中西医结合治疗共病焦虑抑郁慢性失眠患者的临床研究

Clinical Study of Integrated Chinese and Western Medicine in the Treatment of Comorbid Anxiety and Depression in Patients with Chronic Insomnia

目的探讨中西医结合治疗焦虑和抑郁障碍等共病的慢性失眠患者治疗方法和效果。方法依照完全随机的方法将172例患者分为中西医综合治疗组(简称治疗组)和传统药物对照组(简称对照组),观察两组患者的总睡眠时间、睡眠效率、睡眠潜伏期、睡眠满意度等,同时监测患者的睡眠指数(Pittsburgh Sleep Quality Index,PSQI)。并观察患者治疗前后HAMD及HAMA评分情况,并对患者的镇静剂使用情况做对比分析。结果治疗组患者总睡眠时间延长、睡眠效率增加、睡眠潜伏期缩短等方面均较对照组改善明显,PSQI下降也更为显著(P<0.05);两组HAMD及HAMA评分显著低于治疗前,与治疗前比较差异有统计学意义(P<0.05),治疗后组间比较,治疗组患者的HAMD评分和HAMA评分显著低于对照组(P<0.05,P<0.01)。治疗组患者服用镇静剂较对照组的量和种类明显减少(P<0.05)。结论中西医结合治疗共病焦虑和抑郁障碍等慢性失眠患者,疗效肯定,患者睡眠明显改善,服用镇静剂数量减少,大部分患者解除了镇静剂成瘾依赖。

Objective To explore the therapeutic method and effects of integrated Chinese and western medicine in the treatment of comorbid anxiety and depression in the patients with chronic insomnia.Methods According to the randomized method,172 patients were divided into a treatment group with comprehensive Chinese and western medicine( treatment group) and a control group with traditional medicine( control group). The total sleep time,sleep efficacy,sleep latency and sleep satisfaction as well PSQI( Pittsburgh sleep quality index) were observed and monitored in the patients of two groups. Additionally,HAMD and HAMA scores were observed before and after treatment and the use of sedative was compared and analyzed. Results In the treatment group,the results of the total sleep time prolonging,sleep efficacy increasing,sleep latency shortening were apparently improved as compared with those in the control group and PSQI was reduced much more significantly( P < 0. 05). HAMD and HAMA scores were lower significantly after treatment as compared with those before treatment in the two groups,indicating the significant differences( P< 0. 05). In the comparison between the two groups,HAMD and HAMA scores in the treatment group were lower significantly than those in the control group( P < 0. 05,P < 0. 01). In the treatment group,the dosage and variety of sedatives used in the patients were apparently less than those in the control group. Conclusion Integrated Chinese and western medicine achieves the definite efficacy on comorbid anxiety and depression in patients with chronic insomnia. This therapy apparently improves sleep quality,reduces the dosage of sedatives and relieves the drug dependence.