曲唑酮治疗老年期失眠症的临床观察

TRAZODONE FOR SENILE PATIENTS WITH INSOMNIA:A CLINICAL OBSERVATION

目的探讨曲唑酮治疗老年期失眠症的临床疗效和安全性。方法将60例门诊老年失眠症病人随机分为曲唑酮组(治疗组)和地西泮组(对照组),每组各30例,疗程6周。于治疗前及治疗6周末评定病人的睡眠状况,并采用汉密尔顿抑郁量表(HAMD)、焦虑量表(HAMA)评价临床疗效,同时采用副作用量表(TESS)评价不良反应,进行比较分析。结果治疗组总有效率为86.67%,对照组总有效率为83.33%,两组之间差异无显著性(χ2=0.612,P>0.05);与治疗前相比,治疗组及对照组治疗后HAMA、HAMD评分均显著降低(t=7.19～9.43,P<0.01);治疗组和对照组治疗前后HAMA、HAMD评分的下降值比较,差异均有显著性(t=4.21、5.13,P<0.05);两组不良反应相当,均较轻微,不影响治疗。结论曲唑酮能有效缓解老年失眠及伴随的病人的焦虑、抑郁情绪,无副作用,值得临床推广。

Objective To explore the efficacy and safety of trazodone for insomnia in the aged. Methods Sixty senior outpatients with insomnia were evenly randomized to trazodone group and diazepam group, the course of therapy was eight weeks for both groups. Their sleep status was assessed before and at the end of the course. The efficacy was evaluated by HAMD and HAMA, the adverse effects were assessed by TESS. An analysis and comparison were made in both groups. Results The effec tive rate of trazodone group was 86.67 % compared with 83.33 % for diazepam group, with difference being not significant between the two groups （X^2= 0.612,P〉0.05）. The HAMD and HAMA scores upon completion of the therapy showed dramatically lower than that before treatment in both groups （t=7.19 9.43,P〈0.01）, and the differences of decreased values of the scores between the two groups were also significant （t=4.21,5.13;P〈50.05）. The side effects were mild and similar in both groups, which did not impact the therapeutic outcomes. Conclusion Trazodone can effectively relieve insomnia and accompanying anxiety and de pression in the aged without side effects, which is worth while to extent its use clinically.