曲唑酮治疗老年苯二氮卓类药物依赖患者临床观察

A clinical study of trazodone replacement treatment on benzodiazepine drugs dependence in senile patient

目的探讨曲唑酮对老年苯二氮卓类药物（BZD）依赖患者替代治疗的疗效及对认知功的影响。方法对51例老年BZD依赖患者采用剂量快速递减、曲唑酮替代疗法。14d内停用BZD，之后睡前顿服曲唑酮，连服6个月。采用匹兹堡睡眠质量指数（PSQJ）量表和副反应量表（TESS）评定临床疗效和不良反应。选用韦氏成人智力量表（WAIS-RC）、韦氏成人记忆量表（WMS-RC）评定认知功能。疗效和不良反应于治疗前后评定；认知功能于治疗前后各评定1次。结果PSQJ总分[（13．17±3．70）分，（11．05±3．48）分]、睡眠质量[（2．36±0．33）分，（1．91±0．29）分]、睡眠障碍、日问功能障碍分疗后低于疗前（P〈0．05），其他成份分无差异。曲唑酮副反应少而轻，更无依赖发生。认知功能中的知识、算术、数字符号、木块拼图、长时记忆、短时记忆、即刻记忆及记忆商数分方面疗前均低于疗后（P〈0．05）。结论曲唑酮可作为老年失眠患者的理想药物。

Objective To explore the efficacy of trazodone replacement treatment on benzodiazepine drugs dependence and effect of cognitive function on senile patients. Methods 51 senile patients with benzodiazepine drugs dependence were assigned with dosage tacho-decrement and replaced by trazodone. The patients were discon- tinuaneed taking benzodiazepine in 14 days and taken at a draught of trazodone before retiring about 6 months. Clinical effect and side effects were assessed with the Pittsburgh sleep quality index （PSQJ） and treatment emergent symptom scale（TESS） before and after treatment. Cognitive function was evaluated with Wechsler intelligence scale for adult-Chinese revised （ WAIS-RC ） and Weehsler mermory scale for adult-Chinese revised （ WMS-RC ） once before and after treatment. Results The scores total PSQJ （ （ 13.17 ± 3.70）, （ 11.05 ± 3.48 ） ）, the sleep quality （ （2.36 ± 0.33 ）, （ 1.91 ± 0.29） ） , daily function disorder, sleep disorder were significantly lower than be- fore treatment while the other factor scores were not significantly changed, Trazodone wes effective without severe side effects and dependence. The study group showed significantly lower scores in learning, calculation, the signs of figure,wood puzzles,long-term memory,short-term memory,immediate memory,memory quotient in the assessment of cognitive funetion than after treatmemt （P 〈 0.05 ）. Conclusion Trazodone is an ideal medicine to senile insomnia.