基于中医时间医学配合认知行为疗法治疗早醒型失眠的效果观察

Observation on the Effect of Time Medicine Based on Traditional Chinese Medicine Combined with Cognitive Behavioral Therapy in the Treatment of Early Awakening Insomnia

目的:研究基于中医时间医学配合认知行为疗法(CBT)治疗早醒型失眠患者的影响。方法:选取2021年3月—2022年9月中国中医科学院广安门医院心身医学科就诊的76例早醒型失眠患者,按随机数字表法分为试验组和对照组,各38例。对照组采用CBT治疗,试验组采用中医时间医学理论配合CBT治疗,比较两组临床疗效、心率变异性指标、匹兹堡睡眠质量指数(PSQI)、健康调查简表(SF-36)。结果:治疗后,试验组总有效率高于对照组(P<0.05);试验组总功率(TP)、低频功率(LF)、高频功率(HF)、R-R间隔的标准差(SDNN)、相邻R-R间隔差值的平方和再取均值的平方根(RMSSD)均高于对照组,低频/高频比值(LF/HF)低于对照组(P<0.05);试验组PSQI各方面及总评分低于对照组(P<0.05);试验组生理功能、躯体疼痛、精神健康以及总体健康评分高于对照组(P<0.05)。结论:基于中医时间医学配合CBT治疗早醒型失眠患者能够有效提高治疗总有效率,改善早醒症状和自主神经功能,提升睡眠质量指数和生活健康状况。

Objective:To study the effect of time medicine based on traditional Chinese medicine combined with cognitive behavioral therapy(CBT)on patients with early awakening insomnia.Methods:From March 2021 to September 2022,76 patients with early-wake insomnia from the Department of Psychosomatic Medicine of Guang’anmen Hospital,China Academy of Traditional Chinese Medicine were divided into 2 groups.The study group and the control group according to the randomized numerical table method,with 38 patients in each group.The control group was given CBT,while the study group was given time medicine based on traditional Chinese medicine combined with CBT.The clinical efficacy,heart rate variability index,Pittsburgh Sleep Quality Index(PSQI),and 36-item short-form health survey(SF-36)were compared between the two groups..Results:After treatment,the total effective rate of the experimental group was higher than that of the control group(P<0.05).The total power(TP),low-frequency(LF),high-frequency(HF),standard deviation of R-R interval(SDNN),and root mean square of successive differences(RMSSD)in the experimental group were higher than those in the control group,and the low frequency/high frequency ratio(LF/HF)was lower than that in the control group(P<0.05).The PSQI scores and total scores of the experimental group were lower than those of the control group(P<0.05).The scores of physiological function,physical pain,mental health and overall health in the experimental group were higher than those in the control group(P<0.05).Conclusion:Time medicine based on traditional Chinese medicine combined with CBT can effectively improve the total effective rate of treatment in patients with early awakening insomnia,improve the symptoms of early awakening and autonomic nerve function,improve sleep quality index and life health status.