认知行为疗法治疗慢性失眠症的临床对照研究  

Comparison between Cognitive-behavior therapy and Benzodiazepines in the treatment of chronic insomnia

作　　者：赵萍[1] 王俊平[2] 

机构地区：[1]大连医科大学附属第一医院院内感染控制办公室,辽宁大连116011 [2]大连医科大学附属第一医院神经内科,辽宁大连116011

出　　处：《大连医科大学学报》2010年第6期680-682,共3页Journal of Dalian Medical University

摘　　要：[目的]比较认知行为疗法与苯二氮卓类药物治疗慢性失眠症的临床效果。[方法]53名慢性失眠患者,随机分成2组,分别接受认知行为疗法与艾司唑仑治疗,通过睡眠日记及匹兹堡睡眠质量指数记录患者治疗前后的睡眠相关指标。[结果]治疗第1周,艾司唑仑组患者睡眠状况明显改善,睡眠潜伏期为53 min,睡眠效率为65%,总睡眠时间为362 min,匹兹堡睡眠质量指数评分为11。与治疗前及认知行为组比较,差异有显著性意义(P<0.01)。治疗第4周及第8周时,认知行为组患者睡眠状况改善显著,睡眠各项指标与治疗前及艾司唑仑组相比,差异具有显著性意义(P<0.01),而艾司唑仑组患者的睡眠状况又恢复到治疗前的水平。治疗结束后12周,认知行为组患者的睡眠潜伏期为35 min,睡眠效率为74%,总睡眠时间为376 min,匹兹堡睡眠质量指数评分为9.9。与治疗前及艾司唑仑组比较,差异具有显著性意义(P<0.01)。[结论]苯二氮卓类药物治疗慢性失眠症具有短期疗效,认知行为疗法的远期效果较好。[Objective] To compare clinical effect of cognitive-behavior therapy and benzodiazepines on chronic insomnia.[Methods] Fifty-three patients with chronic insomnia were divided into 2 groups,receiving treatments of cognitive-behavior therapy and benzodiazepines separately.All of the subjects were assessed with Pittsburgh sleep quality index（PSQI） and sleep diary.[Results]（1） During the treatment in eight days,benzodiazepines group showed improvement.Sleep latencies were 53 min,sleep efficacy were 65%,total sleep time were 362 min and the scores of PSQI were 11,which were better than those of pre-treatments and cognitive-behavior therapy group（P0.01）.（2） On the forth week and at the end of 8 weeks of treatment,cognitive-behavior group showed improvement in the above three indexes,which were better than those of pre-treatments and the results of benzodiazepines group（P0.01）.While the indexes of the benzodiazepines group could not maintain the effect of treatment.（3） At the end of 12 weeks＇ follow up,cognitive-behavior therapy group still showed better effect in sleep indexes than those of benzodiazepines group and those of pre-treatments.Sleep latencies were 35 min,sleep efficacy were 74%,total sleep time were 376 min and the scores of PSQI were 9.9,which were better than those of pre-treatments and the results of benzodiazepines group（P0.01）.[Conclusion] Benzodiazepines shows a short-term effect on chronic insomnia and cognitive-behavior therapy has long-term effect.

关 键 词：失眠症 病例对照研究 心理治疗 

分 类 号：R740[医药卫生—神经病学与精神病学]