(67.5%) was higher than control group(40%) significantly.Recurrent rate was lower than control group after 6 months and 12 months(p<0.05 ～ 0.01).
  Conclusion: CBT can improve therapeutic compliance of first-episode schizophrenics and reduce recurrant rate.
  Key words: congnitive behavior therapy;first-episode schizophrenia;theraputic compliance
   
  

• P315
  家庭参与青少年抑郁和行 为问题的小组治疗 - Family Groups in the Treatment of Adolescence with Depression and Behavior Problems
  晓利 柏 1 , 洪 鸿 1 , 李 梅 1 , 孙晓 峰 1
  1 北京友 谊医 院 , 神 经内科 , 北京 , Chinese Mainland
  
  青少年抑郁的治 疗是目前青少年心理障碍治疗中的难点。各治疗学派从自家的理论出发进行治疗，但干预效果并不理想。目前的研究认为，青少年抑郁的形成过程中，家庭是一个重要因素。将家庭纳入治疗计划，可以在促进青少年自我改变的同时，协助其建立有利于情绪和行为改变的家庭环境。同时结合导致抑郁的各种因素，从更加全面的角度思考、建立干预手段，为抑郁青少年的治疗康复提供更为有效的方法。我国对青少年抑郁的心理因素和治疗的研究，不论是理论基础还是临床实践都在刚刚起步的阶段 。从 2004 年至 2007 年，我 们针对约 300 名 9-21 岁的存在抑郁和行为问题的青少年进行小组治疗，每组的治疗时间为 36 小 时。同时，进行了其家长的心理教育小组。在青少年小组治疗中的内容主要包括自我概念的建立，如何交朋友，情绪管理，和父母沟通以及降低危险行为的训练。家长小组的内容包括对于疾病和药物的认识，亲子沟通、自我压力管理以及寻找社会支持。家长和青少年对于小组治疗均有较高的满意度且在小组治疗后，家庭亲密度、家庭成员管理情绪的能力均有所改善。中国青少年抑郁的发病近年呈增加的趋势，由此带来一系列家庭和社会问题。针对青少年抑郁的心理治疗，在药物和个体心理治疗的同时，可以将多个家庭组成小组，并将促进家庭的改变纳入治疗计划。它对于提高治疗效果 ， 减少复发有积极的作用 ， 这种模式在我国青少年抑郁的临床治疗实践中将有很大的发展空间。 主席 ： 柏 晓利
  
  Aims: The treatment of adolescent depression is a difficulty in the psychotherapy. Each school of therapy has his own theory but the effect was not ideal. The affection of family was an important factor in the adolescent depression. The model including not only the therapy to adolescences but also the psychoeducation to parents may help to set up a better circumstance beneficial to the improvement of the young's emotions and behaviors. The practices could be done in families, schools and residential areas in other countries. It also will help to found a full-scale means to intervene.
  Methods: In China , it was only the first step both in the academic study and the clinical practice in adolescence depression. From 2004-2007, we had made 36 hours group psychotherapy to nearly 300 adolescences from 9-21 years old with depression and behavior problems. At the same time, their parents were made psychoeducation in groups. In the adolescence groups, the main methods include the foundation of self-concept, how to make friends with others, emotion management, communicating with parents and reducing dangerous behaviors. In parents' sessions, the main contents include the knowledge about depression and medication, communications with adolescence, stress management to themselves and social supports. The results is both parents and adolescences were satisfied with the program. Their ability to manage emotions were higher, and the family adaptability and cohesion are improved.
  In china, Adolescence depression has increased in recent years, and brought a serious of family and social problems. The treatment to depressed adolescence may include psychoeducation to the whole family besides the individual psychotherapy and the medication. The model may provide the curative effect and reduce the relapse. It will have a wide field in clinical therapy to adolescence depression in China .
   
  

• P316
  精神分裂症系 统家庭治疗的前瞻性研究 - Three Year Prospect Control Treat of Systemic Family Treatment for Schizophrenic Patients
  明廉 张 1 , 建 军 姚 1 , 素琴 倪 1 , 宝富 安 1
  1 无 锡精神卫生中心 , 精神科 , 无 锡市 , Chinese Mainland
  
  目的 : 评估系统家庭治疗对精神分裂症患者的综合治疗效果和对照料者心身健康的影响。
  方法 : 140 例精神分裂症患者随机分 为治疗组和对照组 ， 在两组均使用抗精神病药物治疗的基础上 ， 仅对治疗组辅以系统家庭治疗 ， 并于治疗前后采 用 PANSS 、 DAS 及 GHQ 评估临床疗效及亲属的心身健康状况和统计两组的复发率。
  结果 : 两 组复发率随访 1 年末分 别为 19.0% 和 35.4% （ P<0.05 ）； 随 访 3 年末分 别为 22.9% 和 52.8% （ P<0.01 ） 。治 疗组出院时和随访 3 年末 PANSS 评分分别为（ 48.1±7.8 ）和（ 40.3±8.6 ）（ P<0.01 ）； 对照组分别为（ 47.5±8.6 ）和（ 48.3±9.9 ）（ P>0.05 ）。治 疗组治疗前和随访 3 年末 DAS 评分分别为（ 17.8±4.1 ）和（ 8.5±3.7 ）（ P<0.01 ）； 对照组分别为（ 16.8±8.1 ）和（ 15.4±4.9 ）（ P>0.05 ）。治 疗组治疗前和随访 3 年末 GHQ 评分分别为（ 4.8±4.1 ）和（ 3.2±2.6 ）（ P<0.05 ）； 对照组分别为（ 4.5±3.9 ）和（ 4.3±3.7 ）（ P>0.05 ）。
  结论 : 系 统家庭治疗可以降低精神分裂症患者的复发率 ， 减轻其精神症状和社会功能残疾程度 ， 并在一定程度上改善照料者心身健康状况。
  
  Objects: The aim was to evaluate the effect of systemic family treatment for schizophrenic patients and the effect of mental and physical health for the relatives of patients.
  Methods: The cases in family group were provided systemic family treatment, while the control group were only followed by regular clinic visits.
  Results: The relapse rates of psychotic symptoms in family and control groups were 19.0% and 35.4% (P<0.05) at the end of 1st year, 22.9% and 52.8% (P<0.01) at the end of 3rd years. In family group the PANSS were (48.1±7.8) and (40.3±8.6) (P<0.01) ， the DAS were (17.8±4.1) and (8.5±3.7)(P<0.01) ， the GHQ were (4.8±4.1) and (3.2±2.6)(P<0.05)at baseline and the end of 3rd year. In control group the PANSS were (47.5±8.6) and (48.3±9.9) (P>0.05) ， the DAS were (16.8±8.1) and (15.4±4.9) (P>0.05) ， the GHQ of control group were (4.5±3.9) and (4.3±3.7) (P>0.05) at baseline and the end of 3rd year.
  Conclusions: Systemic family treatment can reduces the relapse, improve the symptoms and the social function, also improve mental and physical health of the relatives of patients.
   
  

• P317
  家庭支持性心理治 疗对精神分裂症复发的影响 - Effect of Backup Psychotherapy in Family on Schizophrenic Recrudescence
  陆平 蒋 1
  1 海南省安宁医院 , 海口 , Chinese Mainland
  
  目的 ： 探 讨家庭支持性心理治疗和精神分裂症复发的关系。
  方法 ： 对 90 例精神分裂症患者 ， 随机分 为研究组 45 人 ， 对照组 45 人。研究 组出院后除药物治疗外均接受系统的心理治疗，对照组只用药物治疗。
  结果： 二年后，研究 组复发率为 33% ， 对照组为 56% 。两 组间有显著性差异（ P<0.01 ）。
  结论： 家庭支持性心理治 疗是促进康复，降低精神分裂症复发的有效方法。
  关键词 ： 家庭支持性心理治 疗 ； 精神分裂症 ； 复发
  
  Objective: To study ralationgship between backup psychotherapy in family and schizophrenic recrudescence.
  Methods: 90 patients with schizophrenia were randomly divided into, medication group(control group, 45 patients) and medication combined with psychotherapy groups(study group, 45 patients).
  Results: Relapse rate is 33% in study group and 56% in control group after treating two years ,there was significant difference between two groups.
  Conclusion: Backup psychotherapy in family is a effective means to reducing schizophrenic recrudescence and accelerating healing.
  Key words: Backup psychotherapy; Family; Schizophrenia; Recrudescence
   
  

• P318
  住院精神病患者心 脏性猝死的预测与护理对策研究 - The Study on Prediction and Nursing Strategy to Hospitalized Patients with Mental Disorder under the Risk of Sudden Heart Attack
  靖 张 1 , 杰 郭 1
  1 天津市安定医院 , 天津市 , Chinese Mainland
  
  心 脏猝死 （ sudden cardia death ， SCD ） 指由于心 脏原因所致的突然而出乎意料的自然死亡。住院治疗的老年精神病患者往往合并一种或多种躯体疾病，如冠心病、高血压、 糖尿病等，而且 长期服用精神药物，有的甚至多种药物联合使用。高龄、体弱、躯体疾病以及药物的不良反应，使得这些患者成为精神科 SCD 发生的高危人群，给临床护理工作带来一定的难度。在治疗过程中，认真观察患者的病情变化的同时提高预测心血管不良事件发生的报警信号十分必要。总结内容包括：（！） SCD 相 关因素 ①季 节与时间； ②精神状 态的改变； ③ 饱餐与拒食； ④便秘与用力排便；⑤感染；⑥精神 药物以及其他药物； ⑦体位改 变。（ 2 ） 观测心率价值：室早本身潜在的具有致心律失常作用，使得 SCD 危 险度加剧 [2] 。因此 对那些伴有器质性心脏病的 老年精神病患者，如果 发现有室早，及时通知医师作进一步检查。典型抗精神病药物中低效价药物比高效价药物更容易诱发窦性心动过速，如氯丙嗪。非典型抗精神病药物氯氮平在治疗初期有四分之一的患者会出现心动过速。随着心率增快，促发心绞痛甚至 SCD 。 药物过量；静脉注入药物速度过快；在正常剂量范围，由于个体差异或药物蓄积作用；呼吸功能障碍；以及不规范联合用药，都会导致药物中毒，其结局有 4 个，即①心 动过缓， ②肺水 肿， ③窒息，④哮喘。其中一 种损害或多种损害协同作用均会导致猝死。住院期间，老年精神病人的长时间卧床、安全性约束护理 使得冠脉回流增加， 纤维蛋白溶解系统和血栓形成系统调节异常，血氧饱和度降低，加之 HRV 减弱， 导致 SCD 发生的危险性增加。（ 3 ） 护理对策： ① 长期密切监测生命指标是防治 SCD 最根本的 护理措施之一。 ②加 强夜 间巡视。 ③ 严密观察先兆症状。 ④ 便秘的 预防及护理。 ⑤ 宣教。
  关键词 : 心 脏性猝死 ； 精神疾病 ； 心率
   
  

• P319
  培 训儿科工作人员在儿科病人急性期护理中提供心理护理 . 背景 ： 行 为研究结果 - Educating Staff to Provide Mental Health Care for Paediatric Patients in an Acute Care Setting: Results of an Action Research Study
  Lorna J Moxham 1 , Kerry Reid-Searl 1 , Trudy Dwyer 1 , Julie Kahl 2 , Brenda Happell 3
  1 Central Queensland University, Nursing and Health Studies, Rockhampton,, Australia, 2 Rockhampton Hospital, Paediatric Unit, Rockhampton,, Australia, 3 Central Queensland University, Nursing and Health Studies, Rockhampton, Australia
  
  儿科 护士常没有正规的心理健康护理资质。由于儿童发生心理问题的比例增加，这部分病人对病房工作提出了新的挑战，期望儿科病房的工作人员能为这一人群提供服务。 本文 调查了儿科的工作人员如何通过一个共享行动研究计划为有心理障碍的儿童提供服务。对问题的确认，对政策和 程序、医院和政府 报告的回顾，评估工具以及正在进行中的评估这些都会在讨论中说明。
  
  Nurses in paediatric settings often have limited and/or no formal qualifications in mental health. Due to an increase in admission rates of children with mental health disorders, staff in childrens wards are expected to provide care for this challenging group. This paper will examine how paediatric staff have been empowered to deliver care to children with mental health disorders using a process of participatory action research. Identification of the problem, review of policy and procedures, hospital and government reports, measurement tools and in progress evaluation will inform the discussion.
  

• P320
  急性 综合性医院心理卫生会诊联络护士的任务 - The Role of the Mental Health Consultation Liaison Nurse in an Acute General Hospital Setting
  Paul Robson 1 , Lorna Moxham 2
  1 Rockhampton Hospital, Mental Health, Emu park, Queensland, Australia, 2 Central Queensland University, Nursing and Health Studies, Rockhampton, Australia
  
  现在 ， 提供心理护理已经成为主流。由此，综合性医院不得不面对普通病房中伴有心理问题的病人。 主 诉有心理问题的病人比例持续上升，这已使那些没有 接受 过心理健康培训的医护人员感到不安，他们缺乏这一专业领域的技能。解决这个问题的方法之一是引入一个心理卫生的新角色 - 心理 卫生会诊联络护士。 本文介 绍了心理卫生会诊联络护士这个新角色 ， 并调查其如何使综合性医院的护士能够为她们的病人提供合适而有效的心理卫生护理。
  
  With mainstreaming now common in health care delivery, general hopsitals are having to deal with many patients who are in general wards but have mental health issues. Admission rates for patients who have mental health issues continue to rise and this causes some anxiety among staff who have not had mental health training and who have little or no skills in this specialist field. One of the ways to address this was to introduce a new mental health role - the Mental Health Consultation Liaison Nurse. This paper describes this role and examines how it has contributed to the empowerment of nurses in general settings to deliver appropriate and effective mental health care to patients in general hospitals.
   
  

• P321
  康 复期精神分裂症和双相情感障碍患者自知力的差异及其影响因素 - Differences of Insight and its Influencing Factors between Patients with Schizophrenia and Bipolar Disorder during Rehabilitation Period
  Zhong-Meng Guo 1 , Feng Liang 1 , Kan Li 1 , Sheng-Jun Zou 1
  1 Psychiatric Hospital of Jiangxi Province, Nanchang, Chinese Mainland
  
  目的 ： 探 讨康复期精神分裂症与双相情感障碍患者自知力的差异及其影响因素。

  方法 : 对 40 例精神分裂症患者、 30 例精神病性双相障碍患者及 32 例非 精神病性双相障碍患者的自知力及其影响因素 进行评估，并作 Logistic 回 归分析。
  结果 : 精神分裂症患者的自知力与情神病性双相障碍患者的自知力差异无 显著性〔 x2=0.038, P=0.812 〕 . 但两者的自知力 评分均低于非精神病性双相障碍患者 , 差异有 显著性意义 (P<0.05 ) 。 在康 复期，有 36% 的精神分裂症、 38% 的精神病性双相障障以及 10% 的非精神病性双相障碍患者存在自知力 损害。精神分裂症组患者的自知力损害是非精神病性双相障碍组患者的 4.65 倍 (95%CI=1.02-20.80) ，而精神病性双相障碍患者的自知力 损害为非精神病性双相障碍组的 5.72 倍 (95%CI=1.30-24.76 ) 。
  结论 : 康 复期少数患者存在自知力损 害，影响患者自知力恢 复的主要因素为精神病性症状。
  
  Aim: To explore differences of insight and its influencing factors between patients with schizophrenia and bipolar disorder during rehabilitation period.
  Methods: The insight and its affecting factors were assessed in 40 patients with schizophrenia, 30 patients with psychotic bipolar disorder(PBD) and 32 patients with non-psychotic bipolar disorder(NPBD), and then the Logistic regression analysis was conducted.
  Results: There was no significant difference in insight between patients with schizophrenia and PBD(x2=0.038,p=0.812),but both were significantly lower than that of patients with NPBD (P<0.05) . During the rehabitation period,insight impairment existed in 36% with schizophrenia, 38% with PBD and 10% with NPBD, the insight impairment of the patients with schizophrenia was 4.65 times severer than that of patients with PBD (95%CI=1.02-20.80), which was 5.72 times severer than that of patients with NPBD (95%CI=1.30-24.76).
  Conclusion: Insight impairment exists in a few patients.The main affecting factor of insight recovery is the psychotic symptom.
   
  

• P322
  【摘要】 目的 ： 观察行为治疗改善慢性精神分裂症患者日常生活不良行为的效果。方法 ： 我们将 40 例住院 10 年以上的慢性精神分裂症 ， 分 为两组 ： 一组行为治疗联合药物治疗 ， 另一组单纯性应用药物治疗 ， 对其结果进行评价研究。行为治疗 6 个月。采用 阴性、阳性量表和日常生活活动能力测定量表作为评定工具，于治疗前后进行疗效评定。结果：行为治疗后，阴性、阳性量表及日常生活量表评分后治疗后比治疗前日常生活有很大的改善，生活提高了，精神症状也有了明显改善。结论：行为治疗能有效改善长期住院的慢性精神分裂症患者的日常生活不良行为，能激起病人的原始行为，增强体质，延缓了病人的衰退。 【 关键词】 行 为治疗，慢性精神分裂症，日常生活不良行为
  聚保 路 1
  1 上海市静安区精神 卫生中心 , 上海市 , Chinese Mainland
  
  长期住院的精神分裂症患者大部分都以阴性症状为主，主要表现为生活极度懒散，缺乏主动性，人际交往能力差，存在不同程度的适应不良。 代 币强化行为治疗以训练和建立良好的适应行为为目标，以病人的渴求的方式，当病人出现良性行为时，通过代币劵换取病人最喜欢的东西，从而矫正不良心理和行为。
  方法： 评定工具为采用阴性、阳性量表和日常生活活动能力测定量表。
  具体 实施方法由 3 名医 师根据每日检查病人遵守行为标准的情况，采取循序渐进的方法对病人存在的问题进行逐步整改，做到每月有重点，每周有计划，每天训练 1 次， 训练有有专职工作人员负责，实行集体辅导与个人辅导相结合采取物质奖励与精神奖励相结合，对遵守行为标准的患者实行代币劵，代币劵可以对换自己想要的物品。 5 代 币劵可以对换 1 包 饼干或 2 支香烟， 10 代 币劵可以对换 5 支香烟， 15 代 币劵可以对换 1 本 书或 10 支香烟， 20 代 币劵可以对换 15 支香烟， 25 代 币劵可以对换一包香烟或工作人员陪同外出购物一次。每周回收 1 次代 币劵并根据病人的需要实现病人的愿望，也可以随时对换物品，同时每个月把代币劵获得最多的病人评选为优秀病人。
  讨论： 目前，我国精神病人都是采取封 闭式的管理方法，由于长期住院和药物的影响都会使病人出现不同程度的不良行为，过着刻板的生活，出现住院综合征，使患者的康复受到了严重的影响。通过对病人不良行为的矫正，本人认为对长期住院的慢性精神患者实施行为治疗措施，能 有效地提高他 们生活的主动性，提高了生活水平，树立了他们对生活的信心，对人生价值有了重新的认识，对全面康复起到了很好的作用
  
  Purpose: Observe the effect of behavior treatment on improving daily life of chronic schizophrenia patients.
  Method: We divide 40 chronic schizophrenia patients, who stayed in the hospital for over 10 years, into two groups. One group is treated by behavior treatment as well as medicine treatment; another group is treated only by medicine treatment. Then we carry on evaluation and research on treatment results after 6 months. Negative, positive and daily life ability graphs are applied as evaluation tools on daily life ability. Treatment result will be assessed before and after the treatment.
  Result: After behavior treatment, Negative, positive and daily life ability graphs show that patients' daily life ability, mood, and spirit symptom are greatly improved.
  Conclusion: Behavior treatment is very effective on improving bad daily life behavior of chronic schizophrenia patients who stay in hospital for a long period of time. It can stimulate patient's original behavior, boost up physical status and delay disease deterioration.
  Keywords: behavior treatment, chronic schizophrenia, bad daily behavior
   
  

• P323
  日本精神分裂症住院病人出院可能性与其 临床和功能状态的相关性 - Associations between the Possibility of Discharge and Clinical and Functional Status among Schizophrenic Inpatients in Japan
  Yoshio Mino 1 , Iwao Oshima 2
  1 Osaka Prefecture University, Mental Health Section, School of Human Science, Sakai, Japan, 2 Tokyo University of Social Work, Tokyo, Japan
  
  背景 ： 有些研究探 讨了精神障碍患者从精神病院出院的可 能性 ， 然而并没有研究 对精神科医生如何判断精神病人是否可以出院 ， 回归社会进行探索。判断的有效性没有被调查过。
  方法： 对 549 名住院一年或一年以上的精神分裂症患者的出院判断 进行调查。精神科医生判断的有效性用大体评定量表（ GAS ）作 为金标准。分析了精神科医生对出院的判断与简明精神病评定量表（ BPRS ）， 阴性症状评定量表（ SANS ）， GAS ，病人 对出院的态度，其他因素之间的关系。
  结果： 精神科医生 对出院的判断与 GAS 间有很好的一致性。通过 Logistic 多元回 归分析控制了潜在的混杂因素后，判断与 BPRS-P ， SANS ， GAS 及病人的 态度间显著相关。
  结论 ： 精神科医生 对出院的判断是准确的 ， 而且是综合考虑了病人的精神病症状 ， 社会功能及其愿望后的一个全面的决定。
  
  Background: There have been some studies about the possibility to be discharged for mentally ill inpatients from mental hospitals. However no study has attempted to investigate how a psychiatrist judge that an inpatient should be discharged to community. Validity of the judgment has not been investigated.
  Methods: Survey about the judgment about discharge was conducted among 549 schizophrenic inpatients with 1 year or more hospital stay. Validity of the psychiatrists' judgment was evaluated with Global Assessment Scale (GAS) as the gold standard. Relationships between psychiatrists' judgment about discharge and Brief Psychiatric Rating Scale (BPRS), Scales for the Assessment of Negative Symptoms (SANS), GAS, patients' attitudes to discharge and other variables were investigated.
  Results: Psychiatrists' judgment to be discharged had good validity with GAS. After controlling for potential confounding factors using multiple logistic regression analysis, the judgment had significant relationships with BPRS-P, SANS, GAS, and patients' attitude.
  Conclusions: Psychiatrists' judgment about discharge is principally valid, and is comprehensive decision considering psychiatric symptoms, social function, and patients' will.
   
  

• P324
  家庭干 预对精神分裂症患者社会康复的作用 - The Effectment for Social Healing of Family Intervention on Patients with Schizophrenia
  明廉 张 1 , 宝富 安 1 , 素琴 倪 1 , 晓刚 陈 1
  1 无 锡精神卫生中心 , 精神科 , 无 锡市 , Chinese Mainland
  
  方法 ： 探 讨家庭干预对精神分裂症患者社会功能康复的影响。
  方法 : 将符合 CCMD-3 精神分裂症 诊断标准的患者 150 例随机分 为家庭组和对照组。家庭组在接受抗精神病药物治疗的同时 ， 给予家庭干预治疗 ， 对照组单一给予药物治疗。采用社会功能残疾评定量表（ DAS ）和生活 质量量表（ QOULI ） 评定精神分裂症患者的残疾程度和生活质量。
  结果： 观察 3 年，家庭 组治疗依从性 82.7% ， 显著高于对照组 41.3% （ P<0.01 ）， 复发率 22.7% ， 显著低于对照组 50.7% （ P<0.01 ）。社会功能残疾家庭 组显著轻于对照组（ P<0.01 ），生活 质量家庭组显著好于对照组（ P<0.05 ）
  结论： 精神分裂症 给予精神药物 治 疗配合家庭干预可以提高依从性，减少复发率，降低社会残疾程度和改善社会功能。
  
  Objective: The aim of this study was to evaluate the effectiveness of family intervention for healing of Schizophrenic patients.
  Methods: 150 Patients with Schizophrenia were randomly divided into family group and control group patients. Family group received drug treatment and family intervention, while patients in the Control group received drug treatment only. All the patients were evaluated with Dysfunction Assessment Scale(DAS) and Generic Quality of Life Inventory(GQOLI).
  Results: In three years the dependence of family group was better than in control group （ 82.7%vs41.3% ）（ P<0.01 ） .The relapse rates of family group was lower than in control group(22.7%vs50.7%) （ P<0.01 ） .The social function of family group was better than in control group （ P<0.01 ） . The quality of life of family group was better than in control group （ P<0.05 ） .
  Conclusion: Family intervention can enhance the dependence, reduce the relapse rates, improve the social function.
   
  

• P325
  Quetiapine vs Perphenazine in Behavioral and Psychological Symptoms of Dementia in Age
  启琴 文 1 , 洁华 孔 2 , 凤霞 黄 2 , 建平 陈 2 , 世超 徐 2 , 卫仙 符 2 , 全球 温 2 , 昌武 徐 2 , C7
  1 广州市精神病医院 , 早期干 预科 3 区 , 广州市 , Chinese Mainland, 2 广州市精神病医院 , 广州市 , Chinese Mainland
  
  目的 ： 比 较奎硫平 （ 思瑞康 ） 和奋乃静对治疗老年痴呆精神行为症状的疗效和安全性。

  方法 : 111 例住院病人 ，① 符合 CCMD-3 中阿 尔茨海默氏病 （ AD ） 和血管性痴呆 （ VD ） 所致精神障碍的 诊断标准 ； ② 痴呆病理行 为评定量表 （ BEHAVE-AD ） 总分 ≥ 8 分 ， 简易精神状况检查表 （ MMSE ）＜ 24 分。奎硫平 组（奎组） 58 例， 奋乃静组（奋组） 53 例，两 组病人性别、年龄、诊断、病程、 MMSE 总分、 ADL 总分和基线 BEHAVE-AD 评分均无显著差异。奎组平均剂量（ 137±80 ） mg/d ； 奋组平均剂量（ 4.8±2.4 ） mg/d 。 疗程 12 周。 疗效观察分别在治疗前及治疗后 4 、 8 、 12 周末 应用 BEHAVE-AD 评定总分，减 分率 ≥ 30 ％～＜ 60 ％ 为有效， ≥ 60 ％ 为显效，＜ 30 ％ 为无效 . 以 TESS 评定不良反应，治疗前后检查血常规、尿常规、肝功能、肾功能、心电图和脑电图。
  结果： 治 疗前后 BEHAVE-AD 评分显示两种药物对老年痴呆的精神行为症状有显著疗效，两药疗效相当。奎组治疗后 4 周减分明 显，两组比较有明显差异。奎组显效率、有效率分别为 48.27 ％、 81.03 ％， 奋组分别为 45.28 ％， 79.24 ％，两 组间比较均 P ＞ 0.05 。不良反 应：两组病人治疗前后血常规、尿常规、肾功能和脑电图检查无特殊。肝功能异常者 10 例，奎 组 3 例， 奋组 7 例， 对证处理后均恢复正常。奎组锥体外系不良反应 3 例（ 5.17 ％）， 奋组不良反应 45 例（ 84.09 ％）， P ＜ 0 ． 05 。 两 组间有显著性差异。治疗前后 MMSE 和 ADL 评分显示两药对认知和生活功能无影响。
  结论： 奎硫平和 奋乃静治疗老年痴呆的精神行为症状有效，治疗 12 周后有效率与国内外 报道一致。本研究发现奎硫平起效更快，能快速控制老年痴呆病人的精神行为症状。奎组不良反应发生率低，程度轻，特别是锥体外系不良反应发生率显著低于奋乃静组，支持国内外已有的报道结果。老年人躯体疾病较多 ， 选用不良反应少的药物更容易耐受 ， 风险也相对较小。两药短期应用均不损害认知功能。
  
  Objective: T0 assess the efficacy and safety of quetiapine and perphenazine in the treatment of behavioral and psychological symptoms of dementia (BPSD) ．
  Methods: A randomized comparative study was carried out for 58 patients of quetiapine group which were treated with quetiapine25~400 mg/d,(137±80)mg/d, individually ； and 53 patients of perphenazine group received perphenazine2~20 mg/d, (4 ． 8±1 ． 4)mg/d,individually ； with a course of 12 week ． BEHAVE-AD was used for the pathogenesis analysis of dementia before and after treatment ． TESS was taken for the evaluation of the efficacy and adverse reactions during treatment ．
  Results: After 12 week treatment, the scores of BEHAVE-AD of patients in both groups were significantly reduced (P<0.01)but no significant difference between them (P>0.05) ． The incidence of EPS was 5.17 ％ in quetiapine group ， which was significantly lower than 84.09 ％ in perphenazine group (P<0 ． 05).
  Conclusion: Quetiapine and perphenazine show good efficacy for treating BPSD ． Quetiapine is better with less adverse reaction ．
  
• 326
  社区精神疾病患者 监护人的现况调查 - A Cross-sectional Investigation on the Guardians of Mental Disorder Patients in Community
  寿宝 张 1 , 玉美 成 1 , 怀惠 张 1 , 美康 黄 2
  1 上海市 杨浦区精神卫生中心 , 上海市 , Chinese Mainland, 2 上海市 杨浦区老年医院 , 上海市 , Chinese Mainland
  
  目的 ： 了解社区精神疾病患者 监护人的监护能力及对患者病情的影响。
  方法 ： 在上海市 杨浦区某社区随机抽取 780 名精神疾病患者 监护人 ， 对其监护能力 （ 包括家庭经济收入、监护人年龄、监护人身体状况、监护人行为能力、责任能力等 ） 进行评估。使用大体评定量表（ GAS ） 对被监护患者的精神疾病进行综合评定。
  结果： 1 、 780 名 监护人中，男性 378 人，女性 402 人，平均年 龄为（ 54±9.7 ） 岁；已婚 606 人，离异、 丧偶 174 人；文化程度：文盲 73 人，小学 166 人，初、高中 554 人，大 专以上 104 人。被 监护的精神 疾病患者中，精神分裂症 695 例，情感障碍 16 例，精神 发育迟滞 19 例，老年痴呆 37 例，其他 13 例。 2 、 经总体评估， 42.4% 监护人的监护能力较好， 38.4% 为一般， 19.2% 较差。 3 、 监护能力较好组的患者按医嘱服药率、门诊随访率和 GAS 评分均高于一般组和较差组，差异有显著统计学意义（ P<0.05 ）。
  结论 ： 社区精神疾病患者 监护人的监护能力较低 ， 其监护能力影响患者的病情控制。
  

  Objective ： To explore the guard capability of mental disorder patients' guardians in community and how the guard capability can effect on the control of psychosis.
  Method ： 780 guardians of mental disorder patients in a community of Shanghai Yangpu district were investigated, and the patients were evaluated by GAS.
  Results ： 1 、 There were 378 male and 402 female in 780guardians with mean age of 54±9.68 years, and 606 guardians were married, 174 divorced or lose spouse. 73 guardians were illiterate, 166 only attended elementary school, 554 attended middle school, 104 got university diploma. There were 695 schizophrenia, 16 affective disorder, 19 mental retardation, 37 senile dementia and 13 patients with other diagnose. 2 、 42.4% guardians' guard capability are better, 38.4% are common and 19.2% worse. 3 、 The patients with better guard had higher GAS score, higher rate of overdose and clinic follow-up than patients with common and worse guard （ P<0.05 ） .
  Conclusion ： The guard capability of mental disorder patients' guardians in community are weak, and can effect on the control of psychosis.
   
  

• P327
  Prevent and Solve Mental Diseases from the Root
  Hong Chen 1 , Jie Ya Chen 2
  1 World Federation of Chinese Medicine Societies, Beijing, Chinese Mainland, 2 Haidian third Experimental Primary School, Beijing, Chinese Mainland
  
  Objectives: Use "Chan Ding"(called by Buddhism)therapy to improve immunology ability,to prevent the mental diseases before it attack persons.
  Methods: "Excessive grief,sorrow,worry and melancholy will affect the heart, when the heart is affected, the whole body--both pysically and mentally will all be stirred in accordance. "(from one of the older documents on medicine named Miraculous Pivot) Buddhism focus in heart's training. Tcm think emotions affect the functional activities of Chi Flow. Powerful Chi Flow can resist pathogenic factors which means immunological techniques. How to build up Chi Flow power to resist pathogenic factors (tcm)? How to improve immunology ability (modern medicine)? The meaning of the two questions above is the same. Get to the point, Chan Ding IS THE WAY!
  Results: 1) Mental medication brings both good and bad effects to patients.“good“ is to reduce the sympothy,"bad" is to cause side effects. 2) Other methods can reduce the sympothy as well as mental medication and they have at least less "bad" effects.Why not choose those methods in place of pills? For example,we can use either Bai Youjie pills to cure depression or use other therapys which are more effectively.I don't think it is the best choice to take medication to solve mental problems,even if it could bring a quick fix,the problems would happened again and again! 3) It's cheaper to protect your health now rather than to fix the problem later on.mental edication is useful to reduce the sympothy guickly,but it can't solve the disease from the root,it's useless for Etiology of disease.
  Conclusions: In order to get to Chan Ding,man should first overcome 7 sins (christians) or 3 sins(Buddhism),and then heshe can get to Chan Ding. When Chan Ding starts, healthy life both pysically and mentally comes, also high level inteligence, instinct all come with you (with correct purpors and correct methods).
   
  

• P328
  行 为治疗对改善慢性精神分裂症患者日常生活的作用 上海市静安区精神 卫生中心 - The Effect of Behavior Therapy on Chronic Schizophrenia Patients′ Daily Life Activities
  聚保 路 1
  1 上海市静安区精神 卫生中心 , 住院部 , 上海 , Chinese Taipai
  
  目的 ： 观察行为治疗改善慢性精神分裂症患者日常生活不良行为的效果。
  方法 ： 我 们将 40 例住院 10 年以上的慢性精神分裂症 ， 分 为两组 ： 一组行为治疗联合药物治疗 ， 另一组单纯性应用药物治疗 ， 对其结果进行评价研究。行为治疗 6 个月。采用 阴性、阳性量表和日常生活活动能力测定量表作为评定工具，于治疗前后进行疗效评定。
  结果： 行 为治疗后，阴性、阳性量表及日常生活量表评分后治疗后比治疗前日常生活有很大的改善，生活提高了，精神症状也有了明显改善。
  结论： 行 为治疗能有效改善长期住院的慢 性精神分裂症患者的日常生活不良行 为，能激起病人的原始行为，增强体质，延缓了病人的衰退。
  关键词 : 行 为治疗 ， 慢性精神分裂症 ， 日常生活不良行为
  
  Purpose: Observe the effect of behavior treatment on improving daily life of chronic schizophrenia patients.
  Method: We divide 40 chronic schizophrenia patients, who stayed in the hospital for over 10 years, into two groups. One group is treated by behavior treatment as well as medicine treatment; another group is treated only by medicine treatment. Then we carry on evaluation and research on treatment results after 6 months. Negative, positive and daily life ability graphs are applied as evaluation tools on daily life ability. Treatment result will be assessed before and after the treatment.
  Result: After behavior treatment, Negative, positive and daily life ability graphs show that patients' daily life ability, mood, and spirit symptom are greatly improved.
  Conclusion: Behavior treatment is very effective on improving bad daily life behavior of chronic schizophrenia patients who stay in hospital for a long period of time. It can stimulate patient's original behavior, boost up physical status and delay disease deterioration.
  Keyword: behavior treatment, chronic schizophrenia, bad daily behavior
   
  

• P329
  应激干预抑郁障碍患者心理生理指标的影响 - Influencing of Physical and Psychological Index on Intervention of Stress in Patients with Depressive Disorders
  朝霞 苏 1 , 学 义 王 1 , 青翠 王 1
  1 河北医科大学第一附属医院精神 卫生中心 , 石家庄 , Chinese Mainland
  
  目的 ： 介 绍抑郁障碍患者心理生理指标的特点及测量 ， 探讨应激干预对抑郁障碍患者心理生理指标的影响。资料来源：应用计算机检索 Medline 1996-01/2006-12 与 应激干预抑郁障碍患者及抑郁患者心理生理指标相关的文章，检索词为 “Stress-coping ， Relaxation training ， Inactivity ， Depression ， Anxiety ， heart-rate-variability” ， 限定文献 语种为 “English” ；万方数据 库 2004/2007 有 关文章，检索词为 “ 应激干预，放松训练，静坐，抑郁症，焦虑，心率变异性 ” ，并限定文章 语言种类为中文。
  资料选择： 共搜集到 300 余篇文献， 选择与放松训练及静坐相关的临床研究文献，无论是否随机、有无对照组都纳入，排除基础研究和重复文献。资料提炼：共纳入 35 篇文献 进行综述，其中 9 篇介 绍应激与抑郁及应激干预方式， 18 篇 陈述抑郁患 者心理生理指 标的特点及测量，另外 8 篇探 讨应激干预对抑郁患者心理生理指标的影响。
  资料综合： ①早期 应激会导致个体抑郁易感性，成年期抑郁障碍是由于素质因素和应激的交互作用而产生的。较低的心率变异性是患有抑郁症的心脏患者的死亡率比没有抑郁症的心脏患者死亡率高的原因。 ②目前 较常用的测量心理生理的指标有皮电、心率及心率变异性。 ③抑郁症的 应激干预包括早期和成年期间应激干预，临床上以成年期应激干预为主。放松技术作为最常用的应激干预技术对抑郁症有着较好的应用效果。放松训练和静坐都可以让正常人和抑郁症患者放松，使交感神经活动 下降，但是放松 训练的效果要好于静坐放松训练。
  结论： 放松 训练对抑郁症和正常人都有效果，但从皮电和心率等指标可以发现，抑郁症伴焦虑症患者的反应效果要好于单纯抑郁患者和正常人，故放松训练对抑郁症伴焦虑症患者是一种很好的辅助治疗方法。
   
  

• P330
  The Effect of the Depressed Patients' Physiopsychological Indexes Resulting from Stress-coping
  Zhaoxia Su 1 , Xueyi Wang 1 , Qingcui Wang 1
  1 First Hospital of Hehei Medical University, Shijiazhuang, Chinese Mainland
  
  Aim: Introduce the characteristics and measuring of physiopsychological indexes and the effects on the indexes by stress-coping.
  Source of data: The theses concerning the depressed patients and their physiopsychological indexes by stress-coping come from computer Searching (Medline 1996-01/2006-12 & WanFang Data 2004/2007). The searching words are “ stress-coping ， relaxation training ， inactivity ， depression ， anxiety ， heart-rate-variability”, and the thesis in Medline are all written in English and the thesis in WanFang Data are all written in Chinese.
  Selection of data: More than 300 articles are collected within which research documents on relaxation training and inactivity are selected with the exception of basic studies and repetitive researches.
  Abstraction of data: The summarization is based on the 35 articles having been selected.
  Synthesis of data: The stress at an early stage may result in individual susceptibility of depression, and the depression in adult may arise from the interplay of the diathesis and the stressor. Owing to the low heart-rate-variability(HRV), the death rate of cardiopathy patients with depression is higher than that of cardiopathy patients without depression. The most commonly used indexes include galvanic skin response ， heart rate and the HRV. The stress-coping of depression includes the stress-coping at an early stage and in adulthood. The clinical stress-coping is mainly applied to adults. As the most commonly practiced technique, the relaxation technique has a better practical effect. It can alleviate the sufferers' negative emotion and physical response aroused by stressor. Relaxation and sitting quietly can reduce the activity of both the depressed patients and the normal persons' sympathetic nerve, and the effect of relaxation training is better than that of inactivity.
  Conclusion: Both relaxation training and inactivity can be effective on the depressed patients and normal persons, and the effect on the depressed patients with anxiety is better than that on the pure depressed ones and the normal persons. Therefore, relaxation training is a very good auxiliary remedy.
   
  

• P331
  精神分裂症患者社会康 复 - Social Healing of Schizophrenic Patients
  Zhen Guo 1 , 明廉 张 2 , 建 军 姚 3
  1 WuXi Mental Health Center, WuXi, Chinese Mainland, 2 无 锡精神卫生中心 , 无 锡市 , Chinese Mainland, 3 无 锡精神卫生中心 , 无 锡 , Chinese Mainland
  
  目的 ： 探 讨家庭干预对精神分裂症患者社会功能康复的影响。
  方法 : 将符合 CCMD-3 精神分裂症 诊断标准的患者 160 例随机分 为家庭组 (80 例 ) 和 对照组 (80 例 ) 。家庭 组在接受抗精神病药物治疗的同时 ， 给予家庭干预治疗 ， 对照组单一给予药物治疗。采用社会功能残疾评定量表（ DAS ）和生活 质量量表（ QOULI ） 评定精神分裂症患者的残疾程度和生活质量。
  结果： 家庭 组治疗依从性显著高于对照组（ P<0.01 ）， 复发率显著低于对照组（ P<0.05 ）。社会功能残疾家庭 组显著轻于对照组（ P<0.01 ），生活 质量家庭组显著好于对照组（ P<0.05 ）
  结论： 精神分裂症 给予精神药物治疗配合家庭干预可以提高依从性，减少复发率，降低社会残疾程度和改善社会功能。
  
  Objective: The aim of this study was to evaluate the effectiveness of family intervention for healing of Schizophrenic patients.
  Methods: 180 Patients with Schizophrenia were randomly divided into family group (n=80) and control group patients (n=80). Family group received drug treatment and family intervention, while patients in the Control group received drug treatment only. All the patients were evaluated with Dysfunction Assessment Scale(DAS) and Generic Quality of Life Inventory(GQOLI).
  Results: The dependence of family group was better than in control group （ P<0.01 ） .The relapse rates of family group was lower than in control group （ P<0.05 ） . The social function of family group was better than in control group （ P<0.01 ） . The quality of life of family group was better than in control group （ P<0.05 ） .
  Conclusion: Family intervention can enhance the dependence, reduce the relapse rates, improve the social function.
   
  

• P332
  A Randomized, Double-blind, Multicenter Study Comparing Efficacy and Safety of Quetiapine and Lithium in the Treatment of Acute Mania
  Niufan Gu 1 , Huafang Li 2 , Cui Ma 3 , Gang Wang 4 , Shiping Xie 5 , Xiaoping Wang 6 , Xiufeng Xu 7 , Xin Yu 8
  1 Shanghai Mental Health Center, Psychiatry, Shanghai, Chinese Mainland, 2 Shanghai Mental Health Center, Shanghai, Chinese Mainland, 3 Guang Zhou Brain Hospital, Guangzhou, Chinese Mainland, 4 Anding Hospital, Beijing, Chinese Mainland, 5 Nanjing Brain Hospital, Nanjing, Chinese Mainland, 6 Renmin Hospital, Wuhan University, Wuhan, Chinese Mainland, 7 No.1 Hospital of Kunming Medical College, Kunming, Chinese Mainland, 8 Mental Health Institute, Beijing University, Beijing, Chinese Mainland
  
  Objective: To evaluate the efficacy and safety of quetiapine fumarate used as monotherapy in the treatment of symptoms of acute mania in patients with bipolar disorder.
  Methods: The study was designed as randomized, double blind, double dummy, active controlled, multicenter trial. Patients with bipolar disorder hospitalized for the treatment of an acute manic episode (based on the Chinese Classification of Mental Disorders version 3; CCMD-3) and Young Mania Rating Scale (YMRS) total score ≥20 were randomized to receive quetiapine (twice daily up to 800 mg/day; dose titration according to the prescribing information) or lithium (twice daily up to 2000 mg/day; dose titration according to the prescribing information). Primary endpoint: change of YMRS total score from baseline to Day 28 (last observation carried forward; LOCF). Secondary endpoints included: response rate (50% reduction in YMRS total score), changes of MADRS and PANSS total score at Day 28. Safety was evaluated by adverse events (AEs), laboratory test and ECG.
  Results: 155 patients were randomized: (78, quetiapine; 77, lithium). ITT included 154 subjects (77 respectively). Mean doses were 642.9 mg/day and 1377.7 mg/day for quetiapine and lithium respectively. Changes of YMRS total score from baseline to Day 28 in quetiapine and lithium group were 15.9, respectively (p=0.1052). - 18.2 and - At Day 28, the response rate was significantly higher in quetiapine-treated patients (77.9% vs. 59.7%; p=0.0132). Quetiapine was well tolerated up to doses of 800 mg/day; 61 % (quetiapine group) and 53 % (lithium group) of patients reported AEs. The most frequently reported AEs for quetiapine were constipation (34.6%), dizziness (15.4%), and diarrhea (10.3%); compared with nausea(16.9%), constipation (13.0%), and vomiting (13.0%) for lithium. Three subjects in lithium group but none in quetiapine group withdrew due to AEs.
  Conclusions: The study confirms previous finding and shows that quetiapine monotherapy is effective and well tolerated in the treatment of acute mania with bipolar disorder.
  Key words: Acute mania; Quetiapine; Lithium, Randomized controlled trial
   
  

• P333
  精神 药理学和种族性 : 新 进展 - Psychopharmacology and Ethnicity: Recent Advances
  Pedro Ruiz 1
  1 University of Texas Health Science Center at Houston , Psychiatry, Houston , United States
  
  近二十年来 ， 种族精神药理学不仅在美国而且在其他工业化的国家都已经取得了广泛的认可。对此有重要影响的因素是席卷全球的全球化进程和目前从发展中国家到工业化国家的移民潮。除此以外，近 12 至 15 年来，在精神医学 领域占主导地位的神经科学的发展也导致了关于种族、民族和文化，及其与精神药物的交互作用的大量优秀研究的开展。这些研究的核心是遗传药理学 、 药代动力学、药效学以及细胞色素 P450 系 统的作用。种族精神药理学这一新兴的充满希望的领域将会带来对全世界不同种族、民族及文化的人群的精神障碍的药物治疗的新发现。教育的

  目的： 1 、理解 遗传药理学、药代动力学、药效学对不同种族人群的精神药物治疗的作用。 2 、学 习细胞色素 P450 在精神 药物治疗中的作用。 3 、 获得对不同种族人群进行精神药物治疗的专业知识。
  
  The field of ethnopsychopharmacology has achieved much recognition in the last two decades, not only in the United States but in many other industrialized nations as well. The globalization which is taking place all over the world, as well as the extensive migration that is currently taking place from developing countries to industrialized nations have been the major contributing factors in this regard. Additionally, the emphasis on neurosciences, which prevailed in the field of psychiatry during the last 12-15 years, has also led to numerous and excellent research contributions focusing on race, ethnicity and culture, including their interface with psychopharmacology. At the core of these investigative efforts is the role of pharmacogenetics, pharmacokinetics and pharmacodynamics, as well as the cytochome P450 system. Hopefully, these new and promising initiatives in the field of ethnopychopharmacology will lead to additional discoveries in the pharmacological treatment of psychiatric disorders and conditions among the different racial, ethnic and cultural populations all over the world. Educational Objectives 1. To understand the role of pharmacogenetics, pharmacokinetics and pharmacodynamic in the psychopharmacological treatment of different ethnic group. 2. To learn from the role of the cythochrome P-450 in the psychopharmacological treament of psychiatric disorders. 3. To gain expertise in the psychopharmacological treatment of different ethnic populations.
  
• P334
  精神分裂症患者奥氮平血 药浓度监测 65 例分析 - Clinical Monitoring and Analysis of Blood Drug Concentration of Olanzapine in 65 Cases of Patients with Schizophrenia
  明廉 张 1 , 国 桢 袁 1 , 庆 季 1 , 霞 张 1 , C07 精神 药理学和躯体治疗
  1 无 锡精神卫生中心 , 精神科 , 无 锡市 , Chinese Mainland
  
  论文摘要 ： 目 标 ： 监测奥氮平血药浓度、观察临床效应与血药浓度之间的关系 ， 指导合理用药。素材和方法：采用高效液相色谱法监测 65 例 单用奥氮平治疗的精神分裂症患者的血药浓度，同时记录剂量、疗效和不良反应。
  结果： 奥氮平血 药浓度 3.0-86.0μg/L ，平均 (25.5±13.5)μg/L ，血 药浓度和剂量正相关 (r=0.582) 。在有效血 药浓度 10-20μg/L 范 围内 43 例（ 66% ）、 显效 33 例（ 77% ）、 发生不良反应 21 例（ 53% ）， 显效率优于小于 10μg/L 患者的 38% ，不良反 应低于大于 20μg/L 患者的 89% 。只 监测 1 次血 药浓度的患者显效 6 例（ 40% ），多次 监测血药浓度的患者显效 38 例（ 76% ），多次 监测与一次监测患者显效率差异有显著性 (P <0.01) 。
  结论： 奥氮平治 疗精神分裂症患者的血药浓度以 10-20μg/L 为宜，疗效较好，不良反应较少，监测血药浓度有利于调整剂量，提高疗效。
  
  Objective: To monitor blood drug concentration of olanzapine, observe relationship between blood drug concentration and clinical effect, direct medicine treatment with reason.
  Methods: To monitor blood drug concentration of olanzapine by high performance liquid chromatography in 65 caces of patients with schizophrenia, recorde dosage of olanzapine, clinical efficacy and side effects.
  Results: In 65 cases of patients with schizophrenia, range of blood drug concentration of olanzapine was 3.0-86.0 μ g/L, average(25.5±13.5) μ g/L. The best clinical affect was observed in the patients with the serum olanzapine level 10-20 μ g/L ， which was better than ones with serum concentration of less than 10 μ g/L(P<0.05) ， bu no better than that more than 20(P>0.05) ， the dose of olanzapine was positively related to the concentration(r=0.582).
  Conclusion: Range of blood drug concentration for treating patients with schizophrenia by olanzapine was 10-20 μ g/L,it was better therapeutic effects and lower side effects.
   
  
• P335
  低血糖所致精神障碍 误诊为癔症一例 淮安市第三人民医院老年精神科 汤 华 张志艳 - Misdiagnosing the Hypoglycemia as Hysteria: A Case Report
  从杰 王 1
  1 江 苏省淮安市第三人民医院 , 精神科 , 淮安市 , Chinese Mainland
  
  患者 ， 女性 ， 68 岁 ， 文盲 ， 农民。因发作性烦躁不语，行为乱一年加重一月，于 2006 年 6 月 4 日入院。一年前凌晨 3 时许家人发现患者睡梦中出现烦躁不安，大声呻吟，问话不答伴全身大汗淋漓，持续一小时左右缓解，事后不能回忆但生活如常，以后每隔 10 至 20 天 发作一次持续时间一 小 时左右，发作时有时行为乱将自己衣服脱光并将洗后未干衣服穿在身上，有两次将大便涂在身上，近一月来发作频繁几乎每天都有发作，每次发作都在凌晨，持续一两小时自行缓解，发作间隙期生活及家务均正常，患病期间在当地医院多次查脑电图均正常，曾服用抗癫痫药物病情未缓解，既往有糖尿病病史八年，据家人回忆当时血糖略偏高但患者坚持服用二甲双胍 0.5 一日三次， 优降糖 5 ㎎一日三次，八年来一直未 复测血糖。门诊拟癔症性精神障碍收入院，入院后查体无特殊，精神检查：意识清，接触交谈好，问答切题，思维联想正常，对发作经过不能回忆，自述对发作 情况均是事后家人告知。入院次日 实验室检查脑电图、视频脑电图均正常，血糖 3.65mmol/L 。入院后停用降糖 药物后给予维生素 B 观察八天未见发作症状，再次复测血糖 3.95 mmol/L 。出院 诊断低血糖所致精神障碍，出院后停服降糖药物，十月随访无类似发作，生活及劳动均正常。
   
  
• P336
  阿立 哌唑治疗老年精神分裂症临床观察 - Clinical Study of Aripiprazole in Treatment of the Patients with Senile Schizophrenia
  德志 曾 1
  1 咸宁学院附属第二医院 , 咸宁 , Chinese Mainland
  
  目的： 探 讨阿立哌唑治疗老年精神分裂症的疗效与安全性。
  方法： 将 80 例年 龄 ≥60 岁符合中国精神障碍分类与诊断标准第 3 版（ CCMD-3 ）有 关精神分裂症诊断标准的老年精神分裂症患者，随机分为研究组和对照组，每组 40 例，患者家属均知情同意。研究 组用阿立哌唑治疗，起始剂量 5 mg/d ， 2 周内根据 临床反应渐加至 20 mg/d ，最大 剂量 30mg/d ，平均 剂量（ 15.5±9.5 ） mg/d ， 对照组用舒必利治疗，起始剂量 200 mg/d ， 2 周内根据 临床反应渐加至 800 mg/d ，最大 剂量 1000mg/d ，平均 剂量（ 650.5±202.5 ） mg/d ， 观察治疗时间 8 周，治 疗期间不合用其它抗精神病药物或电休克等治疗。在治疗前和治疗后第 1 、 2 、 4 、 8 周末，分 别用阳性与阴性综合征量表（ PANSS ）和治 疗中需处理的不良反应量表（ TESS ） 评定临床疗效与安全性。临床疗效以 PANSS 总分减分率进行判定， ≥75% 为临床痊愈， ≥50% 为显著进步， ≥25% 为进步，＜ 25% 为无效。统计学处理：计量资料用均数 ± 标准差表示，采用配对和成组 t 检验，计数资料用例数和百分比表示，采用 χ2 检验。
  结果： 治 疗 8 周后，研究 组临床痊愈 10 例， 显著进步 15 例， 进步 12 例，无效 3 例； 对照组分别为 11 、 13 、 13 和 3 例；研究 组显效率 62.5% ，有效率 92.5% ， 对照组分别为 60% 和 92.5% ，两 组间差异无显著性意义（均 P>0.05 ）。两 组自治疗后第 2 周末 开始， PANSS 总分和各因子积分均较治疗前有显著性意义的下降（ P<0.05 或 P<0.01 ），但同期比 较两组间差异均无显著性意义（均 P>0.05 ）。研究 组不良反应主要有嗜睡、恶心呕吐、头昏、头痛，大多反应轻微，患者均可耐受，且随着治疗时间延长逐渐消失，未发现心、肝、肾及血液方面的不良反应，研究组不良反应总发生率（ 12/40 ）和各 时段 TESS 评分均显著低于对照组（ P<0.05 或 P<0.01 ）。
  结论： 阿立 哌唑治疗老年精神分裂症疗效确切，与舒必利相当，不良反应少且轻微，临床使用安全，可作为治疗老年精神分裂症的一线药物。
  关键词 : 阿立 哌唑 ； 老年 ； 精神分裂症 ； 疗效 ； 安全性
  
  
  Objective: To explore efficacy and safety of aripiprazole in treatment of the patients with senile schizophrenia.
  Methods: All 80 patients with senile schizophrenia diagnosed according to CCMD-3 criteria were randomly assigned to two groups treated with aripiprazole or sulpiride respectively for 8 weeks.The Positive and Negative Syndrome Scale(PANSS) and Treatment Emergent Side effect Scale (TESS) were used to evaluate the efficacy and advers effect respectively.
  Results: The clinical efficacy had no significant difference between the two groups. The scores of PANSS in two groups after treatment were lower significantly than those before. But the scores of PANSS had no significant difference between the two groups. The incidence of adverse effect in the study group was significantly lower than that in the control group.
  Conclusion: Aripiprazole is as effective as sulpiride in treatment of the patients with senile schizophrenia. But it is much safer than sulpiride.
  Key words ： Aripiprazole ； Senile Schizophrenia ； Efficacy ； Safety
   
  
• P337
  齐拉西酮治疗精神分裂症的疗效与安全性 - Efficacy and Safety of Ziprasidone in Treatment of Schizophrenia
  Jia-sheng Zhu 1 , 精神 药理学
  1 The Second Hospital Affiliated to Xianning University, 咸宁市 , Chinese Mainland
  
  目的 ： 探 讨齐拉西酮治疗精神分裂症的疗效和安全性。
  方法 ： 将 80 例符合中国精神障碍分 类与诊断标准第 3 版 （ CCMD-3 ） 有 关精神分裂症诊断标准的患者随机分为齐拉西酮组 （ 研究组 ， 齐拉西酮治疗 ） 和利培酮组 （ 对照组 ， 利培酮治疗 ）， 每组 40 例 ， 患者家属均知情同意 ， 治 疗观察时间 8 周。 齐拉西酮起始剂量 20mg/d ， 2 周内根据 临床反应逐渐加至 60mg ~160mg/d ，平均（ 115.5±35.5 ） mg/d ；利培 酮起始剂量为 1mg/d ， 2 周内加至 3~5mg/d ，平均 (3.8±0.8)mg/d ，治 疗期间不合用其它抗精神病药物或电休克等治疗。用阳性和阴性综合征量表（ PANSS ）和治 疗中需处理的不良反应量表（ TESS ） 评定临床疗效和药物不良反应。临床疗效根据治疗后第 8 周末 PANSS 总分减分率进行评定 , 减分率 ≥75 ％ 为临床痊愈 , ≥50 ％ 为显著进步， ≥25 ％ 为进步， <25 ％ 为无效。统计分析：计量资料采用配对和成组 t 检验，计数资料用 χ2 检验。
  结果： 治 疗 8 周后， 齐拉西酮组痊愈 14 例， 显著进步 12 例， 进步 8 例，无效 6 例， 显效率 65% ，有效率 85% ；利培 酮组分别为 16 、 11 、 8 和 5 例， 显效率 67.5% ，有效率 87.5% ； 2 组显效率和有效率差异均无显著性意义（ P 均 >0.05 ）。 2 组 PANSS 总分和阳性、阴性症状因子积分从治疗后 2 周末 开始，一般精神病理因子积分从治疗后 4 周末 开始较治疗前有显著意义的下降（ P<0.05 或 0.01 ）。 2 组同期比较，治疗 8 周末， 齐拉西酮组阴性症状因子积分低于利培酮组，而阳性症状因子积分却高于后者，其差异具有统计学意义（ P<0.05 ），其他 时段 2 组间差异无统计学意（ P>0.05 ）。 齐拉西酮组不良反应主要有嗜睡、锥体外系反应、心动过速、心电图异常、头痛和头昏，体重以及女性患者月经周期无明显改变，不良反应总发生率（ 15/40 ）低于利培 酮组（ 24/40 ），月 经改变、体重增加、锥体外系反应亦少于后者，但嗜睡较利培酮组多见，具有统计学意义， P<0.05 或 0.01 ，其余 2 组间差异无显著性意义。
  结论： 齐拉西酮治疗精神分裂症有较好的疗效，与利培酮相当，而不良反应比利培酮更少，临床使用安全，可作为治疗 精神分裂症的一 线药物。
  关键词 ： 齐拉西酮 ； 利培酮 ； 精神分裂症 ； 疗效 ； 安全性
  
  Objective: To explore efficacy and safety of ziprasidone in treatment of schizophrenia.
  Methods: All 80 patients with schizophrenia diagnosed according to CCMD-3 criteria were randomly assigned to two groups treated with ziprasidone or resperidone respectively for 8 weeks. The Positive and Negative Syndrome Scale(PANSS) and Treatment Emergent Side effect Scale (TESS) were used to evaluate the efficacy and advers effect respectively.
  Results: The clinical efficacy had no significant difference between the two groups. The scores of PANSS in two groups after treatment were lower significantly than those before. But the scores of PANSS had no significant difference between the two groups. The incidence of adverse effect in the ziprasidone group was significantly lower than that in the resperidone group. Conclusion: Ziprasidone is as effective as resperidone in treatment of first-episode schizophrenia. But it is much safer than resperidone.
  Key words: Ziprasidone ； Resperidone ； Schizophrenia ； Efficacy ； Safety
   
  
• P338
  颅脑损伤患者家属心理健康状况的调查 - An Investigation on Mental Health Status of the Family Members of Patients with Head Injury
  Quan-xin Sun 1 , Jia-sheng Zhu 1 , Gui-ying Gu 1 , 心理治 疗
  1 The Second Affiliated Hospital of Xianning University, Xianning, Chinese Mainland
  
  目的 ： 颅脑损伤在日常生活中已越来越常见。颅脑损伤不但会危及患者的生命，同时对患者家属的心理带来巨大的冲击，并产生心理问题，严重损害患者家属的心理健康。本研究对颅脑损伤患者家属的心理健康状况及其影响因素进行调查分析，旨在为患者家属进行心理干预提供理论依据。
  方法： 对 80 名 颅脑损伤患者家属采用症状自评量表（ SCL-90 ）、 简易应对方式问卷（ SCSQ ）、艾森克个性 问卷（ EPQ ） 进行调查。将 SCL-90 评分结果与国内常模进行比较，并根据常模规定 SCL-90 的 10 个因子中任何一个 评分超过 2 分就 认为有异常，筛选出有心理问题的患者家属及其心理症状的分布情况。 EPQ 只取内外向（ E ）、情 绪稳定性（ N ） 为统计指标，对患者家属的 EPQ-E 、 EPQ-N 、 应对方式评分与 SCL-90 总分及各因子分进行相关分析。
  结果： 80 名患者家属中男 36 名，女 44 名；年 龄 22 岁 ~61 岁，平均（ 36.6±10.5 ） 岁；已婚 72 名，未婚 8 名；教育年限 5 年 ~17 年，平均（ 10.2±4.2 ）年； 职业：工人 24 名， 农民 12 名，干部 16 名，个体 12 名，其他 16 名；与患者 关系：父（母）子（女） 42 名，配偶 30 名，兄（姐）弟（妹） 8 名。 颅脑损伤患者家属 SCL-90 总分及各因子分均明显高于国内常模（ P 均 <0.01 ）， 80% （ 64/80 ）的患者家属心理健康状况不良，其异常的心理症状 为强迫症状 48 人（ 60% ）， 敌对 40 人（ 50% ），抑郁 36 人（ 45% ），焦 虑 32 人（ 40% ），躯体化症状 32 人（ 40% ），人 际关系敏感 24 人（ 30% ），恐怖、偏 执、精神病性各 20 人（ 25% ）。 积极应对方式、性格内外向（ EPQ-E ）与 SCL-90 呈 显著负相关（ P<0.05~0.01 ），消极 应对方式、情绪稳定性（ EPQ-N ）与 SCL-90 呈 显著正相关（ P<0.05~0.01 ）。
  结论： 颅脑损伤患者家属心理健康状况较差，普遍存在不同程度的心理问题，并受多种因素影响。性格越内向、情绪稳定性越差的患者家属，其心理健康水平越低，积极的应对方式有利于患者家属的心理健康，而消极的应对方式则有损身心健康。因此，临床工作中在重视颅脑损伤患者治疗的同时，不能忽视患者家属的心理问题，应予以心理干预。以提高患者家属的心理健康水平，更好地促进患者的早日康复。
  关键词 : 颅脑损伤 ； 家属 ； 心理健康
  
  Objective: To know the mental health status of the family members of patients with head injury and its influenced factors.
  Methods: 80 family members of patients with head injury were investigated by SCL-90, SCSQ and EPQ.
  Results: Total score of SCL-90 and factors scores in family members of patients with head injury were significantly higher than those in the norm (P all<0.01). 80% (64/80) family members of patients showed bad mental health status, they mainly expressed obsessive symptoms, hostility, depression and anxiety. The positive coping styles and EPQ-E were negatively correlated with SCL-90 (P<0.05~0.01), whereas negative coping styles and EPQ-N were positively correlated with SCL-90(P<0.05~0.01).
  Conclusions: There are many mental health problems in the family members of patients with head injury , and those problems are influenced by mang factors. We should give psychological intervention to family members of patiens.
  Key words: Head injury; Family member; Mental health
   
  
• P339
  精神病学中 药品监管 25 年 - 25 Years of Drug Surveillance in Psychiatry
  Eckart Ruether 1 , Renate Grohmann 2 , Angelica Gruber-Ruether 1
  1 Medical School, University Goettingen, Psychiatry and Psychotherapy, Goettingen, Germany, 2 Medical School LMU Munich, Psychiatry and Psychotherapy, Munich, Germany
  
  目 标 : 药品监管是精神药理学最重要的内容之一。
  方法 : 一 种精神病院中药品监管系统 1979 年 开始于德国 ， 并且从 1992 年 开始延伸到瑞士、奥地利、匈牙利和比利时。 52 个精神病院的超 过 50000 名病人受到了 观察。依据 AMSP 系 统，在使用精神药物进行治疗期间产生的严重药物不良反应 ( ADR ) 受到了 监控。使用处方数据计算 ADRs 的 发生率。
  结果 : 第一代和第二代抗精神病 药物被发现有不同的 ADR 表 现，对不同种类的抗抑郁剂和心境稳定剂也有同样发现。 ADR 风险因素能够得到证实并且与病人的条件和联合用药相关联。血药水平检测显示了重要的药 物相互作用。定 义了与 ADR 相 关的可预防药物。不常见的和未知的 ADR 得以 证实。
  结论 : 药品监管程序对于使用精神药理学药物治疗的病人的安全是必须的 ， 并且必须在所有国家得到政策上的支持。
  
  Objectives: Drug surveillance is one of the most important issues in pharmacopsychiatry.
  Methods: A drug surveillance system in psychiatric hospitals was started in Germany in 1979 and extended to Switzerland , Austria , Hungary and Belgium since 1992. In 52 psychiatric hospitals more than 50000 patients were observed. Severe adverse drug reactions (ADR) during treatment with psychotropic medication were monitored according to the special AMSP sytem. The frequency of ADRs was calculated using the prescription data.
  Results: For antipsychotics of the first and second generation different ADR-profiles were found as well for different classes of antidepressants and mood stabilizers. Riskfactors for ADR could be demonstrated and were related to patients conditions and to combinations of medication. Drug blood level monitoring shows important drug-drug interactions. Preventable drug related ADR were defined. Unusual and unknown ADR were demonstrated.
  Conclusions: Drug surveillance programs are nessecary for the safety of patients treated with psychopharmacological medication and must be supported politically in all countries.
  
• 340
  帕 罗西汀对终末期肾病透析患者的焦虑抑郁障碍的治疗研究 - The Study on Treating Anxious and Depressive Symptom with Paroxetine for Dialysis Patients on Terminal Stage of Nephrosis
  后 锋 赵 1
  1 江 苏省徐州市东方人民医院心理研究所 , 江 苏省徐州市 , Chinese Mainland
  
  目的 ： 抑郁与焦 虑障碍是终末期肾病 （ ESRD ） 病人血透 时最多见的心理问题 ， 本研究将帕罗西汀用于终末期肾病的患者透析期间的辅助治疗 ， 以评价其效果。
  对象与方法 ： 对象　为 2006.07.01—12.31 在徐医附院血液透析中心首次 进行透析且符合入组标准的住院患者 （ 74/237 ） ; 对符合入组标准的患者按顺序分为两组。其中帕罗西汀组 37 人 ，， 帕 罗西汀 （ 葛兰素史克公司 ， 商品名 ： 赛乐特 ） 起始剂量为 10mg/d ， 1 周内逐 渐加至 20-30mg/d ， 平均 22.02±4.17 mg/d) ， 并予以支持性心理治 疗 ,1/w ； 对照组 37 人 ， 予以支持性心理治 疗 ,1/w 。 2. 评定方法：采用 HAMD 、 HAMA 量表于治 疗前、治疗后 1 、 2 、 3 、 4 周末共五个 时点由两名经验丰富的心理科医师进行评定。 3. 统计方法：组间比较采用 SPSS11.0 统计软件进行 t 检验。
  结果： 1.HAMD 及 HAMA 临床疗效分析：与治疗前比较，帕罗西汀组治疗后 1 、 2 、 3 、 4 周末 HAMD 及 HAMA 评分差异具有显著性（ P ＜ 0.01 ）；其中帕 罗西汀组 HAMD 及 HAMA 评分及减分率与对照组均有显著性差异； 2. 不良反 应分析：临床观察结合病人自诉，在帕罗西汀治疗组中有 7 例 (18%) 出 现头痛，但能耐受而未做处理， 3 － 7 天均自行 缓解。
  结论 周安琪于 1993 年 报道较大系列 ESRD 透析病人抑郁焦 虑的总罹患率为 85 ． 11% ， 显著高于同期住院的外科病人，其中抑郁率为 74 ． 47% ，焦 虑为 65 ． 96% 。根据国外的研究， 53% 透析病人有抑郁、焦 虑反应，本研究中重度焦虑与抑郁发生率 31.2% ，因此 应引起临床医师的重视。
  帕 罗西汀作为选择性 5 － 羟色胺（ 5-HT ）再 摄取抑制剂，对抑制 5HT 再 摄取的选择性较同类药物更强，且对于抑郁与焦虑共病治疗有效，本研究显示其对终末期肾病透析患者的焦虑与抑郁症状于第一周末均显改善，且无明显药物副反应，本研究仅发现有 18% 出 现轻度头痛，且能自行缓解。
  综上所述 ， 帕罗西汀能较快缓解终末期肾病透析患者所出现的焦虑抑郁症状 ， 提高治疗依从性。
   
  
• P341
  The Association Analysis between Histamine Receptor Gene Polymorphism and Resperidone's Efficacy
  Qinghe Xing 1 , Mengmeng Zhang 1 , Jiekun Xuan 1 , Lei Wang 1 , Aiping Zhang 1 , Guoyin Feng 1 , Lin He 1
  1 Bio-x center, Shanghai Jiao Tong University, Shanghai, Chinese Mainland
  
  Objectives: Some previous studies supported the hypothesis that the treatment efficacy of risperidone may be associated with histamine receptor (HR). The present study was therefore designed to examine whether polymorphisms of the HR genes are related to therapeutic response.
  Methods: Plasma drug concentrations were monitored by HPLC and clinical symptoms were evaluated using the Brief Psychiatric Rating Scale (BPRS) before and 8 weeks after the treatment. Association tests between genotypes and percentage improvement in total BPRS scores were performed using analyses of variance (ANOVA) in 130 Chinese schizophrenia patients. A total of seven SNPs of four sub-class histamine receptor (H1, H2, H3 and H4) genes were selected and genotyped.
  Results: No significant association between the polymorphisms of HR genes and the risperidone response was found in Chinese schizophrenia patients (all P values > 0.05 after correction by the program SNPSpD).
  Conclusions: Our results do not support the hypothesis that genetic variations in the HR genes may influence the individual response to risperidone.
   
• P342
  拉莫三 嗪合并帕罗西汀治疗双相抑郁的临床研究 - A Clinical Study of Lamotrigine Combined with Paroxetine in Biplor Depression
  兰芬 刘 1
  1 山 东省精神卫生中心 , 济南 , Chinese Mainland
  
  目的 : 探 讨拉莫三嗪合并帕罗西 汀 对双相抑郁的疗效、安全性
  方法 : 符合 标准的 53 例 门诊或住院患者按先后顺序随即分为研究组和对照组 ， 研究组 23 例 ， 应用拉莫三嗪合并帕罗西汀治疗 ， 对照组 30 例 单一应用帕罗西汀治疗 6 周 ， 入 组前先清洗 7 天 （ 清洗期口服安慰 剂 ）， 所有药物均采用口服给药 ， 研究组拉莫三嗪起始剂量 25 mg ， 以后 每周增加 25 mg ， 三周内加至 100 mg ， 最大不超 过 200 mg ， 同 时合并帕罗西汀 ， 固定剂量 20 mg/ d 晨服 ; 对照组患者单一服用帕罗西汀固定剂量 20 mg/ d 晨服。 采用 汉米尔顿抑郁量表 （ HAMD ） 、副反 应量表 （ TESS ） 、大体 评定量表 （ CGI ） 分 别于治疗前、治疗后 1 、 2 、 4 、 6 周末 进行评定。 结果 : 研究 组显效时间 6 ～ 22(10.11 ±8.20) d , 对照组 14 ～ 34 (14.5 ±7.8) d , 以前者起效 较早 ( t = 2.264 , P < 0. 05) 。研究 组完成治疗 21 例 : 其中痊愈 6 例 , 显进 12 例 , 好 转 3 例 , 无效 0, 显效率 85.71 %; 对照组完成治疗 27 例 , 痊愈 7 例 , 显进 15 例 , 好 转 4 例 , 无效 1 例 , 显效率 81.28 %; 两 组间显效率差异无显著性 ( χ 2 = 0.19 , P > 0. 05) 。治 疗后第 1 、 2 、 4 、 6 周末两 组间的 HAMD 评分差异有显著性 ( P 均 < 0. 05 ) ， 治 疗一周末研究组与对照组 HAMD 评分即出现差异显著性 ， 治 疗后第 1 、 2 、 4 、 6 周末两 组间的 TESS 评分无显著性差异。
  结论 : 拉莫三 嗪联合帕罗西汀治疗抑郁症疗效优于单纯使用氟西汀 , 且耐受性好。拉莫三 嗪可作为双相抑郁的有效增效剂。
  
  Objective: To study the efficacy of lamotrigine combined with paroxetine for depression.
  Methods: A total of fifty three inpatient, s and outpatient,s with depression were randomly assigned to paroxetine group(n=30) and lamotrigine combined with paroxetine group(n=23) for 6 weeks , all drugs were used for oral, efficacy and side reactions were evaluated with HAMD , CGI and TESS before and after the treatment .
  Results: Findings indicated that the efficacy of lamotrigine combined with paroxetine was superior to the paroxetine only , the former showed effect more quickly and their side effects were the same
  Conclusion: lamotrigine combined with paroxetine was more effective in treatment of depression .
  Key words: Depression ; lamotrigine; paroxetine.
   
• P343
  西 酞普兰对 SERT 转运功能影响的电生理学观察 - Electrophysiology Observation on the Influence of Citalopram on the SERT Transport Function
  野 张 1
  1 上海交通大学医学院附属上海市精神 卫生中心 , 分子 遗传室 , 上海 , Chinese Mainland
  
  目的 ： 探 讨西酞普兰对 SERT 功能的影响特点。 方法 ： 显微注射方法将 hSERT 基因 cRNA 注射到非洲爪蟾卵母 细胞内 ， 建立异体表达系统。采用双微电极电压钳技术观察西酞普兰对 SERT 介 导 5-HT 转运电流的影响。
  结果 ： 1) 将表达 hSERT 的卵母 细胞膜电位钳制在 -60 mV ， 用含有 10 μΜ 5-HT 的任氏液灌流 细胞 ， 可记录到 40-100 nA 的内向 5-HT 转运电流。
  2) 西 酞普兰对 5-HT 转运电流具有阻断作用 ， 这种阻断作用具有浓度依赖性 （ IC50= 1.008 μ M ） 和 长时程效应。
  3) 细胞内显微注射 cGMP 对 5-HT 转运电流有显著的抑制作用。 结论 ： 西酞普兰能抑制 hSERT 的 转运功能 ， 并且这种抑制具有起效快、浓度依赖和长时程的效应。这可能是其抗抑郁作用的分子机制。
  
  Subjects: To observed the effects of Citalopram on 5-HT transportation mediated by serotonin transporter.
  Methods: Microinjection technique was used to structure the human SERT (hSERT) heterologious system. Then the effects of Citalopram on 5-HT transportation in Xenopus Oocytes heterologously expressing (hSERT) was observed using the two-electrode voltage clamp technique.
  Results: 1. Oocytes were perfused with Ringers solution and voltage-clamped at –50 mV. When the extracellular solution was switched to Ringers containing 10 μ M 5-HT, an inward current ranging from 40 to 100 nA was registered in cells microinjected with hSERT genes but not in control cells pre-injected with vehicle. This current was blocked by the selective SERT blocker, Desipramine (10 μ M). Citalopram, like Desipramine, attenuated the 5-HT transporting current. The effect was of rapid onset, concentration-dependent and long-lasting. IC50 of Citalopram on 5-HT current was estimated to be 1.008 μ M.
  2. We attempted to investigate the modulatory role of cGMP on hSERT. However, following injection of cGMP, the decline in 5-HT current was greater compared with that following injection of vehicle.
  Conclusion: Citalopram was able to inhibit 5-HT uptake in Oocytes expressing hSERT and the effect was of rapid onset, concentration-dependent and long-lasting.
   
• P344
  采用无抽搐 电痉挛方法维 持治 疗 19 例患者 总结 - The Summarizing of 19 Patients who Maintained Electroconvulsive Therapy
  庆梅 孔 1 , 沫 周 1
  1 北京大学精神 卫生研究所 , 北京 , Chinese Mainland
  
  目的 ： 总结维持无抽搐电痉挛治疗情况。
  方法 ： 对 ECT 维持治疗的 19 例患者 进行总结。其中 9 人 进行成人韦氏记忆测查。
  结果 ： 精神分裂症 8 例、抑郁症 11 例。平均病程 10 年。 维持治疗原因： 1 ） 难治性 13 例、 2 ）耐受差 2 例； 3 ） 药物疗效不满意 4 例。 ECT 治 疗 7-36 个月，治 疗 18-242 次。治 疗间隔差别很大，主要根据疗效进行调整。所有患者均无严重不良反应。患者的社会功能也比药物治疗时明显改善。排除治疗频率 3 次 /2 周的患者，其余 8 名患者 韦氏记忆分平均 101±22 分。初 步相 关分析，发现记忆分与治疗频率呈负相关，相关系数为 -0.71 ， p=0.048 。
  结论： 维持电痉挛治疗的不良反应并不比急性电痉挛治疗增多，尤其是对记忆力影响反而小，同时维持病情稳定，所以对于一些药物疗效欠佳或难以耐受的精神疾病患者，临床精神科医生可以考虑选用无抽搐电痉挛合并抗精神病药物长期治疗。
  
  Objectives: To summarize the maintained electroconvulsive therapy (ECT) in the hospital.
  Methods: We analyzed the data of 19 patients who took maintenance ECT in the past three years. Nine of them completed WMS.
  Results: 8 of them were schizophrenia patients, and 11 of them were major depression patients. The causes for maintenance ECT were drug-resistance, intolerability and dissatisfying efficacy of drugs. The durations of ECT were 7-36 months, and the numbers of ECT were 18-242. The ECT intervals were quite different, and the shortest interval was 3 times every two weeks, the longest interval was 2 months. None of them had severe side effects. Except one schizophrenia who treated three times every two weeks, the mean WMS score of others was 101±22. The scores of WMS had a significantly negative relation with treatment interval(r=-0.71 ， p=0.048).
  Conclusion: Maintenance ECT dose not show more side effects than acute ECT, and memory loss is often absent. Maintenance ECT could be used to the patients who are resisting or intolerable to drugs.
   
• P345
  安非他 酮缓释片多剂量给药在健康人体的生物等效性研究 - Bioequivalence of Amfebutamone Sustained Release Tablets after Multiple Doses to Chinese Healthy Volunteers
  扬波 郭 1 , 预关 温 1 , 崔 马 1 , 振 环 赵 1
  1 广州市精神病医院 , 广 东省广州市 , Chinese Mainland
  
  目的 ： 研究两 种盐酸安非 他 酮片多剂量给药在健康人体的生物利用度 ， 评价其生物等效性。
  方法 ： 采用双周期自身交叉 设计 ， 20 名健康志愿者多 剂量口服受试制剂或参比制剂 ， 连续给药 7 天。用 HPLC-MS 测定血浆中安非他酮的浓度 ， 并采用 BECS 程序 计算有关药动学参数。
  结果 ： 得出 20 名健康志愿者多 剂量口服受试制剂和参比制剂后的各药代动力学参数。以 AUC0-24(ss) 计 ， 多剂量口服受试制剂的相对生物利用度为 （ 105.56±14.95 ） % ， 以 AUC0-∞(ss) 计 ， 多剂量口服受试制剂的相对生物利用度为 （ 105.72±14.76 ） % 。两制 剂的 Tmax 经 Wilcoxon 检验，有显著性差异。采用双单侧 t 检验，受试制剂的 AUC0-24(ss) 的 90% 置信区 间为参比制剂相应参数的 98.58% ～ 110.77% ， AUC0-∞(ss) 的 90% 置信区 间为参比制剂相应参数的 98.90% ～ 110.94% ； Cmax 的 90% 置信区 间为参比制剂相应参数的 65.80 ～ 74.53% 。
  结论 ： 两制 剂具有生物等效性。
  
  Objective: To evaluate the bioequivalence of tow kinds of tablets after multiple doses to Chinese healthy volunteers.
  Methods: In a randomized crossover design,20 healthy subjects received multiple oral dose of test or reference tables during seven days. The plasma concentrations of Amfebutamone were determined by an HPLC-MS. Data of plasma level-time were disposed with BECS software.
  Results: The main pharmacokinetics parameters of test and reference Amfebutamone tables were gotten respectively. The relative bioavailability of test tables was （ 105.56±14.95 ） % . There was significant difference in Tmax between the two preparations.The 90% confidential interval of AUC0-24(ss) and AUC0-∞(ss) were between 98.58% ～ 110.77%, and 98.90% ～ 110.94% respectively according to those of the reference tablets.Those of the Cmax was 65.80 ～ 74.53% .
  Counclusions: The two preparations were bioequivalent.
   
• P346
  氟西汀 对慢性应激大鼠海马 S100B 和 RAGE 表达的影响 - Effects of Fluxetine on the Changes of Protein Levels of S100B and RAGE in Hippocampus after Chronic Unpredictable Stress
  高 华 王 1 , 晗 荣 2
  1 武 汉大学人民医院 , 精神 卫生中心 , 武 汉 , Chinese Mainland, 2 武 汉大学人民医院 , 武 汉 , Chinese Mainland
  
  目的 ： 了解神 经胶质细胞在抑郁症发生机理和抗抑郁剂作用机制中的地位 ， 探讨氟西汀对慢性应激大鼠海马 S100B 和 RAGE 含量的影响。
  方法 ： 将雄性 SD 大鼠 40 只随机分 为正常对照组 (NC 组 ) 、抑郁 组 (D 组 ) 、氟西汀 （ 10mg.kg-1 ip ） + 模型 组 （ F+D 组 ） 、氟西汀 ( 10mg.kg-1 ip) ＋ 正常 组 (F 十 NC 组 ) ， 每 组 10 只。采用 长期不可预见性中等强度应激造成大鼠抑郁模型，于应激前及应激第 22 天， 观察大鼠体重和 24h 饮用 1 ％蔗糖溶液量；同 时用 open filed 法 观察各组大鼠行为的变化；最后每组随机挑选 5 只大鼠，以 Western blotting 和激光共聚焦 显微镜测定药物对各组大鼠海马 S100B 及 RAGE 表达水平的影响。全部数据的 统计由 SPSS11.5 软件包完成，应激后各组大鼠体重及蔗糖消耗量，水平运动，垂直运动，排便次数的比较采用方差分析。
  结果： （ 1 ）在 应激第 22 天， D 组大鼠体重和蔗糖溶液消耗量均低于 NC 组 (P<0.05) ；而 F 十 D 组体重和蔗糖溶液消耗量均高于 D 组 (P<0.01) 。（ 2 ） 0pen fIeld 行 为评定：与 NC 组相 比， D 组大鼠出现明显抑郁行为；与 D 组大鼠相比， F 十 D 组大鼠抑郁行为明显减少。（ 3 ） D 组大鼠海马 S100B ， RAGE 蛋白水平 较 NC 组明显降低， F+NC 组 S100B ， RAGE 蛋白表达水平 较 NC 组增高，而 F+D 组 S100B ， RAGE 蛋白表达水平 较 D 组明显增高。 结论： 作 为神经胶质细胞表达的一种细胞因子， S100B 在抑郁症的 发病和抗抑郁剂的作用机制中扮演重要角色，提示神经胶质细胞及其在抑郁症中的作用，可能为抑郁症的治疗提供新的可能途径。
  
  Objective: To investigate the effects of Fluxetine on the changes of protein levels of S100B and its receptor receptor for advanced glycation end products (RAGE) in hippocampus in the rats of depression model .
  Methods: use chronic unpredictable mild stress as depression model. Forty SD rats were randomly divided into normal(NC), Fluxetine ( 10mg.kg-1 ip) （ F+D ） , stress(D), stress/fluxetine ( 10mg.kg-1 ip) (F 十 NC) groups, with ten in each group ． The weight of rats and consumption of saccharose was monitored during the periods of stress as an index. Open filed test was used to observe the behavior of rats on the day before stimulation and the 22 nd day during experiment. Furthermore, the S100B and RAGE level in the hippocampus after stress was measured with confocal laser scanning microscopy and the Western blotting ．
  Results: (1) On the 22 nd day, the increase of body weight and consumption of saccharose in D group were lower than that in NC group respectively(p<0.01 );while both were higher in F+D group than in D group(p<0.01); (2)In comparison with the D group ， the depressive behavior in F+D group was significantly improved (P<0.05). (3) The expression of protein S100B and RAGE in hippocampus of D group was Lower compared with group NC ( P <0.05);Compared with group D,S100B and RAGE in hippocampus of group F+D were significantly increased ( P < 0.05); and Compared with group NC, S100B and RAGE in hippocampus of group F+NC were increased significantly.
  Conclusion: chronic unpredictable mild stress down-regulate the protein level of S100B and RAGE in hippocampus. Fluxetine has the effect of elevated levels of S100B and RAGE. S100B and RAGE involved in development and maintenance of depression and may play a important role in the mechanism of the antidepressants therapeutic action.
  Key words: chronic stress hippocampus S100B RAGE
  
• P347
  艾司西 酞普兰与氯丙咪嗪治疗抑郁和焦虑共病比较 - Control Study of Treatment for Depression and Anxiety Disorder by Escitalopram and Chlorimipramine
  Yi-Ping Zhu 1 , Min-Cai Qian 1 , Xue-min Jin 1
  1 Huzhou, Third People`s Hospital, Huzhou, Chinese Mainland
  
  目的 : 比 较艾司西酞普兰与氯丙咪嗪治疗抑郁和焦虑的共病作用和不良反应。方法 63 例同 时符合抑郁症与焦虑障碍断标准门诊治疗的患者， HAMD 总分 ≥17 分， ≤ 23 分、 HAMA 总分 ≥14 分， ≤ 29 分。分 别随机给予口服艾司西酞普兰（简称 A 组），氯丙咪嗪（简称 B 组）。研究全程为期 4 周， 鉴署知情同意书。禁止应用任何抗精神病药物，允许使用阿普唑仑，剂量控制在 0.2 ～ 0.6mg/d 。艾司西 酞普兰起始量 5mg/d ，可增加到 15 ～ 20mg/d ，均 为早餐后 1 次 顿服。氯丙咪嗪起始量 50mg/d ，可增加到 125 ～ 175mg/d 。入 组前、治疗后第 1 、 2 、 4 、周末分交叉 进行 HAMD 、 HAMA 、 TESS 评定。 HAMD 、 HAMA 得分 ≤7 分 为治愈，减分 ≥50% 为有效。数据进行 x2 及 t 检验。
  结果 : 入 组时两组患者 HAMD 、 HAMA 得分无 显著差异（ p ＞ 0.05 ）， 资料具有可比性。治疗第 1 周末 A 组 HAMD 、 HAMA 得分比入 组时有明显下降（ p ＜ 0.01 ），而 B 组在治疗第 2 周末 HAMD 、 HAMA 才 开始明显下降（ p ＜ 0.01 ）。第 4 周末两 组有效率无显著差异（ p ＞ 0.05 ），但 A 组临床治愈率远高于 B 组（ p ＜ 0.01 ）。 A 组 TESS 总分远低于 B 组（ p ＜ 0.01 ）。
  结论 : 艾司西 酞普兰能迅速控制抑郁和焦虑症状，且副作用轻微，发生率低。
  关键词 : 艾司西 酞普兰 氯丙咪嗪　抑郁症 焦 虑障碍 共病
  
  Objective: to compare the effect and side effect of treatment for depression and anxiety disorder by escitalopram and chlorimipramine.
  Methods: 63 cases under the diagnose standard both for depression and anxiety disorder were enrolled with the total score of HAMD ≥17 ， ≤ 23 and HAMA≥14 ， ≤ 29. These patients were administered randomly escitalopram (briefly group A) chlorimipramine (briefly group B). Before the treatment, all the patients knew how they would be dealt with. During the 4- week observation, no other antipsychotic drugs was used except alprazolam with the dose 0.2 mg ～ 0.6mg/d. The dose of escitalopram were 5mg/d first, 15 mg ～ 20mg/d then. The drug was taken after breakfast. The dose of chlorimipramine were 50mg/d first and increased to 125 mg ～ 175mg/d if necessary. At the end of 1, 2, 3week, all the patients were assessed with HAMD, HAMA , TESS independently. The score of HAMD, HAMA ≤7 was deemed as cured, and the decrease of score more than 50% was effective. All data was treated by kappa square and t test.
  Results: The HAMD and HAMA was no statistical difference between the two groups after enrolled immediately （ p ＞ 0.05 ） , so they were comparable. After one week treatment, the score of HAMD and HAMA in group A were decreased quickly(p ＜ 0.01), but the HAMD and HAMA in group in group B began to decrease obviously at the end of the second week(p ＜ 0.01). There were no difference between two groups after 4 weeks treatment （ p ＞ 0.05 ） , the decrease of HAMD in group A was more obvious than that in group B （ p ＜ 0.01 ） , and the TESS of group A is always lower than that of group B （ p ＜ 0.01 ） .
  Conclusion: escitalopram can control depression and anxiety disorder rapidly and it has only a slight side effect and it seldom occurs.
  Key words: escitalopram chlorimipramine depression anxiety disorder comorbidity
   
• P348
  阿立 哌唑对精神分裂症认知功能康复的中期影响 - Effects of Aripiprazole on Middle-period Rehabilitation of Cognitive Function in First-onset Schizophrenia
  志榕 李 1 , 平 黄 1 , 富松 张 1 , 建 华 杨 1
  1 开封市第五人民医院 , 开封市 , Chinese Mainland
  
  目的 : 了解阿立 哌唑对精神分裂症认知功能的中期影响。
  方法 : 65 例首 发精神分裂症患者以阿立哌唑治疗 24 周 ， 治 疗前后进行威斯康星卡片分类测验 （ WCST ） 、持 续操作试验 （ CPT ） 、阳性与 阴性症状量表 （ PANSS ） 评定 ， 并与 45 例正常人 对照。结果 治 疗组在治疗后 PANSS 量表各 项指标分值均有明显下降； WCST 总测验数、持续错误数、非持续错误数及 CPT 各 项指标均较治疗前有显著改善；治疗组于 治 疗后在上述 WCST 和 CPT 指 标与对照组比较仍有显著性差异； PANSS 总分、阳性症状分量表分、阴性症状分量表分的改善与 WCST 总测验数、持续错误数、非持续错误数呈正相关，与 CPT 总分呈负相关，一般精神病理分量表分与持续错误数呈正相关。
  结论 : 阿立 哌唑对精神分裂症的认知功能障碍有一定改善作用 ， 且认知功能的改善与精神症状的改善存在着明显相关。
  
  Objective: To explore the effects of aripiprazole on rehabilitation of cognitive function in first-onset schizophrenia.
  Methods: 65 patients with schizophrenia (treatment group) were assessed by Wisconsin Card Sorting test (WCST), Continue performance test (CPT) and Positive and Negative syndrome scale (PANSS) before and after treatment by aripiprazole for 24 weeks. 45 health volunteers were assessed by WCST and CPT as control group.
  Results: There were significant differences in scores of PANSS, number of total trials of WCST, number of persisting errors, number of random errors and number of total CPT test between before and after treatment in treatment group, but there were also significant differences in these indexes between the treatment group after accepting 24 weeks of treatment and the control group. Number of total WCST tests, number of random errors were all positively related to total scores of PANSS , scores of SAPS and SANS, but number of total trials of CPT is negatively related to them and there was a positive relation between number of persisting errors and the factor of common psychopathology in PANSS (r=0.393).
  Conclusion: Aripiprazole can, to some degree, improve the cognitive disorder in schizophrenia, and the improvement of cognitive function is related significantly to the degree of psychopathology.
   
• P349
  穴位刺激 调控 法与 氯米帕明治疗强迫症的对照研究 - Clinical Study on Treatment of Obsessive-Compulsive Neurosis between Methods of Acpuncture Point Regulatory-control and Chlorimipramine
  Bin Feng 1
  1 Tongde Hospital of Zhejiang Province, Zhejiang, Chinese Mainland
  
  目的 ： 研究 氯米帕明与穴位刺激调控法及氯米帕明加穴 位刺激 调控法治疗强迫症临床疗效差异 ；
  方法 : 对住院及门诊的强迫症患者 102 例 进行对照研究 ， 其中氯米帕明组 33 例 ， 穴位刺激 调控法组 35 例 ， 穴位刺激 调控法加氯米帕明组 34 例。以 Yale-Brown 强迫症量表、 汉密尔顿抑郁量表 (HAMD) 、副反 应量表（ TESS ） 评定疗效和副反应。结果 : 氯米帕明组痊愈率为 24.24%, 显效率为 57.58% 。穴位刺激 调控法组痊愈率为 45.71%, 显效率为 77.14% 。穴位刺激 调控法加小剂量氯米帕明组痊愈率为 38.24%, 显效率为 79.41% 。三 组在不同时点 Y-BOCS 评分的差异有显著 性（ P<0.01 ），在 Y-BOCS 总分以及 HAMA 减分 值上有显著性差异（ P<0.05 ）。 氯米帕明组不良反应发生率为 66.67% ，穴位刺激 调控法组不良反应发生率为 20% ，穴位刺激 调控法加氯米帕明组不良反应发生率为 41.18% 。三 组不良反应发生率有极显著的统计学差异（ P<0.01 ）。
  结论 : 氯米帕明、穴位刺激调控法治疗强迫症具有较肯定的疗效，穴位刺激调控法加小剂量氯米帕明疗效法具有疗效好、副作用小，安全性好。
  
  Objective: To compare the clinical efficacy on treatment of obsessive-compulsive neurosis between methods of acupuncture point regulatory-control (APRC) and chlorimipramine.
  Method: 102 obsessive-compulsive neurotic patients were randomly distributed into three different treatment groups: 35 patients were treated with APRC, 33 patients were treated with chlorimipramine, 34 patients were treated with APRC append chlorimipramine. The clinical efficacy and side effects were evaluated by Y-BOCS, HAND,BPRS and TESS during the 8-week treatment.
  Results: In the group of APRC, the average of effective time was 1-2 week, the recovers from illness rate as 45.71%, 77.14% of the group showed some clinical improvement. In the group of chlorimipramine treatment, the average of effective time was 3-4 week, the recovers from illness rate was 24.24%, showing efficiency was 57.58%. In the group of APRC append chlorimipramine, the recovers from illness rate was 38.24%, 79.41% of the group showed some clinical improvement. the clinical efficacy of the APRC group and the chlorimipramine group was superior to the APRC append chlorimipramine group, Significant difference was found between the former two groups and the later group(p<0.01). There was significant difference on the rate of the side effects among the three groups （ P<0.01 ） , the rate of the side effects the chlorimipramine group was 66.67%,the APRC group was 20.0% ， the group of APRC append chlorimipramine was41.18%.
  Conclusion: Chlorimipramine is an effective treatment with obsessive-compulsive neurotic patients, but there were more side effects in it. APRC treatment and APRC append low dose chlorimipramine treatment show more clinical efficacy than single chlorimipramine treatment. These suggested that APRC treatment is a effective, safe and low side effects treatment to obsessive-compulsive neurosis.
   
• P350
  Comparative Study of Compliance between Aripiprazole and Risperidone in the Treatment of Schizophrenia
  Jia Liang 1 , Qiang Zeng 1 , Jian-qing Tao 1
  1 Kang Hong Center of Mental Rehabilitation, The Peoples Hospital of Guangxi Zhuang Autonomous Region, Nanning, Chinese Mainland
  
  Objective: To explore the compliance between aripiprazole and risperidone in the treatment of schizophrenia.
  Methods: A total of 120 patients were randomly allocated to two groups treated with aripiprazole and risperidone for 12 weeks. Before thetreatment and at the end of 8 and 12 weeks of treatment, comparision between the two medicatian was used by the tools of Positive and Negative Symptom Scale(PANSS), and Treatment Emergent Symptom Scale(TESS) to assessthe compliance and adverse-efficts.
  Results: After 12 weeks, the efficacy rates of the aripiprazole group and risperidone group were 90% and 88.3% respectively, there was no obvious difference between two groups in significant improvement rate (P>0.05). But there was obvious difference between two groups in significant compliance (P<0.05). The incidence rate of the drowsiness , EPS, body weight gain , menstrual disorder , acathisia and so other side effects significantly reduced than risperidone group.
  Conclusion: Aripiprazole was as clinical effects as risperidone for the treatment of schizophrenia,and has fewer side effect,but was a new drug in treating schizophrenia with better complionce and good for long-term treatment.
  Key words: Aripiprazole; Risperidone; Schizophrenia; Compliance
   
• P351
  氢溴酸加兰他敏 (Razadyne) 在 电休克治疗中对患者认知和情绪的影响 - Impact of Galantamine HBr (Razadyne) on Cognition and Mood During Electroconvulsive Therapy
  John D Matthews 1 , Mark Blais 1 , Lawrence T Park 2 , Charles Welch 1 , Caleb Siefert 1 , Caitlin Homberger 1 , Sarah Stone 1
  1 Massachusetts General Hospital, Psychiatry, Boston, MA, United States, 2 Massachusetts General Hospital/Harvard Medical School, Psychiatry, Boston, United States
  
  简介 ： 电休克治疗 (ECT) 在重性心境障碍的治 疗中十分有效。 ECT 治 疗的一个主要并发症是潜在的认知缺损包括逆行性和顺 行性 遗忘。目前尚仍无可用来预防这些认知缺损发生的干预措施。加兰他敏，一种用于治疗阿尔采默氏病的药物，具有双重作用机制，可以可逆性地竞争抑制乙酰胆碱酯酶，并对烟碱样乙酰胆碱受体产生变构调节作用。本研究之意图是评价加兰他敏对减少 ECT 治 疗患者认知缺陷的疗效。
  目的： 评价加兰他敏在预防 ECT 治 疗中认知损害的疗效。
  方法： 18 位 ECT 治 疗患者在整个 ECT 治 疗过程中随机地接受加兰他敏或安慰剂治疗。在 ECT 治 疗前后对患者进行认知功能和抑郁程度的客观量表评定。每周进行抑郁症状，精神状态及药物副反应的主观评定。
  结果： 两 组 在年 龄，性别及默认的认知功能评分 (R-BANS) 上相似。治 疗前后两组在药物副反应、癫痫样发作平均持续时间、诱发癫痫发作所允许的能量、血压及心率变化上均无显著差异。未发现有严重的药物不良反应。加兰他敏治疗组较安慰剂组在延迟记忆及抽象推理功能上有显著性改善，该组的情绪症状也得到改善但无显著性差异。
  结论： 本研究表明加 兰他敏可降低 ECT 治 疗对认知功能的易损伤性。此外，加兰他敏也可提高 ECT 的抗抑郁 疗效。加兰他敏在 ECT 治 疗中使用既安全又可耐受。
  
  Introduction: Electroconvulsive therapy (ECT) is a highly effective treatment for severe mood disorders. One of the major complications of ECT is the potential for cognitive impairment including retrograde and anterograde amnesia. Currently, no interventions are available to protect against these cognitive deficits. Galantamine, a treatment for Alzheimer's disease, has a dual mechanism of action, providing reversible competitive inhibition of acetylcholinesterase and allosteric modulation of nicotinic acetylcholine receptors. The purpose of this study is to determine the effectiveness of galantamine in reducing the potential for cognitive deficits in patients receiving ECT.
  Objective: The purpose of this study is to assess the effectiveness of galantamine in the prevention of the cognitive impairments during ECT treatment.
  Methods: Eighteen ECT patients were randomized to receive galantamine or placebo throughout the course of their ECT treatments. Objective measures of cognitive functioning and depression were performed pre- and post-ECT. Subjective ratings of depression, confusion, and side effects were obtained weekly.
  Results: The two groups were similar in age, gender and admission cognitive functioning scores (R-BANS). No significant differences were found in galantamine side effects, mean seizure duration, energy administered to induce seizures, and blood pressure or heart rate during and post-ECT treatment. There were no severe adverse drug reactions. Patients receiving galantamine performed significantly better on delayed memory and abstract reasoning following ECT. The galantamine group showed a greater but non-significant mood improvement.
  Conclusions: Our intrem data suggest that galantamine may reduce vulnerability to cognitive impairment during ECT. In addition, galantamine may also enhance the antidepressant action of ECT. Galantamine was both safe and well tolerated during ECT.
  
• P352
  氧化 应激和迟发性运动障碍 - Oxidative Stress and Tardive Dyskinesia
  Feng-Yan Zhu 1 , Xiang-yang Zhang 1 , Xia-ming Shi 1
  1 Beijing Huilongguan Hospital , The Third Clinical Department, Beijing , Chinese Mainland
  
  目的 ： 已 经把药源性自由基病理学说用于解释迟发性运动障碍 （ TD ） 的 发生 ， 抗氧化防御系统的变化导致脂过氧化氢增加 ， 以解释与 TD 神 经元损伤的可能机制。试图研究抗氧化酶、脂过氧化氢产物和 TD 症状的 严重程度之间的关系。
  方法： 课题开始前对参加人员开展研究程序及各种使用量表使用一致性培训，选择我院三个病区的全部病人进行 TD 筛查，筛查前告知病人研究目的及要做的检查，取得病人和家属同意。共有 80 例患有精神分裂症病人确 认符 合 TD 的 标准，同时选择 45 例无 TD 精神分裂症病人按照年 龄、性别、抽烟情况匹配后作为对照。对全部病人空腹 12 小 时后取血，由实验室技师在不知道病人有无 TD 的情况下， 测查血浆丙二醛（ MDA ）、血 浆超氧化物歧化酶（ SOD ）、谷光苷 肽过氧化物酶（ GSH-Px ）、 过氧化氢酶（ CAT ） 浓度。用异常不自主运动量表（ AIMS ） 评定 TD 的 严重程度，同时用阳性和阴性症状量表（ PANSS ） 评定病人的精神病理学状况。
  结果： TD 组病人与无 TD 组病人相比血浆 SOD 、 GSH-Px 和 CAT 浓度显著低， MDA 浓度则显著高。 TD 组病人的 MDA 水平与 AIMS 总分和 PANSS 阴性症状因子分正相关。 SOD 和 CAT 活性 则与 MDA 浓度负相关。
  结论： 支持氧化 应激学说在 TD 病理生理学机制中的作用， 这些资料也提示 TD 病人氧化 应激和运动障碍严重程度之间的关系，增加脂过氧化氢物可能导致 TD 病人内源性抗氧化 酶活性降低。
  关键词：精神分裂症 迟发性运动障碍 自由基 氧化 应激 抗氧化 酶 脂 过氧化氢
   
• P353
  情感性精神障碍患者 认知功能障碍的 - Study on Cognition Dysfunction in Affective Disorder
  Qing-tao Bian 1 , Xiao-lan Di 1 , Fu-xin Yao 1
  1 Beijing Huilongguan Hospital, Beijing, Chinese Mainland
  
  目的： 探 讨情感性障碍患者是否存在认知功能损害，比较各亚型认知功能的特征。
  方法： 使用 HAMD （ 17 项）、 YOUNG 、 CGI 、 WCST 、 WAIS-RC 、 WMS 及 HRB-RC 分 别于疗前、疗后（治疗 12 周） 评定，并与 30 名正常人 进行对照。
  结果： （ 1 ）患者各 组治疗前 WCST 操作的 总测验次数、持续错误数、随机错误数、分类数， IQ ， MQ 以及 单相抑郁症和双相抑郁症组的正确数与正常人对照组相比 , 差异有 显著性或非常显著性 (P<0.05 或 P<0.01) ；治 疗后各患者组 WCST 操作的 总测验次数、持续错误数、随机错误数、分类数及 MQ 和 对照组比较 , 差异有 显著性或非常显著性 (P<0.05 或 P<0.01) ；在各患者 组中， WCST 操作的 总测验次数、随机错误数、分类数， IQ 和 MQ 治 疗前、后差异有显著性或非常显著性 (P<0.05 或 P<0.01) ，而患者 组治疗前、后组间比较差异无显著性 (P>0.05) ；（ 2 ）患者各 组治疗前、后 HRB-RC 测验的连线乙、触摸总时间、范畴，单相抑郁症组治疗前、后的连线甲，以及单、双相抑郁组治疗前的敲击次数等，与正常对照组相比 , 差异有 显著性或非常显著性 (P<0.05 或 P<0.01) 。
  结论： （ 1 ）部分情感障碍患者存在 认知功能损害，且各亚型间差异不明显；（ 2 ）情感症状 对患者认知功能有严重影响；（ 3 ）部分 缓解期患者长期存在认知功能损害。
  关键词 : 情感性精神障碍 ； 认知功能 ； 神经心理学
   
• P354
  The Clinical Study of “Stop Salivation Porridge” in Treating Salivation of Clozapine
  芬 培 姚 1 , 麟 玉 张 2
  1 上海市精神 卫生中心 , 中西医 结合科 , 上海 , Chinese Taipai, 2 上海市精神 卫生中心 , 中西医 结合科 , 上海 , Chinese Mainland
  
  The aim of this study was to evaluate the efficacy and safety of “Stop Salivation porridge” in the treatment of Salivation of Clozapine. 96 Schizophrenic inpatients with clozapine induced salivation were treated with self-made“Stop Salivation porridge (yiyiren 50 mg 、 sanyao 50mg, cooked porridge Bid )”for 4 week .PNASS 、 TESS and Laboratory examinations were performed. There was a significant difference in effect on salivation after the therapeutic group. The effective rate was 69.8%. No side effect was recorded. “Stop Salivation porridge” is practical 、 safety 、 convenient 、 value cheap and artifactitious simple.
   
• P355
  阿立 哌唑 （ 博思清 ） 治疗迟发性运动障碍一例报道 - A Case Report of Aripiprazole (Brisking) Therapy in Tardive Dyskinesia
  建喜 石 1 , 小 东 周 1
  1 解放 军白求恩国际和平医院 256, 临床部精神科 , 正定 , Chinese Mainland
  
  迟发性运动障碍 [1] （ tardive dyskinesia 简称 TD ） 是指在 长期的抗精神病药物治疗中出现的一种严重的锥体外系副反应 ， 主要表现 ： 口面舌颊部、下颌、肢体及躯干出现的快速的、不随意的、无节律的舞蹈样运动和肌张力障碍。其发生机理存在多种假说，如：神经 毒性学 说、多巴胺增敏假说、 GABA 功能低下学 说、去甲肾上腺素和 5- 羟色胺学说，但均不能对 TD 的 发生做出圆满地解释。由于机理不明，临床治疗效果欠佳，严重影响患者的正常生活。作者在临床工作中遇到一例，使用阿立哌唑（博思清）治疗获得了成功，现报告如下： 患者王 ×× ，女性， 72 岁，文盲，汉族，已婚，住院号： 208658 。因 间断失眠、情绪低落 4 年，伴口唇不自主运 动 3 个月于 2005 年 7 月入院治 疗。患者于 2001 年出 现间断失眠，心烦，情绪低落，兴趣减少等症状，曾于 2002 年 7 月到我院就 诊当时考虑为 “ 神 经官能性抑郁 ” ，服用 “ 马普替林、丁螺环酮、氯硝安定 ” 等 药治疗，效果欠佳， 2003 年 7 月因患者出 现恐惧害怕，自责自罪，疑心邻居对自己不好，担心有人害她等症状。又给予博乐欣、佳静安定等药治疗，病情时轻时重， 2004 年 4 月病情加重，常感 烦躁不安，总跟家人不停的唠叨 “ 自己的病不好，自己没 钱，什么都不敢买，自己没衣穿，吃不成饭 ” ，行 为紊乱，要外跑说要死，要去外边冻死，家人阻拦，就乱脱裤子，在院里解小便而再次入院。诊断：老年抑郁症，应用马普替林、丁螺环酮、氯硝安定治疗，病情好转后出院，院外坚持服用马普替林 100 毫克 / 天， 氯硝安定 2 毫克 / 天，丁螺 环酮 30 毫克 / 天、病情尚平 稳。 2005 年 4 月患者逐 渐出现口、舌、颊、唇的不自主运动，白天明显，夜间睡眠时消失，严重时影响饮食，患者短时间内能自行控制，但不能持久，长时间的不自主运动导致患者三颗牙齿脱落，为求治疗再次住院治疗。入院常规实验室检查及头颅 CT 检查均未见异常，诊断： 1. 老年抑郁症， 2. 迟发性运动障碍。入院后换用博乐欣改善抑郁症状，联合应用阿立哌唑（博思清） 10 毫克 / 天治 疗迟发性运动障碍， 10 天后口、舌、 颊、唇的不自主运动缓解，随即停用阿立哌唑（博思清）； 1 周后口、舌、 颊、唇的不自主运动再次出现 ， 复用阿立哌唑（博思清） 10 毫克 / 天治 疗， 5 天后患者的不自主运 动再次消失，后一直坚持服用阿立哌唑（博思清） 10 毫克 / 天，至今未出 现 TD 症状。 讨论：该例患者长期应用马普替林等精神科药物 4 年余， 临床上呈现典型的 TD 表 现，在使用阿立哌唑后症状消失，停药后症状重现，再用症状又消失，故考虑阿立哌唑对该例的 TD 症状有控制作用， 该药对 TD 治 疗或预防作用原理可能为：阿立哌唑被称之为第三代抗精神病药物 [2] ，是多巴胺和 5— 羟色胺系统的稳定剂，突触后多巴胺受体的阻滞剂，同时又是突触前自主受体的激动剂，与 D2 和 D3 的 亲和力较强 ， 对Ｄ 2 与 5-HT1A 部分激 动 ( 而非完全拮抗 ) ， 对 5-HT2A 完全拮抗。阿立 哌唑的作用特点不是阻断而是稳定多巴胺系统，这样就可以预期减少在中脑 - 皮 质通路和黑质纹状体通路所不需要的Ｄ 2 拮抗作用，减少 锥体外系症状及 TD 的出 现。在当前临床应用阿立哌唑的过程中也确实未见有迟发性运动障碍的案例报道 ， 本例体现的其对迟发性运动障碍的治疗作用 ， 为深入进行 TD 机理研究提供了一些借 鉴。
   
• P356
  Nursing Strategy and Prognosis of Psychotic SCD in Hospital
  Jing Zhang 1
  1 Tianjin'anding Hospital, Tianjin, Chinese Mainland
  
  Summary: Sudden cardiac death (SCD) is the result of natural death suddenly happened because of heart reasons .The aging hospitalized psychotics usually are complicated with one or more other diseases, such as coronary, high blood pressure, diabetes et al, and they have been taking antipsychotic drugs for a long time, some even take various medicines. Advanced age, weakness, diseases and adverse effects make some difficulties in clinical nursing. It is necessary to estimate the signals of heart and blood events. It includes:(1) SCD related factors ① season and time; ② mental state; ③ have a big meal or apositia; ④ Constipation and straining defecate; ⑤ Infection; ⑥ antipsychotic and other drugs; ⑦ body position .(2)heart rate : 3)Nursing strategies: ① monitor life signal. ② strengthen night round ③ exactitude observation precursory symptom. ④ prevention of constipation. ⑤ education.
  Keyword: sudden cardiac death ; mental disorder ; heart rate
   
• P357
  A Comparative Study of Ziprasidone versus Risperdal in Patients with Schizophrenia
  新友 王 1
  1 河南省精神病院 , 普通精神二科 , 河南省新 乡市 , Chinese Mainland
  
  Objective: To evaluate the efficacy 、 survivability and safety of Ziprasidone in the treatment of schizophrenia compared to Risperdal.
  Methods: 86 patients with first-episode schizophrenia were divided into two groups who treated with Ziprasidone or Risperdal respectively for 8 weeks.
  Result: The result shows that no significant difference in efficacy and rate of adverse effect (P>0 ． 05). No severe harmful occurrence.
  Conclusion: The study indicates that the efficacy of Ziprasidone and Risperdal is equal in the treatment of first-episode schizophrenia, and side effect is less. The two drugs can be the first choice in treatment of first-episode schizophrenia.
   
• P358
  应用阿立哌唑治疗带有强迫症状的精神分裂症 - Aripiprazole in Treatment of Schizophrenia Accompany with Obsessive Symptoms
  辉 润 田 1
  1 吉林大学第一医院 , 精神科 , 长春市 , Chinese Mainland
  
  目的 : 探 讨阿立哌唑对带有强迫症状的精神分裂症的临床疗效。
  方法 : 把 临床上由于各种原因产生的带有强迫症状的精神分裂症患者应用阿立哌唑治疗 8 周。 应用 PANSS 、 Y—BOCS 评定疗效。结果 应用阿立哌唑治疗带有强迫症状的精神分裂症患者确实有效。结论 阿立 哌唑对各种原因产生的带有强迫症状的精神分裂症患的治疗有明确的疗效。
  关键词 : 阿立 哌唑 精神分裂症 强迫症 状
  
  Objective: discusses Aripiprazole to has theforce symptom the schizophrenia clinical curative effect.
  Method: onclinical because each kind of reason produces the schizophreniapatient which has Obsessive-complusive symptoms symptom to apply Aripiprazole treats 8 weeks. Using PANSS, Y - BOCS evaluates the curativeeffect.
  Result: applies Aripiprazole the schizophreniapatient which Aripiprazole the treatment has Obsessive-complusive symptoms symptom to be trulyeffective.
  Conclusion: Aripiprazole produces to eachkind of reason has the force symptom the schizophrenia troubletreatment to have the explicit curative effect.
  Key words: Aripiprazole Obsessive-complusive symptoms schizophrenia
   
• P359
  Prognosis of Patients with GPI Treated with Penicillin G
  东 郑 1
  1 广州市精神病医院 , 广州市 , Chinese Mainland
  
  Objective: To study prostecdtive efficacy of patients with general paralysis of the insane (GPI) treated with penicillin G.
  Methods: 72 cases of patients with GPI treated with high dose of penicillin G followed “Sexually Transmitted Diseases Treatment Guidelines” prepared by Center for Disease Control (CDC) of American had been followed up for more half a year. Therapeutic effect and aggravation in half a year was observed. MMSE and serum TRUST and TPHA was examined at the just time of pretherapy, post-treatment, and after half a year.
  Results: (1) data of 65 cases of whom completed the follow-up was analyzed. (2) 80% (52/65) of the patients improved by the time of post-treatment but 46.15% (30/65) increased in 6 months. (3) score of MMSE went up (P<0.001) but went down (P<0.001) in the next 6 months.(4) tite of plasma TRUST descended (P<0.001) after the treatment and maintain in the next 6 months.
  Conclusion: The prostecdtive efficacy of patients with GPI treated with high dose of penicillin G guided by “Sexually Transmitted Diseases Treatment Guidelines” of American CDC are not satisfactory, and more rational therapy scheme should be explored.
   
• P360
  中 药解郁丸与万拉法新治疗首发抑郁症疗效的对照研 - Controlled Study on Efficacy Jieyu Pill and Venlafaxine in Treating the First Onset Depression
  克 强 王　 1 , 恒永 关 1 , 素 伟 徐 1
  1 河北省 荣军医院 , 保定 , Chinese Mainland
  
  目的 : 观察中药解郁丸治疗首发抑郁症的临床疗效及副作用。
  方法 : 选取门诊及住 院首 发抑郁症患者 ：（ 1 ） 符合 CCMD-3 关于抑郁症诊断标准。 （ 2 ） 汉密尔顿抑郁量表 17 项 >17 分 （ 3 ） 无 严重躯体疾病 ， 实验室检查正常 ， 心电图正常。共纳入 41 例患者，随机分 为试验组即解郁丸组共 22 例，男性 10 例，女性 12 例，平均年 龄 24.51±18.73 岁，病程 2-18 月，平均病程 8.23±6.64 月； 对照组即万拉法新组 19 例，男性 9 例，女性 10 例，平均年 龄 26.47±17.81 岁，病程 3-24 月，平均 9.04±8.12 月。两 组间年龄、性别、病程均无统计学差异（ P>0.05 ）。治 疗方法：解郁丸组口服解郁丸 ， 该药由郑州豫密药业公司产生，药物组成：白芍、柴胡、郁金、当归、茯苓、百合、合欢皮、甘草、小麦、大枣、制剂为水丸，每次 4g （ 60 粒）， 每日 3 次，共 6 周； 对照组应用国产万拉法新（成都大西南制药厂生产），起始剂量为 25mg ， 每日 3 次， 剂量递增到每日 100mg 以上，以后根据病情及副反 应大小递减剂量，用药量每天 100-250mg ，共服 6 周，治 疗期间不合并其它药物治疗。于用药前及用药后 14 ， 28 ， 42 天分 别采用临床疗效总评（ CGΙ ）、 HAMD 抑郁量表 对两组患者进行评定。应用自制副作用量表评定不良反应。采用 t 检验和卡方检验对两组资料进行处理。以 HAMD 减分率 评定疗效，减分率 ≥75% 为治愈， 74%~50% 为显著进步， 49%~25% 为进步，＜ 25% 为无效。
  结果 : 解郁丸 组：治愈 8 例（ 36.36% ）， 显著进步 7 例（ 31.82% ）， 进步 5 例（ 22.73% ），无效 2 例（ 9.09% ）；万拉法新 组：治愈 7 例（ 36.84% ）， 显著进步 7 例（ 36.84% ）， 进步 4 例（ 21.05% ），无效 1 例（ 5.26% ）。 解郁丸 组的显效率为 68.18% ，万拉法新 组显效率为 73.68% ，两 组间的显效率无显著性差异（ P> 0.05 ）。两 组在治疗前与治疗后 14 ， 28 ， 42 天用 HAMD 量表 评定对比均有显著差异（ P<0.05 ）。解郁丸 组有 3 例（ 13.64% ）出 现轻度副反应较万拉法新组出现的副反应 10 例（ 52.63% ） 显著为低（ x2=11.11 ， P<0.01 ）。治 疗前两组患者病情严重程度（ SI ）以及治 疗后疗效总评（ GI ）比 较差异无显著性。由于万拉法新的副反应明显多于解郁丸组，因此解郁丸组的疗效指数（ EI ） 较对照组显著为高 (P<0.05) 。
  结论 : 解郁丸 组治疗首发抑郁症与万拉法新组对比疗效相当 ， 但副作用明显少于万拉法新。
  
  Objective: To investigate the clinical efficacy and the side-effects of Jieyu Pill(JYP)in treating the first onset depression.
  Methods: The randomized controlled study was conducted in 22 patients in the treated group and 19 patients in the control group treated with venlafaxine (Ven). The efficacy of treatment was evaluated before treatment and 14, 28, and 42 days after treatment, with Hamilton depression rating scale, self-made side effect scale and clinical global impression.
  Result: JYP was effective in treating depression, the markedly effective rate being 68.18%, corresponded to that of Ven(73.68%). After treatment, the scores assessed by HAMD were all lower than those before treatment(P<0.05) respectively, but comparision between the two groups showed insignificant difference(P>0.05). However, the side effects of JYP was significantly lower than that of Ven(x2=11.11,P<0.01).
  Conclusion: JYP in treating the first onset depression shows the efficacy corresponded to that of Ven and with less the sida-effects.
  
• 361
  ( 采用 ） CE 法定量 测定阿利哌唑及其主要代谢产物的研究 - The Quantitative Detection of Aripiprazole and its Main Metabolite by Using CE Method
  Tsung-Ming Hu 1 , Tsuo-Hung Lan 1 , El-Wui Loh 2 , Chin-Han Chao 1 , Yen-Hsin Yu 2 , Hsien-Jane Chiu 1
  1 Yu-Li Hospital, DOH, Psychiatry, Hualien, Taiwan, Province of China, 2 National Health Resaerch Institute, Mental Health, Taipei, Taiwan, Province of China
  
  目的 ： 研究 测定非典型抗精神病药阿利哌唑浓度的快速、可靠的实验室检测方法 ， 以用于今后临床实践。
  方法 ： 毛 细电泳 (CE) 是一 种能在不同液相如血清或尿液中测定化学药物试剂含量的方便可靠的检查手段。我们招募了 10 个符合 DSM-IV TR 诊断标准的精神分裂症志愿者 ， 每天给予至少 10mg 的阿利 哌唑治疗 ， 2 周后抽取 5 毫升外周血 进行测定。所有研究者都签署了知情同意书，并将样本分为两组，分别进行毛细电泳 (CE) 和气相 层析 - 质谱 (GC-MS) 分析。气相 层析 - 质谱分析 (GC-MS 是研究 对照的金标准。
  结果： 总体上， CE 法与 GC-MS 法 测定血清阿利哌唑浓度相比，两者有超过 90% 的 关联性。阿利哌唑的最终浓度变化范围为 1ppm 到 0.01ppm 。
  结论： 本研究表明在日常的 处方使用水平范围内可采用毛细电泳作为测定阿利哌唑浓度的合适方法，该检测手段具有价格低廉，结果可靠，省时等优点。可用在今后接受阿利哌唑治疗的精神分裂症患者的临床实践中 。
  
  Objectives: To develop a quick and reliable laboratory method to detect atypical antipsychotics aripiprazole for future clinical application.
  Methods: Capillary electrophoresis (CE) is a convenient and reliable instrument to detect chemical reagents in different liquid phases such as serum or urine. We recruited ten volunteers with the schizophrenia diagnosis based on DSM-IV TR criteria and collected their peripheral serum 5cc after 2 weeks of at least 10mg per day aripiprazole prescription. All consent forms have been completed. These samples were divided to halves and delivered for both CE and GC-MS analysis. The GC-MS analysis has been considered as the golden standard to be compared with.
  Results: The correlation between CE and GC-MS detection of serum aripiprazole can reach more than 90% in general. The ultimate detection level of aripiprazole in serum ranged from 1 ppm to 0.1 ppm.
  Conclusions: Our study suggests capillary electrophoresis might be an appropriate tool to detect serum aripiprazole under daily prescription level with advantages of low expense, acceptable reliability, and time saving. It can be applied to the future clinical observations after aripiprazole among schizophrenic people.
   
• P362
  阿立 哌唑所致老年病人持续性低血压一例 - A Case in which Aripiprazole Was Used to Treat Alzheimer′s Disease of the Old and it Led to the Patient′s Consecutive Hypotension
  Changping Zhai 1
  1 安徽省 荣军医院 , 手机号 , Chinese Mainland
  
  阿立 哌唑是对精神障碍治疗的药理作用机制具有革新性 新一代 药。这里提交并讨论了一例应用于老年阿尔采默症病人并导致了持续性低血压的病例 . 虽然阿立哌唑的动力学研究表明 , 该药不为患者的年龄 , 性 别 , 人 种 , 吸烟状况 , 肝功能 , 肾功能等而改变 , 但 对老年病人 , 尤其是 65 岁以上的老年人的药代动力学尚未更好研究 . 阿 尔采默症相 关的老年精神病患者可能较年轻分裂症患者存在对该药的不同耐受性 . 该病人使用阿立哌唑导致持续性低血压的机理尚需进一步探讨。
  
  Aripiprazole is the new generation of medicine which is used for the treatment of mental disorder, and for its pharmacological mechanism, it is innovation. Here is a case in which the medicine was used to treat Alzheimer′s disease of the old, but it led to the patient's consecutive hypotension.. Although the study of aripiprazole's kinetics shows that the medicine's function remains unchanged in spite of the patients'different ages.sexual distinctions. human races. liver function. renal function and smoking habits. there's not any further study of aripiprazole's pharmacokinetics for the treatment of an old patient with mental disorder ,especially for patients of more than sisty. The old mental patients with Alzheimer's disease and the younger patients with Schizophrenia are different in the patient's endurance of the medicine. We shoud delve further into the mechanism of the patient's consecutive hypotension caused by the use of the medicine.
   
• P363
  西 酞普兰合并认知疗法治疗脑卒中后抑郁的 疗效观察 - Effect of Citalopram Combined with Cognitive Therapy in the Treatment of Post-Stroke Depression
  Liu Yu 1
  1 The Third Hospital of Mianyang, Mianyang , Sichuan , Chinese Mainland
  
  目的 : 了解西 酞普兰合并认知疗法治疗脑卒中后抑郁的疗效。
  方法 : 将 64 例 脑卒中后抑郁患者随机分为研究组和对照组 ， 研究组给予西酞普兰合并认知疗法 ， 对照组单独用西酞普兰治疗 ， 疗程 12 周。用 汉密顿抑郁量表 (HAMD) 、副反 应量表 (TESS) 分 别评定疗效和副反应。结果 在治 疗第 4 ， 8 及 12 周后，研究 组上述治疗时段的 HAMD 评分均分别明显低于对照组；临床疗效研究组优于对照组 (u=2.10 ， P<0.05) ；两 组药物副反应差异无显著性 (P>0.05) 。
  结论 : 西 酞普兰合并认知疗法治疗脑卒中后抑郁的疗效较好。
  
  Objective: To study the effect of citalopram combined with cognitive therapy in the treatment of post-stroke depression.
  Method: 64 patients with post-stroke depressicon were randomly divided into research group and controlled group, the research group were treated by citalopram combined with cognitive therapy and the controlled group were treated by citalopram only for 12 weeks. The efficacy was assessed by Hamilton Depression Rating Scale(HAMD). The side effects were assessed by Treatment Emergent Symptoms Scale(TESS).
  Results: The scores of HAMD of the research group were significantly lower than the controlled group,the therapeutic efficacy in the research group were significantly better than that in the controlled group (u=2.10, P<0.05).
  Conclusion: Citalopram combined with cognitive therapy has better effect in the treatment of post-stroke depression.
   
• P364
  Applying Jingluo Methodology to the Body to Solve Mental Problems
  Hong Chen 1 , Jie Ya Chen 2
  1 World Federation of Chinese Medicine Societies, Beijing, Chinese Mainland, 2 Haidian third Experimental Primary School, Beijing, Chinese Mainland
  
  Objectives: To apply Jingluo (Chi -vital energy- channels, and circulatory networks) to the physical body via Chi Flow, Herbalism, and Acupuncture/Pressure Points for the purpose of curing mental ailments.
  Methods :Chi Flow, Herbalism and acupuncture.
  Results: Authentic TCM, and properly applied Energy based medicine can be much more effective than modern medications.
  Conclusions: Balanced Medicine is based on the theory that illnesses are caused by blockages that cause the Body, and Jingluo System to inhibit each other. A blockage in the Jingluo System will result in physical/mental illness, and in turn harm done to the body/mind will result in blocks in the Jingluo System. The ancient Chinese document "Huang Di Nei Jing" illustrates this theory, detailing how utilizing Acupuncture Points, and Herbs with both physical, and Jingluo enhancing proerties can more effectively, and with more longevity cure ailments than physical medies/medications alone. The mind is the liaison between the body, and the Jingluo System, which influences, and is influenced by both. Practices such as authentic Tai Chi, Kung Fu, and other exercise the body, and Jingluo system which effectively aid the mind, as well as promoting healthy thinking patterns which effectively aid the body, and Jingluo System. The vicious cycle that causes the ailment is removed, and the patient is more permanently cured than a patient treated with a heavily refined drug that has undesired side effects, and short lived benefits. Promoting Chi circulation in the Jingluo System through more natural means such as herbs will allow the patient to think more clearly, and freely than any modern drug, and that is very important to a mental patient.
   
• P365
  沙 盘游戏治疗 79 例中学生网 络成瘾的疗效观察 - A Research on Therapeutic Effect of Sandplay Therapy in Treating 84 Middle School Students with Internet Addiction Disorders
  子文 彭 1 , 文 辉 莫 2
  1 广州市中小学心理教育中心 , 广州 , Chinese Mainland, 2 广 东省佛山市禅城区中心医院 , 佛山 , Chinese Mainland
  
  目的 : 评估沙盘游戏治疗中学生网络成瘾的疗效。
  方法 : 将 79 例网 络成瘾 （ IAD ） 中学生 进行沙盘游戏治疗 ， 疗程为 16 次 ， 并利用网 络成瘾自评量表 （ IAII ） 、焦 虑自评量表 （ SAS ） 、 IAD 诊断问卷 （ IAD-DQ ） 及治 疗前后数学、语文成绩来评估其临床疗效。
  结果 : 治 疗显效率和总有效率分别为 63.29℅ （ 50 例 ） 和 91.14℅ （ 72 例 ）， 其治 疗后的 IAD-DQ 、 IAII 、 SAS 评分及上网时间和频率较治疗前均明显下降而数学、语文成绩较治疗前明显提高 ， 差异具有统计学意义 （ P ＜ 0.01 或 P ＜ 0.05 ） 。 结论 : 沙 盘游戏可能是治疗中学生网络成瘾的有效方法之一。
  关键词 : 沙 盘游戏 ； 网 络成瘾障碍 ； 中学生 ； 心理治疗
  
  Objective: To investigate the therapeutic effect of Sandplay Therapy in treating middle school students with Internet Addiction Disorders.
  Methods: Sandplay Therapy was employed on seventy-nine middle school students with internet addiction disorders for sixteen times and the therapeutic effects were assessed with IAD-diagnosis questionnaire 、 Internet Addiction Inventory Index 、 Self-Rating Anxiety Scale and the scores of mathematics and Chinese.
  Results: The scores of IAD-diagnosis questionnaire 、 Internet Addiction Inventory Index and Self-Rating Anxiety Scale decreased significantly, while the scores of mathematics and Chinese increased significantly (P ＜ 0.05 or P ＜ 0.01), and the significant improved clinical effect rates and total effect improved rates were 63.29℅ and 91.14℅, respectively.
  Conclusion: Sandplay Therapy may be one of valid methods in treating middle school students with Internet Addiction Disorders.
  Key words: Sandplay Therapy; Internet Addiction Disorders; Middle school students; Psychology therapy
   
• P366
  Bowen 家庭治 疗对抑郁症的作用 - Therapeutic Effect of Bowens Family Therapy Therapy on Depression
  胜利 支 1 , 毅平 朱 1 , 帆 张 1 , 华 钟 1 , 菊水 孙 1 , 列 任 1 , 坚白 刘 1
  1 浙江省湖州市第三人民医院 , 心身科 , 湖州市 , Chinese Mainland
  
  目的 : 探 讨 Bowen 家庭治 疗合并文拉法欣治疗抑郁症的疗效。 方法 : 将 100 例住院抑郁症患者随机分 为两组 , 研究 组 50 例以 Bowen 家庭治 疗合并文拉法欣治疗 , 对照组 50 例， 单一服用文拉法欣，疗程 6 周， 应用汉密尔顿抑郁量表 (HAMD) 和 汉密尔顿焦虑量表（ HAMA ） 评估治疗效果。
  结果 : 至治 疗的第 4 、 6 周 时疗效均以研究组显著较好，研究组所服药物剂量显著低于对照组。
  结论 : Bowen 家庭治 疗合并文拉法欣治疗能迅速缓解症状 , 对各类抑郁症均有效。
  关键词 : 抑郁症 Bowen 家庭治 疗
  
  Objective: To explore the efficacy of Bowen's family therapy combined with venlafen on depression. Method: 100 depressive outpatients were randomly assigned to receive Bowen's family therapy plus venlafenxin (n=50) and only receive venlafenxin (n=50) for 6 weeks.The efficacy was assessed with Hamilton depression scale (HAMD) and Hamilton Anxiety scale ( HAMA ).
  Results: At the end of 4 th and 6 th weeks, the therapeutic effect of the study group was significantly better than that of the contrast group , and the dose of venlafaxin in the study group was significantly lower than that in the contrast group 。
  Conclusion: It is suggested that family therapy combined with venlafen maybe a better way to treat depression 。
  Keywords: depression ； Bowen's family therapy
  

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