曲唑酮治疗老年期痴呆睡眠障碍的临床探讨  

Trazodone for treatment of sleep disorders in senile dementia：a clinical observation

作　　者：徐淼[1] 潘霄[2] 尹又[3] 拓西平[1] 

机构地区：[1]第二军医大学附属长海医院老年病科,上海200433 [2]第二军医大学心理与精神卫生学系医学心理学教研室,上海200433 [3]第二军医大学附属长征医院神经内科,上海200003

出　　处：《中华老年多器官疾病杂志》2014年第5期340-343,共4页Chinese Journal of Multiple Organ Diseases in the Elderly

摘　　要：目的：评价曲唑酮治疗老年期痴呆睡眠障碍（SD）的临床效果。方法2012年1月至2012年12月，选择在长海医院接受治疗的老年期痴呆SD患者63例，年龄60～80（79.1±7.4）岁，随机分配到曲唑酮组、氯硝西泮组和阿米替林组，每组21例，分别采用各自药物进行治疗4周。于治疗前、后评估睡眠改善情况，并采用汉密尔顿焦虑量表（HAMA）和汉密尔顿抑郁量表（HAMD）评价临床疗效，同时采用副作用量表即治疗急诊症状量表（TESS）评价不良反应，并进行比较分析。结果曲唑酮组总有效率85.7%，高于阿米替林组（76.2%）和氯硝西泮组（66.7%，c2＝6.860，P＜0.05）；曲唑酮组与氯硝西泮组比较，HAMA、HAMD评分均显著降低（t＝4.21，5.13；P＜0.05），曲唑酮组与阿米替林组比较，HAMA、HAMD评分均显著降低（t＝6.47，7.24；P＜0.05）；曲唑酮组不良反应发生率低，程度轻，患者耐受性好。结论曲唑酮能有效缓解老年期痴呆SD及伴随的焦虑、抑郁情绪，不良反应小，值得临床进一步研究。Objective To evaluate the clinical efficacy of trazodone in the treatment of sleep disorders （SD） in the senile dementia patients. Methods A total of 63 elderly dementia patients admitted in Changhai Hospital from January to December 2012, aged 60 to 80 （79.1±7.4） years, presenting SD, were randomly divided into trazodone group （n=21）, clonazepam group （n=21） and amitriptyline group （n=21）. The course of therapy was 4 weeks for the 3 groups. The patients’ sleep status was assessed before and after treatment. The clinical efficacy was evaluated by Hamilton Anxiety Scale （HAMA） and Hamilton Depression Scale Rating （HAMD）. The adverse effects were assessed by Treatment Emergent Symptom Scale （TESS）. Results The total efficiency was 85.7% in trazodone group, significantly higher than that of amitriptyline group （76.2%） and clonazepam group （66.7%, Chi-sqaure=6.860, P〈0.05）. The HAMA and HAMD were dramatically lower in trazodone group than in clonazepam group （t=4.21, 5.13; P〈0.05） and amitriptyline group（t=6.47, 7.24; P〈0.05）. The trazodone group had lower incidence of adverse reactions, milder side effects and better tolerance. Conclusion Trazodone can effectively relieve SD and accompanying anxiety and depression in the senile dementia patients only with mild side effect, which is worth to further clinical study.

关 键 词：睡眠 痴呆 曲唑酮 焦虑 抑郁 

分 类 号：R592[医药卫生—老年医学]