认知行为与安眠药物治疗慢性失眠症临床效果对比分析

倪智勇

[摘要] 目的 探讨对慢性失眠症患者使用安眠药物和认知行为治疗的临床效果。 方法 现对于本院就诊的156例慢性失眠症患者展开研究，入院时间在2017年2月～2019年6月间，参照均等单盲法将156例患者分为A组、B组和C组，各52例，其中A组患者在参与研究的过程中单纯使用安眠药物治疗;B组则单纯使用认知行为治疗;C组联合使用安眠药物和认知行为治疗。比较三组的焦虑、抑郁评分以及睡眠潜伏期和总睡眠时长之间的差异。结果 A组、B组和C组治疗前焦虑评分、抑郁评分、睡眠潜伏期时长和总睡眠时长之间未见明显差异（P>0.05）;治疗结束时，C组焦虑评分和抑郁评分低于A组和B组，睡眠潜伏期时长短于A組和B组，总睡眠时长长于A组和B组，差异有统计学意义（P<0.05），但治疗结束3个月、6个月后，B组焦虑和抑郁评分低于A组和C组，睡眠潜伏期时长短于A组和C组，总睡眠时长长于A组和C组，差异有统计学意义（P<0.05）。 结论 对于慢性失眠症患者单纯使用安眠药物治疗见效较快，短期内可以显著改善患者的症状，而单纯使用认知行为治疗见效较慢，但远期治疗效果更为显著，并且两种治疗方式联合治疗的远期效果与单纯使用认知行为治疗的远期效果相比略显不足。

[关键词] 认知行为;安眠药物;慢性失眠症;夜间多导睡眠图记录;临床效果

[中图分类号] R749.92          [文献标识码] B          [文章编号] 1673-9701（2020）16-0096-04

A comparative analysis of the clinical efficacy of cognitive behavior and hypnotics against chronic insomnia

NI Zhiyong

Department of Sleep Medicine，Xiamen Xianyue Hospital，Xiamen   361012，China

[Abstract] Objective To explore the clinical efficacy of hypnotics and cognitive behavior in the treatment of the patients with chronic insomnia. Methods A study was conducted on 156 patients with chronic insomnia admitted to our hospital from February 2017 to June 2019. The 156 patients were divided into group A， group B and group C with 52 patients in each group according to the equal single blind method， among which group A patients were treated only with hypnotics during the study; group B was treated only with cognitive behavior; group C was treated with the combination of hypnotics and cognitive behavior. The anxiety and depression scores， sleep latency （SL） and total sleep time （TST） of the three groups were compared. Results There was no significant difference in anxiety scores，depression scores，SL and TST among groups A， B and C before treatment（P>0.05）. At the end of the treatment， the anxiety scores and depression scores of group C were lower than those of group A and group B，the SL was shorter than that of group A and group B，the TST was longer than that of group A and group B， and the differences among the groups were significant（P<0.05）. However， 3 months and 6 months after the end of the treatment， the anxiety scores and depression scores of group B were lower than those of group A and group C，the SL was shorter than that of group A and group C，the TST was longer than that of group A and group C，and the differences among the groups were significant（P<0.05）. Conclusion For the patients with chronic insomnia， the treatment only with hypnotics takes effect faster，which can significantly ameliorate the patients symptoms in the short term，while the treatment only with cognitive behavior takes effect more slowly，but its long-term curative effect is more significant，and the long-term effect of the combination of the two therapies is slightly inferior to that of the treatment with cognitive behavior alone.

[Key words] Cognitive behavior; Hypnotic; Chronic insomnia; Nocturnal polysomnography（nPSG） recording; Clinical efficacy

随着生活节奏的加快，工作压力的增大，失眠患者的占比率逐年增多，而当其前往医院就诊时，最常使用的治疗方式是安眠药物治疗[1]。经研究表明[2]，安眠药物治疗过程中具有见效快、起效时间短的特点，对慢性失眠症患者而言，可以有效缩短患者的睡眠潜伏期，减少夜间觉醒次数，延长睡眠总时间，从而提高慢性失眠症患者的睡眠質量。但长期服用药物治疗副作用较大，容易产生药物的依赖性，易导致睡眠状态重新回到治疗前的状态，甚至影响患者的日间正常生活，患者可表现为认知功能受损、动作不协调和反应迟钝等现象[3]。基于……