网络认知行为疗法对慢性失眠症患者睡眠质量及心理状态的影响研究

Effect of internet cognitive behavioral therapy on sleep quality and mental state of patients with chronic insomnia

目的:探讨网络认知行为疗法对慢性失眠症患者睡眠质量及心理状态的影响。方法:选取60例慢性失眠症患者为研究对象,按照干预治疗方式不同分为干预组(n=31)和对照组(n=29)。对照组给予单一催眠药物治疗;干预组在对照组基础上给予网络认知行为疗法,疗程均为6周。比较两组患者干预前、干预结束及12周随访时匹兹堡睡眠质量量表(PSQI)评分、汉密尔顿焦虑量表(HAMA)和抑郁量表(HAMD)评分及催眠药减药率。结果:12周随访时,干预组PSQI各维度得分、PSQI总分、HAMA及HAMD评分低于对照组(P<0.05);患者PSQI总分有时间变化趋势(P<0.01);不同干预方式对患者PSQI总分影响的差异有统计学意义(P<0.01);干预措施与干预时间存在交互效应(P<0.05)。干预结束时,干预组患者催眠药物减药率高于对照组(P<0.05)。结论:网络认知行为疗法联合催眠药物治疗慢性失眠症可以减少催眠药物的使用,且对失眠症患者睡眠质量、心理状态改善效果要好于单一使用催眠药物治疗。

Objective:To explore the effects of internet cognitive behavioral therapy on sleep quality and mental state of patients with chronic insomnia.Methods:64 patients with chronic insomnia were divided into intervention group(n=31) and the control group(n=29) according to different intervention methods.The control group was treated with single hypnotic drug,the intervention group was given network cognitive behavioral therapy on the basis of the control group,and the course of treatment was 6 weeks.The scores of Pittsburgh Sleep Quality Scale(PSQI),Hamilton Anxiety Scale(HAMA) and Depression Scale(HAMD) and the reduction rate of hypnotics were compared between the two groups before intervention,at the end of intervention and 12 weeks of follow-up.Results:At 12 weeks follow-up,PSQI scores,PSQI total scores,HAMA and HAMD scores in the intervention group were significantly lower than those in the control group(P<0.05).The total score of PSQI of patients showed a trend of time variation(F=80.023,P<0.01).Different intervention measures had significant difference in the total score of PSQI of patients(F=34.260,P<0.01).Intervention measures had an interaction effect with intervention time(F=11.732,P<0.01).At the end of the intervention,the hypnotic drug reduction rate in the intervention group was higher than that in the control group(P<0.05).Conclusion:ICBT combined with hypnotic drugs in the treatment of chronic insomnia can reduce the use of hypnotic drugs.And the effect of improving sleep quality and mental state of insomnia patients is better than that of using hypnotic drugs to treat chronic insomnia.