认知行为疗法对失眠症疗效的影响

The Effect of Cognitive Behavior Therapy on Insomnia

目的观察认知行为疗法(CBT)对失眠症患者睡眠质量和心理健康水平疗效的影响。方法选择符合CCMD-3的失眠症患者72例,药物组36例,服用佐匹克隆,联合治疗组36例,以佐匹克隆合并认知行为疗法治疗,共治疗8周,治疗前后分别用症状自评量表(SCL-90)评价心理健康水平,用匹兹堡睡眠质量指数(PSQI)评定临床疗效。结果治疗结束后,比较药物组和联合治疗组SCL-90评分躯体化(t=2.682,P<0.01)、人际关系敏感(t=2.685,P<0.01)、强迫症状(t=2.983,P<0.01)、抑郁(t=2.045,P<0.05)、焦虑(t=2.650,P<0.01),联合治疗组评分明显低于药物组;匹兹堡睡眠质量(t=2.366,P<0.05)、入睡时间(t=2.398,P<0.05)、睡眠效率(t=2.176,P<0.05)、睡眠药物(t=2.060,P<0.05),各因子联合治疗组得分明显低于药物组。结论认知行为疗法可提高失眠症患者的心理健康水平,改善患者睡眠质量和情绪症状,减少药物不良反应。

Objective To explore the effect of cognitive behavior therapy（CBT） on sleep quality and mental health of insomnia patients.Methods A total of 72 patients with insomnia of CCMD-3 were adapted,of which 36 cases forming drug group were given zopiclone,and 36 cases forming combined treatment group were given the administration of zopiclone combined with cognitive behavior therapy for 8 weeks.Before and after treatment Symptom Checklist 90（SCL-90） was conducted for mental health evaluation,and the Pittsburgh Sleep Quality Index（PSQI） for clinical evaluation.Results After treatment,those SCL-90 scores of somatization（t=2.682,P0.01）,interpersonal sensitivity（t=2.685,P0.01）,obsessive-compulsive symptoms（t=2.983,P0.01）,depression（t=2.045,P0.05）,anxiety（t=2.650,P0.01）,in the drug group were significantly higher than those in combined treatment group;the combined treatment group scored significantly lower than the drug group in Pittsburgh sleep quality（t=2.366,P0.05）,sleep time（t=2.398,P0.05）,sleep efficiency（t=2.176,P0.05）,sleep medication（t=2.060,P0.05）.Conclusion Cognitive behavioral therapy can improve the mental health of patients with insomnia and their sleep quality mood symptoms and reduce side effects.