奎硫平对酒依赖患者稽延性戒断症状及睡眠的影响

The impact of quetiapine on protracted withdrawal symptoms and sleep of patients with alcohol dependence

目的：评估奎硫平对酒依赖患者稽延性戒断症状的治疗效果及睡眠质量和睡眠结构的影响。方法：选取80例酒依赖患者急性期戒酒治疗后随机分为奎硫平治疗组（研究组）和维生素治疗组（对照组），研究组给予200~400 mg/ d 奎硫平治疗，对照组给予维生素治疗。采用宾西法尼亚酒精渴求量表（PACS）、视觉模拟渴求量表（VAS）及汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）分别于入组时和治疗4周对两组患者进行评定，同时接受多导睡眠图（PSG）检测。结果：治疗前两组PACS、VAS 和 HAMD、HAMA 评分差异无统计学意义（P 〉0.05），治疗后研究组 PACS、VAS 和 HAMD、HAMA 总分较治疗前均显著降低，差异有统计学意义（P 〈0.05）。治疗前两组 PSG 各指标差异无统计学意义（P 〉0.05），治疗后研究组觉醒次数（AN）减少[（5.93±1.53）vs（6.91±1.60），t =2.559，P =0.000]，睡眠效率（SE）升高[（68.3±4.17）vs（60.8±4.20），t =7.316，P =0.000]，总睡眠时间（TST）增加[（292.5±25.9）vs（271.7±23.3），t =3.451，P =0.018]，差异有统计学意义。睡眠潜伏期（SL）、快眼动睡眠（REM）百分比及 REM 睡眠潜伏期（RL）等指标两组间差异无统计学意义（P 〉0.05）。对照组治疗前后各指标差异无统计学意义（P 〉0.05）。结论：奎硫平可改善酒依赖患者急性戒断后的心理渴求、焦虑、抑郁等稽延性戒断症状，提高部分睡眠质量。

Objective：To assess the effect of quetiapine on inpatients with alcohol dependence after pro-tracted withdrawal symptoms and explore the impact of quetiapine on sleep structure and quality in patients with alcohol dependence. Method：Eighty hospitalized patients with alcohol dependence were randomly divided into quetiapine treated group（study group）and vitamin therapy group（control group）after alcoholism. The pa-tients in study group were prescribed with 200 ~ 400 mg/ d of quetiapine,meanwhile control group given vitamin therapy. Pennsylvania alcohol craving scale（PACS）,visual analog craving scale（VAS）,Hamilton depression rating scale（HAMD）and Hamilton anxiety scale（HAMA）were evaluated in the two groups before and after 4 weeks treatment. Polysomnography（PSG）test was also used. Results：The differences in scores of PACS, VAS,HAMD and HAMA between two groups were not statistically significant before treatment. The scores of PACS,VAS,HAMD and HAMA in study group decreased after treatment and the differences were statistically significant（all P 〈 0. 05）. There were no significant differences in the index of PSG between two groups before treatment（P 〉 0. 05）. The awakening number（AN）in study group decreased[（5. 93 ± 1. 53）vs（6. 91 ± 1. 60）,t = 2. 559,P = 0. 000],the sleep efficiency（SE）heighted[（68. 3 ± 4. 17）vs（60. 8 ± 4. 20）,t =7. 316,P = 0. 000]and total sleep time（TST）increased[（292. 5 ± 25. 9）vs（271. 7 ± 23. 3）,t = 3. 451, P = 0. 018]after treatment. There were no significant differences in the sleep latency（SL）,the percentage of rapid eye movement（REM）between two groups after treatment（P 〉 0. 05）. Conclusion：Quetiapine can im-prove the protracted withdrawal symptoms such as craving,anxiety,depression in patients with alcohol depend-ence after acute withdrawal symptoms and raise some sleep quality indicators.