镇静催眠药物联合睡眠卫生教育对成人2型糖尿病共病失眠症的临床疗效

Clinical efficacy of sedation hypnotic drugs combined with sleep health education in comorbid insomnia of adult type 2 diabetes mellitus

目的 探讨镇静催眠药物联合睡眠卫生教育对成人2型糖尿病共病失眠症的临床疗效。方法 收集2023年1-12月重庆市九龙坡区人民医院神内内分泌科接受短期(2周)胰岛素强化治疗的2型糖尿病共病失眠症患者的一般情况、检查指标和失眠严重程度指数量表(ISI)、宗氏焦虑自评量表(SAS)、宗氏抑郁自评量表(SDS)评分等资料,将接受镇静催眠药物联合睡眠卫生教育治疗的患者65例作为观察组,其中39例伴有轻度焦虑(A1组),22例伴有轻度抑郁(A2组);未接受镇静催眠药物联合睡眠卫生教育治疗的患者54例作为对照组,其中33例伴有轻度焦虑(B1组),22例伴有轻度抑郁(B2组)。所有患者均接受常规糖尿病饮食及运动指导、胰岛素强化治疗。比较各组治疗1、2周血糖控制情况和失眠、焦虑、抑郁改善情况。结果 治疗1周时观察组、对照组空腹血糖(FPG)、餐后2 h血糖(2 hPG)、葡萄糖目标范围内时间(TIR)达标率间差异无统计学意义(P>0.05);治疗2周时观察组的FPG、2 hPG明显低于对照组(P<0.05),观察组的TIR达标率明显高于对照组(P<0.05)。治疗1周时观察组、对照组ISI、SAS、SDS评分差异无统计学意义(P>0.05);治疗2周时观察组的ISI、SAS评分明显低于对照组(P<0.05),SDS评分差异无统计学意义(P>0.05);观察组治疗2周时失眠、焦虑症状的缓解率较治疗1周时明显提高(P<0.05),抑郁症状的缓解率无明显提高(P>0.05);对照组治疗2周时失眠、焦虑、抑郁症状的缓解率与治疗1周时比较差异均无统计学意义(P>0.05)。结论 镇静催眠药物联合睡眠卫生教育治疗成人2型糖尿病共病失眠症不仅可有效提高血糖控制达标率,还改善失眠、焦虑症状。

Objective To investigate the clinical effect of sedation hypnotic drugs combined with sleep health education in comorbid insomnia of adult type 2 diabetes mellitus.Methods The data of general conditions,examination indicators,Insomnia Severity Index Scale(ISI),Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS) scores in the patients with type 2 diabetes mellitus receiving short-term(2 weeks) insulin intensive therapy in the neurology and endocrinology department of this hospital from January to December 2023 were collected.Sixty-five patients receiving the sedation hypnotic drugs combined with sleep health education served as the observation group,among them,39 cases were complicated with mild anxiety(group A1),22 cases were complicated with mild depression(group A2);fifty-four patients without receiving sedative and hypnotic drugs combined with sleep health education served as the control group,among them,33 cases were complicated with mild anxiety(group B1),22 cases were complicated with mild depression(group B2).All patients received the routine diabetes diet,exercise instruction and intensive insulin therapy.The glycemic control and improvement of insomnia,anxiety and depression after 1,2 weeks of treatment were compared among various groups.Results The reaching standard rates of fasting blood glucose(FPG),2 h postprandial glucose(2 hPG) and time in range(TIR) in 1 week after treatment showed no statistical difference between the observation group and control group(P>0.05);FPG and 2 hPG after 2-week treatment in the observation group were were significantly lower than those in the control group(P<0.05),and the TIR reaching standard rate in the observation group was significantly higher than that in the control group(P<0.05).The scores of ISI,SAS and SDS after 1 week treatment had no statistical difference between the observation and control groups(P>0.05);the ISI and SAS scores after 2-week treatment in the observation group were significantly lower than those in the control group(P<0.05),The SDS score had no statistical difference between the observed group and the control group(P>0.05);the remission rate of insomnia and anxiety symptoms in 2 weeks after treatment in the observation group was significantly increased compared with that in 1 week after treatment(P<0.05);the remission rate of insomnia,anxiety and depression symptoms in the control group had no statistic difference between in 2 weeks after treatment and 1 week after treatment(P>0.05).Conclusion Sedation hypnotic drugs combined with sleep health education for treating comorbid insomnia in adult patients with type 2 diabetes mellitus can not only effectively increase the reaching standard rate of blood glucose control,but also improve the symptoms of insomnia and anxiety.