米氮平联合rTMS治疗伴睡眠障碍的老年焦虑症患者的临床疗效

Clinical Efficacy of Mirtazapine Combined with rTMS in Elderly Anxiety Patients with Sleep Disorder

目的研究米氮平和rTMS联合治疗伴睡眠障碍的老年焦虑症患者的疗效。方法选取2014年9月至2016年9月于我院医治的98例焦虑症并睡眠障碍老年患者,分为米氮平治疗对照组和rTMS、米氮平联合治疗组,每组49例,对比两组的SAS评分、PSQI评分及多导图睡眠检测。结果治疗前两组患者SAS评分无统计学差异(P=0.898)。治疗后观察组患者SAS评分显著低于对照组(P=0.000)。两组患者在治疗前睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、催眠药物、日间功能障碍和PSQI总分等差异均无统计学意义(P>0.05)。治疗后观察组患者睡眠质量、入睡时间、睡眠时间、催眠药物、日间功能障碍和PSQI总分均显著低于对照组(P<0.05)。两组患者在治疗前睡眠潜伏期、REM潜伏期、睡眠总时长、睡眠效率和夜晚睡醒次等均无统计学差异(P>0.05)。与对照组比较,治疗后观察组患者睡眠潜伏期显著缩短(P<0.05);REM潜伏期显著缩短(P<0.05);睡眠总时长显著增加(P<0.05);睡眠效率显著增加(P<0.05);夜晚睡醒次显著减少(P<0.05)。结论米氮平联合rTMS治疗可以显著改善焦虑症伴睡眠障碍老年患者的焦虑情绪及睡眠质量。

Objective To explore the effect of Mirtazapine combined with rTMS in elderly anxiety patients with sleep disorders. Methods Ninety-eight elderly anxiety patients with sleep disorder who had received treatment in our hospital from September 2014 and September 2016 were selected and divided into two groups, 49 cases in each group. Those treated with only Mirtazapine were set as control group while those given combined therapy of rTMS and Mirtazapine as observation group. The SAS score, PSQI score and PSG indexes in the two groups were compared. Results There was no significant difference in SAS score between the two groups before treatment （69.39 ±6.37 vs. 69.23 ±5.94, P = 0.898 ）. After treatment, the SAS score of the observation group was significantly lower than that of the control group （ 35.16 ±3.25 vs. 42.35 ±3.92, P=0.000 ） . There were no significant differences in sleep quality, sleep time, sleep time, sleep efficiency, sleep disorders, hypnotic drugs, daytime dysfunction and PSQI score between the two groups before treatment （P〉0.05） . After treatment, the sleep quality, sleep time, sleep time, hypnotic drugs, daytime dysfunction and PSQI score of the observation group were significantly lower than those of the control group （ P 〈 0.05 ） . There were no significant differences between the two groups in sleep latency, REM latency, total sleep time, sleep efficiency and times of waked up during the night before treatment （P 〉 0.05 ） . After treatment, compared with the control group, patients in the observation group got a shortened sleep latency （21.14 ±10.21 vs.32.14 ±12.18min, P〈0.05 ）; a decrease in REM latency （57.02 ±8.16 vs.66.65 ±9.11 rain, P〈0.05 ）; an increase in total sleep time （271.43 ±8.59 vs.238.53 ±17.70 rain, P〈0.05 ）; an elevated sleep efficiency （ 72.17 ± 10.16 vs.63.28 ±1.02 %, P〈0.05 ）; and a decreased times of waked up during the night （ 2.16 ±0.62 vs.4.13 ±0.97, P〈 0.05 ） . Conclusion Mirtazapine combined with rTMS therapy can improve the anxiety emotion and sleep quality of elderly anxiety patients with sleep disorder.