小剂量多塞平配合心理行为干预治疗失眠症的临床研究

Clinical research of small dose doxepin combined with psychological behavior intervention in the treatment of insomnia

目的：运用小剂量多塞平配合心理行为干预治疗失眠症，对患者睡眠质量指标的影响进行研究，观察治疗效果。方法选择21例失眠症患者作为研究对象，每晚睡前口服多塞平25 mg，并由专人进行心理行为干预，连续治疗8周。在治疗前、后采用问卷调查的方法，匹兹堡睡眠质量指数（PSQI）量表进行疗效评定，分析研究对象睡眠质量与睡眠信念、睡眠态度的相关性。结果治疗8周后，患者主观睡眠质量、入睡困难、睡眠时间、睡眠效率、睡眠紊乱、催眠药物使用、日间功能评分均低于治疗前评分（t ＝17．34、16．65、10．54、13．37、11．65、7．66、11．57，均 P ＜0．05）；治疗后 PSQI 总分[（5．80±0．97）分]与治疗前[（13．34±2．28）分]相比，差异有统计学意义（t ＝21．27，P ＜0．01）。结论采用小剂量多塞平配合心理行为干预治疗可以改善失眠症患者睡眠质量相关指数，具有较好的临床效果。

Objective To investigate the effect of small dose of doxepin combined with psychological behav-ior intervention in the treatment of insomnia.Methods 21 patients with insomnia were selected as the study sub-jects,took doxepin 25mg before going to bed at every night,to the research object and psychological behavior interven-tion by hand,continuous treatment for 8 weeks.Used the method of questionnaire survey before and after two periods of time,assessed by using pittsburgh Sleep Quality mder（PSQI）scale,analysed the correlation between sleep quality and sleep beliefs attitudes.Results After treatment with 8 weeks,subjected sleep quality,sleep difficulties,sleep time,sleep efficiency,sleep disturbance,hypnotic drug use,and daytime functional scores were lower than before treat-ment （t =17.34,16.65,10.54,13.37,11.65,7.66,11.57,all P 〈0.05 ）,the difference of the score of PSQI between after treatment[（5.80 ±0.97）points]and before treatment[（13.34 ±2.28）points]was significant（t =21.27,P 〈0.01）.Conclusion Small dose of doxipin combined with psychological behavior intervention in treating insomnia can improve the sleep quality of patients.