氟哌噻吨美利曲辛联合阿普唑仑对老年失眠伴焦虑患者睡眠质量、神经内分泌及不良反应的影响

Effects of Flupentixol and Melitracen Combined with Alprazolam on Sleep Quality,Neuroendocrine and Adverse Effects in Elderly Patients with Insomnia with Anxiety

目的观察氟哌噻吨美利曲辛与阿普唑仑联合治疗对老年失眠伴焦虑患者睡眠质量、神经内分泌及不良反应的影响。方法以洛阳市东方人民医院2020年10月至2022年10月收治的72例老年失眠伴焦虑患者为研究对象,依据随机抽签法分为试验组(36例)、参照组(36例)。参照组采用阿普唑仑治疗,试验组采用氟哌噻吨美利曲辛联合阿普唑仑治疗。比较两组治疗后临床疗效,治疗前后焦虑自评量表(SAS)、汉密尔顿焦虑量表(HAMA)、匹兹堡睡眠质量指数(PSQI)、抑郁自评量表(SDS)评分,去甲肾上腺素(NE)、5-羟色胺(5-HT)、脑源性神经营养因子(BDNF)水平,不良反应及不良事件发生情况。结果试验组临床总有效率为97.22%,高于参照组的77.78%(P<0.05)。治疗后,试验组SAS、HAMA及SDS评分下降幅度大于参照组(P<0.05);试验组PSQI各项评分和总评分均低于参照组(P<0.05)。治疗后,试验组NE水平低于参照组,BDNF及5-HT水平高于参照组(P<0.05)。试验组不良反应发生率19.44%与参照组16.67%相比,差异无统计学意义(P>0.05)。结论氟哌噻吨美利曲辛联合阿普唑仑治疗老年失眠伴焦虑可提高疗效,改善睡眠质量、神经递质水平,缓解焦虑,促进病情恢复。

Objective To investigate the effects of flupentixol and melitracen combined with alprazolam on sleep quality and neuroendocrine in elderly patients with insomnia and anxiety.Methods 72 cases of elderly insomnia with anxiety patients admitted to Luoyang Oriental People's Hospital were the study subjects(from October 2020 to October 2022),which were divided into the experimental group(36 cases)and the reference group(36 cases)based on the random draw method.The reference group was treated with alprazolam,and the experimental group was treated with flupentixol and melitracen combined with alprazolam.The two groups were compared in terms of clinical efficacy,levels of self-assessment scale of anxiety(SAS),Hamilton anxiety scale(HAMA),Pittsburgh sleep quality index(PSQI),self-assessment scale of depression(SDS),norepinephrine(NE),5-hydroxytryptophan(5-HT),brain-derived neurotrophic factor(BDNF)before and after treatment,and the occurrence of adverse reactions and adverse events.Results After treatment,the total effective rate of experimental group was 97.22%,which was higher than that of reference group(77.78%),and the difference was statistically significant(P<0.05).After treatment,the scores of SAS,HAMA and SDS in experimental group were decreased more than those in reference group,and the difference was statistically significant(P<0.05);the PSQI score of experimental group was lower than that of reference group,and the difference was statistically significant(P<0.05).After treatment,the NE level of experimental groups was lower than that of reference group,and the BDNF and 5-HT levels were higher than that of reference group,with statistical significance(P<0.05).There was no statistically significant difference in the incidence of adverse reactions in the experimental group(19.44%)as compared to the reference group(16.67%)(P>0.05).Conclusion Flupentixol and melitracen combined with alprazolam has a definite therapeutic effect on elderly patients with insomnia and anxiety.It can improve the level of neurotransmitters,improve sleep quality,alleviate anxiety,and promote recovery.