屏蔽蓝光干预对双相障碍维持治疗期患者的生物节律疗效与安全性

The efficacy and safety of blue-blocking intervention on biological rhythms in bipolar patients during maintenance treatment

目的:使用屏蔽蓝光附加治疗对伴有失眠症状的双相障碍维持治疗期患者进行干预,探究其对双相障碍患者生物节律及睡眠的疗效与安全性。方法:选取2020年9月至2023年4月在上海市虹口区精神卫生中心符合纳入标准的双相障碍患者45例,随机分为干预组22例和对照组23例。在保持原来治疗方案不变基础上,干预组患者额外每晚不少于2 h佩戴防蓝光的橙色眼镜持续4周。两组患者于基线、第2周末、第4周末进行中文版神经精神科生物节律评估访谈(BRIAN-C)、匹兹堡睡眠质量指数(PSQI)评估。结果:两组之间比较的重复测量方差分析显示B RIAN-C评分(F时间=17.257,P=0.000)、PSQI评分(F时间=17.144,P=0.000)时间效应均显著。第4周末两组之间BRIAN-C量表主导节律因子分差异具有统计学意义(Z=-2.266,P<0.05)。两组患者均未报告研究相关不良事件发生。结论:屏蔽蓝光附加治疗有效改善双相障碍维持治疗期患者的生物节律紊乱及失眠症状,且安全性和耐受性好。

Objective:To explore the efficacy and safety of blue-blocking intervention on biological rhythm and sleep in bipolar disorder patients with insomnia during maintenance treatment.Method:45 eligible patients with bipolar disorder from September 2020 to April 2023,at Shanghai Hongkou Mental Health Center were randomly divided into an intervention group(22 cases)and a control group(23 cases).On the basis of maintaining the original treatment,patients in the intervention group wore orange glasses of blocking blue light for at least 2 hours every night during 4 weeks,while patients in the control group did not receive any additional intervention.At baseline,second week and fourth week,patients in both two groups were assessed with the Chinese version of biological rhythms interview of assessment in neuropsychiatry(BRIAN-C)and Pittsburgh sleep quality index(PSQI).Results:Compared between the two groups,repeated measurement analysis of variance showed that BRIAN-C score(F-time=17.257,P=0.000)and PSQI score(F-time=17.144,P=0.000)had a significant time effect(all P<0.01).At the end of the 4th week,there was also a statistically significant difference in the dominant rhythm factor scores of BRIAN-C between the two groups(Z=-2.266,P<0.05).Neither group reported any adverse events related to the study.Conclusion:Blue-blocking as additive treatment is effective in improving biological rhythm disruption and insomnia symptoms in patients with bipolar disorder during maintenance therapy,and has good safety and tolerance.