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目的:探讨认知疗法对首发精神分裂症患者认知功能的影响。方法将100例首发精神分裂症患者随机分为两组。两组均应用齐拉西酮治疗,研究组在此基础上联合认知疗法,观察12周。于治疗前后采用韦氏成人智力量表、韦氏记忆量表、铁槽铁钉测验、手指敲击试验、动作功能测验、手功能测验、连线测验A和B、威斯康星卡片分类测验及言语流利性测验等评定认知状况,采用阳性与阴性症状量表评定精神症状。结果两组治疗8周起铁槽铁钉测验、手指敲击测验、连线测验完成类别数、韦氏成人智力量表和研究组手功能协调测验得分均较治疗前显著改善( P<0.05或0.01);治疗12周末,两组动作功能测验和研究组视觉连线A得分较治疗前显著改善( P<0.05或0.01)。研究组治疗4周末起操作智商,治疗12周末铁槽铁钉(左右手)、总记忆商和手指敲击(左手)显著优于对照组( P<0.05或0.01)。结论认知治疗能显著改善首发精神分裂症患者的认知功能,效果优于单用药物治疗。“,”Objective To explore the influences of cognitive therapy on cognitive function of first-episode schizophrenia patient .Methods A total of 100 first-episode schizophrenics were randomly divided into two groups .Both groups were treated with ziprasidone , research group was plus cognitive therapy for 12 weeks .Before and after treatment cognitive status was assessed using the Wechsler Adult Intelligence Scale (WAIS) ,Wechsler Memory Scale (WMS) ,Iron Nails Tank Tests (INTT ) ,Finger Tapping Test (FTT) ,Motor Function Test (MFT) ,Hand Function Test (HFT) ,Tail Making Test A and B (TMTA/B) ,Wisconsin Card Sorting Test (WCST ) and Verbal Fluency Test (VF) and mental symptom with the Positive and Negative Syndrome Scale (PANSS) .Results Since the 8th week treatment the INTT ,FTT , completed sorts of the TM T ,WAIS scores of both groups and hand coordination of research group im-proved more significantly compared with pretreatment (P<0 .05 or 0 .01);at the end of the 12th week the MFT scores of both groups and visual TMTA score of research group improved more significantly com-pared with pretreatment (P<0 .05 or 0 .01) .Performance IQ since the end of the 4th week and INTT (left/right hand) ,total MQ and FTT (right hand) at the end of the 12th week were better in research than con-trol group (P<0 .05 or 0 .01) .Conclusion Cognitive therapy could significantly improve cognitive func-tion of first-episode schizophrenic compared with single pharmacotherapy .