老年卒中睡眠障碍相关因素分析及中医药与艾司唑仑治疗的比较研究

Analysis on Somnipathy Related Factors in Elderly Patients with Stroke and Comparative Study on the Efficacy of Treatment by Traditional Chinese Medicine and by Estazolam

目的研究老年卒中患者发生睡眠障碍的相关因素,对中医药与艾司唑仑改善患者睡眠后其神经功能的恢复情况进行比较。方法将老年卒中患者336例,根据其睡眠情况分为睡眠正常组(115例)和睡眠障碍组(221例),分析和研究老年卒中患者发生睡眠障碍的相关因素。然后将睡眠障碍组221例患者随机分为中医治疗组(112例)和对照组(109例),分别采用中医辨证论治与西药艾司唑仑口服治疗21天,观察睡眠障碍量表(SDRS)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、治疗药物副作用量表(TESS)、临床神经功能缺损程度评分(NDS)的变化。结果脑出血患者睡眠障碍的发生率为77.03%(57/74),高于脑梗死患者的62.60%(164/262,P<0.05);发生在脑干、大脑半球(额叶)、基底节部位的卒中患者比其他部位的患者更容易发生睡眠障碍(P<0.05);神经功能缺损程度重的患者易发生睡眠障碍。中医药能显著改善老年卒中患者的失眠症状,其有效率达81.25%(91/112),优于对照组的65.14%(71/109,P<0.01)。随着睡眠的改善,两组神经功能缺损评分均较治疗前显著下降,神经功能明显恢复(P<0.05)。结论卒中发生的性质、部位以及其神经功能缺损程度与睡眠障碍的发生有密切关系。改善卒中患者睡眠有利于其神经功能的恢复,中医药可改善老年卒中患者的睡眠。

Objective To analyze the somnipathy related factors in elderly patients with stroke and to compare effects of traditional Chinese medicine and estazolam on sleep and the followed nervous function.MethodsThe somnipathy related factors in 336 elderly patients with stroke,221 accompanied with somnipathy and 115 with normal sleep,were studied and analyzed.Moreover,the 221 patients with somnipathy were assigned to two groups,112 in the treated group treated with TCM according to syndrome differentiation,and 109 ...