认知行为疗法配合中医治疗对脾胃病失眠症患者焦虑、抑郁心理及睡眠质量的影响

Effects of cognitive behavioral therapy combined with traditional Chinese medicine on anxiety, depression and sleep quality of patients with insomnia caused by spleen and stomach diseases

目的:分析认知行为疗法配合中医治疗对脾胃病失眠患者焦虑、抑郁心理及睡眠质量的影响。方法:选取2017年1月-2018年1月于我院治疗的脾胃病失眠症患者100例,随机法分组。对照组(n=50)患者采用中医治疗,联合组(n=50)患者应用认知行为疗法(CBT)配合中医治疗。8周后,运用Zung氏焦虑自评量表(SAS)、抑郁自评量表(SDS)评价患者焦虑抑郁心理。匹兹堡睡眠质量指数(PSQI)评价患者睡眠质量,记录所有脾胃病失眠患者临床躯体症状改善情况。结论:联合组治疗后临床躯体症状明显改善,且治疗总有效率较对照组高(χ~2=4.891,P<0.05);治疗后联合组患者SAS及SDS各项评分较对照组明显低(t=-7.796,-5.395;P<0.01);联合组治疗后PSQI各因子分(睡眠质量、睡眠时间、睡眠效率、入睡时间、睡眠障碍、催眠药物、日间功能)及总分较对照组显著低(t=-6.932,-8.123,-11.515,-7.032,-7.291,-7.147,-9.373,-19.121;P<0.01)。结论:CBT疗法配合中医疗法可改善脾胃病失眠患者焦虑抑郁症状,提高睡眠质量,值得临床推广。

Objective:To analyze the effects of cognitive behavioral therapy(CBT)combined with traditional Chinese medicine(TCM)on anxiety,depression and sleep quality of patients with insomnia due to spleen and stomach diseases.Methods:One hundred patients with insomnia due to spleen and stomach diseases who were treated in the hospital from January 2017 to January 2018 were randomly divided into the control group(n=50,treated with TCM)and the combined group(n=50,treated with CBT combined with TCM).Eight weeks later,anxiety and depression were evaluated with the Zung’s Self-rating Anxiety Scale(SAS)and the Self-rating Depression Scale(SDS).The sleep quality was assessed by Pittsburgh Sleep Quality Index(PSQI).The improvement of clinical physical symptoms in all patients was recorded.Results:The clinical physical symptoms of the combined group were significantly improved after treatment,and the total treatment response rate was higher than that of the control group(χ~2=4.891,P<0.05).The scores of SAS and SDS of the combined group were significantly lower than those in the control group after treatment(t=-7.796,-5.395;P<0.01),while scores of sleep quality,sleep time,sleep efficiency,the time to fall asleep,sleep disorders,hypnotic drugs and daytime function and the total score of PSQI in the combined group were significantly lower than those in the control group(t=-6.932,-8.123,-11.515,-7.032,-7.291,-7.147,-9.373,-19.121;P<0.01).Conclusion:CBT combined with TCM can relieve anxiety and depression of patients with insomnia caused by spleen and stomach diseases and improve the sleep quality.