高压氧联合西酞普兰治疗抑郁症睡眠障碍患者的临床疗效观察

Clinical effects of hyperbaric oxygen combined with citalopram on sleep disorders in patients with depression

目的:探讨高压氧(HBO)联合西酞普兰治疗抑郁症睡眠障碍患者的临床疗效及其作用机制。方法:收集2016年3月至2019年6月在山西白求恩医院精神卫生科诊治的抑郁症睡眠障碍患者140例,按随机数字表法分为观察组和对照组,每组70例。对照组给予西酞普兰治疗,观察组给予西酞普兰联合HBO治疗,均治疗4周后观察2组患者的治疗效果、抑郁评分、睡眠障碍情况以及血清白细胞介素-1(IL-1)、IL-6、肿瘤坏死因子-α(TNF-α)和皮质醇水平。结果:治疗4周后,观察组患者治疗总有效率(94.29%)显著高于对照组(77.14%),差异有统计学意义( P<0.05);治疗后2组患者睡眠质量、入睡时间、抑郁状态评分均显著低于治疗前,且观察组治疗后下降更显著,差异均有统计学意义( P<0.05或 P<0.01);治疗后2组患者的IL-1、IL-6、TNF-α和皮质醇水平均明显低于治疗前,且观察组治疗后较对照组下降更显著,差异有统计学意义( P<0.05或 P<0.01)。 结论:HBO联合西酞普兰治疗可降低抑郁症睡眠障碍患者血清IL-1、IL-6、TNF-α、皮质醇水平,显著改善抑郁状况和睡眠障碍,有较好的临床疗效。

Objective To investigate the clinical effect and action mechanism of hyperbaric oxygen(HBO)combined with citalopram on sleep disorders.Methods One hundred and forty patients with depression suffering from sleep disorder,admitted to Shanxi Bethune Hospital from March 2016 to June 2019,were enrolled and randomly divided into the observation group and the control group according to random number table method with 70 cases in each group.The control group was treated with citalopram,while the observation group was treated with HBO combined with citalopram.After 4 weeks treatment,the clinical effect,depression score,sleep disorder,serum interleukin-1(IL-1),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),and cortisol levels of the two groups were observed.Results After 4 weeks of treatment,the total effective rate of the observation group(94.29%)was significantly higher than that of the control group(77.14%),with statistically significant difference(P<0.05).After treatment,the scores of sleep quality,sleep time,and depressive state of the two groups decreased significantly than those before treatment,and the decrease in the observation group was more significant after treatment,with statistically significant differences(P<0.05 or P<0.01).The levels of IL-1,IL-6,TNF-αand cortisol in the two groups decreased significantly after treatment,and the decrease of the observation group was more significant,with statistically significant differences(P<0.05 or P<0.01).Conclusion HBO combined with citalopram could reduce the levels of serum IL-1,IL-6,TNF-α,and cortisol in patients with depression suffering from sleep disorders,and significantly improve depression and sleep disorders,indicating it can achieve satisfactory clinic effect.