石杉碱及氯硝西泮治疗慢性失眠症的临床观察

Combining Huperzine with Clonazepam in treatment of Chronic Insomnia

目的 :评价石杉碱、氯硝西泮治疗慢性失眠症的临床疗效。方法 :5 3例长期服用各类催眠药物无效的慢性失眠症患者在停用原药物三天后 ,进入连续二周的夜间睡前 30分钟服用氯硝西泮 2mg (A阶段 ) ;然后连续四周的石杉碱 ,上午、中午各服用 10 0ug ;氯硝西泮夜间睡前 30分钟服用 2mg (B阶段 ) ;最后连续四周 ,自选氯硝西泮夜间用量 (C阶段 )。A、B、C三阶段分别登记日间觉醒及夜间睡眠时间及其每日二者的平均比值 ,每日氯硝西泮用量及每阶段前后匹兹堡睡眠质量指数。结果 :昼夜交替服用石杉碱、氯硝西泮B、C阶段治疗与单一夜间口服氯硝西泮的A阶段比较显示 ,通过延长夜间睡眠时间 ,使睡眠一觉醒时间比值降至 1:4 7± 2 1,较A阶段的 1:6 3± 3 5有明显下降 (P <0 0 2 ) ,同时提高了睡眠质量 ,匹兹堡睡眠质量指数评分值由A阶段的 14 2± 4 5降至C阶段的 8 3± 3 7(P <0 0 1)。并且在C阶段中 ,平均每例患者的用量为 0 8mg± 0 2 2mg ,与A、B阶段的 2mg降低约 6 0 % ,其中有 16例患者在C阶段末期停用氯硝西泮。结论 :石杉碱、氯硝西泮昼夜服用治疗慢性失眠症通过延长睡眠时间而改善睡眠觉醒周期节律的同时亦提高睡眠质量。并逐步减少了氯硝西泮用量 。

Objective:to study the effect of combining huperzine with clonazepam in treatment of chronic insomnia.Method:53 cases of chronic insomnia refractory to mild tranquilizers were treated with a combining description of huperzine and clonazepam after 3 days wash off, i.e. the first stage clonazepam 2mg qn for 2 weeks; the second stage, huperzine 100 ug bid in daytime and clonazepam 2mg qn for 4 weeks; and the third stage, the dosage of clonazepam was determined by patients themselves. Using sleep diary and Pittsburgh Sleep Index to assess the outcome.Result:in the second stage, patients had longer sleep than in the first stage. In the third stage, except for longer sleep, the quality of sleep increased either and the dosage of clonazepam decreased from 2mg to 0.8±0.2 mg.Conclusion:combining huperzine with clonazepam can increase quality of sleep in patients with chronic insomnia, as well as decrease the dosage of mild tranquilizer.