噻奈普汀对脑卒中睡眠障碍患者的疗效分析

Effect of tianeptine on sleep disorders in patients with stroke.

目的比较加用噻奈普汀与单纯应用镇静类药物对脑卒中后睡眠障碍患者脑电图异常率改善的效果。方法将62例患者随机分为噻奈普汀组、常规治疗组各31例。噻奈普汀组给予口服噻奈普汀片,12.5 mg次/,3次/d。常规治疗组采用三环类药物、苯二氮艹卓类药物和水合氯醛等治疗,治疗均1次/d,睡前服用。记录治疗前及治疗2周时患者睡眠及脑电图检查情况。结果噻奈普汀组睡眠障碍积分(2.65±0.19)与治疗前(5.97±0.44)比较有显著差异(t=66.3,P<0.05),脑电图总异常率12.4%。常规治疗组睡眠障碍积分(2.58±0.52)与治疗前(6.54±0.54)比较有显著异(t=37.40,P<0.01),脑电图总异常率45.2%,两组治疗后睡眠障碍积分比较差异无显著性(t=1.0,P>0.05),脑电图总异常率比较有显著差异(χ2=4.72,P<0.05)。结论加用噻奈普汀能改善患者睡眠情况,且较常规镇静治疗对患者脑电图的改善作用明显。

Objective To compare the effect of ameliorating the abnormal rate of EEG in patients with poststroke patients with sleep disorders treated by tranquilizing drug with or without tianeptine. Mthodes 62 patients were randomly divided into the tianeptine group （ n = 31 ） and routine treatment group （ n =31 ）. Patients in the tianeptine group were orally administrated with tianeptine tablets, 12.5 mg per time,three times a day ; and those in the routine treatment group were treated with tricyclic antidepressants, benzodiazepine drugs and chloral hydrate, once a day before sleep. The sleep amelioration and EEG examination were recorded before treatment and at 2 weeks after treatment. Results In the tianeptine group, the score of sleep disorders after treatment was significantly lower than that before treatment （ 2.65 ± 0.19, 5.97 ± 0.44, t = 66.3, P 〈 0.05 ）, and the total abnormal rate of EEG was 12.4%. In the routine treatment group, the score of sleep disorders after treatment was significantly lower than that before treatment （2.58 ± 0.52, 6.54 ± 0.54, t = 37.40, P 〈 0.01 ）, and the total abnormal rate of EEG was 45.2%. After treatment, the score of sleep disorders was not significantly different between the two groups （ t = 1.0, P 〉 0.05 ）, and there was significant difference in the total abnormal rate （ X^2 = 4.72, P 〈 0.05 ）. Conclusion The additional treatment of tianeptine can ameliorate the sleeping status of the patients, it has more obvious effect in improving the EEG of the patients than the routine treatment of tricydic antidepressants.