小剂量米安色林治疗老年人失眠长期效果

Clinical Observation Small Dose Mianserin to Treat of Elderly Adults with Insomnia Disorder

目的:观察小剂量米安色林治疗老年人失眠的临床疗效和安全性。方法:将宁夏中医医院睡眠医学科门诊60例老年人失眠患者随机分为观察组和对照组,每组30例。观察组予以米安色林7.5 mg/d。对照组给予艾司唑仑片1 mg/d,睡前空腹服药,每日或隔日按需治疗,疗程均为3个月。治疗2~3个月间停药3 d。治疗初期每周1次睡眠卫生教育和适当的门诊心理疏导。治疗前、1周、2周、1个月、2个月、3个月、停药期采用阿森斯失眠严重程度量表评估睡眠情况,患者治疗效果满意度量表评价药物治疗满意度,采用治疗不良反应量表评估药物不良反应。观察组每月检验1次血常规,3个月检验1次肝肾功能。结果:观察组治疗后的AIS评分较治疗前降低(P<0.05),2组治疗1个月、2个月、3个月的AIS评分比较,差异有统计学意义(P<0.05),观察组的痊愈率为63%,对照组的痊愈率为33%,2组的痊愈率比较,差异有统计学意义(P<0.05),观察组较对照组的痊愈率更高。观察组有2例头晕和步态不稳,长期治疗无不良反应,停药试验AIS评分无明显增加(P<0.05),无停药反应。结论:小剂量米安色林治疗老年性失眠有效,长期治疗不良反应少,安全性较好。

Objective:To observe the clinical efficacy and safety of low-dose Mianserin in the treatment of insomnia in the elderly.Methods:Sixty elderly patients with insomnia in the outpatient department of sleep medicine of Ningxia traditional Chinese medicine hospital were randomly divided into treatment group and control group,with 30 cases in each group.Treatment group:mianserin tablets 7.5 mg/d,Take an empty stomach at night.control group:Estazolam tablets 1 mg/d,once a day or every other day treatment,on-demand treatment.At the beginning of treatment,sleep health education and appropriate psychological counseling were given once a week.The efficacy was evaluated by AIS at Before treatment,week 1,week 2,1 month,2 months,3 months.Evaluated adverse drug reactions were observed by TESS in the above period.Results:The AIS score of the treatment group after treatment was lower than that before treatment(P<0.05).There was significant difference in the AIS score of the two groups after 1 month,2 months and 3 months of treatment(P<0.05).The cure rate of the treatment group was 63%and that of the control group was 33%.There was significant difference in the cure rate of the two groups(P<0.05).The cure rate of the treatment group was higher than that of the control group.There were 2 cases of dizziness and walking instability in the treatment group.There were no adverse reactions after long-term treatment,no significant increase in AIS score in drug withdrawal test(P<0.05),and no drug withdrawal reaction.Conclusion:Low dose Mianserin is effective in the treatment of senile insomnia,with less long-term adverse reactions and safe clinical application.