短程小组认知行为治疗失眠伴慢性非恶性颈背痛的效果  

Efficacy of short group cognitive behavior therapy on insomnia with chronic back and neck pain

作　　者：王平[1] 郭奕倩 王效敏[1] 

机构地区：[1]首都医科大学附属北京世纪坛医院神经与精神病科,北京100038 [2]新加坡心理卫生学院,新加坡539747

出　　处：《中国医药导报》2015年第14期61-65,共5页China Medical Herald

摘　　要：目的探讨短程小组认知行为治疗失眠伴慢性非恶性颈背部疼痛患者的效果。方法选择2013年6月～2013年12月于首都医科大学附属北京世纪坛医院神经与精神病科诊治的，符合国际睡眠障碍分类第二版失眠的诊断标准．并伴慢性非恶性颈背部疼痛的患者39例，随机分为短程小组认知行为治疗组（干预组，20例）和单纯睡眠卫生教育组（对照组，19例）。患者于治疗前，治疗结束后1、5周填写匹兹堡睡眠质量指数（PSQI）、睡眠日志、医院焦虑抑郁量表（HADS）和疼痛视觉模拟评分，比较并分析两组的结果。结果两组治疗期间各有1例中途脱落未能完成治疗。干预组治疗结束后1周入睡时间、睡眠总时间、睡眠质量、睡眠效率、焦虑得分均较对照组改善[（39±18）比（65±28）min、（429±47）比（413±70）min、（3．8±116）比（3．5±1．5）分、（73±13）％比（66±12）％、（7．0±3．5）比（8．1±3．7）分1。差异均有统计学意义（P〈0．05）；治疗结束后5周干预组入睡时间、睡眠总时间、睡眠质量、睡眠效率、焦虑得分分别较对照组相应指标改善[（35±12）比（62±27）min、（440±52）比（418±75）min、（3．9±1．8）比（3．5±1．6）分、（76±12）％比（66±12）％、（6．5±2．4）比（7．8±3.3）分]，差异均有统计学意义（P〈0．05）。结论短程小组认知行为治疗对失眠伴慢性颈背痛患者的失眠和伴随焦虑症状有持续的效果。Objective To evaluate the efficacy of short group cognitive behavior therapy for on insomnia with chronic non-malignant back and neck pain. Methods From June 2012 to December 2013, in Department of Neurology and Psychiatry of Beijing Shijitan Hospital Affiliated to Capital Medical University, 39 patients with chronic non-malignant back and neck pain meeting the second edition of international classification of sleep disorders for insomnia were divid- ed randomly into of cognitive behavior therapy group （intervention group, 20 cases） and sleep education group （control group, 19 cases）. Pittsburgh sleep quality index （PSQI）, sleep diary, the hospital anxiety and depression scale （HADS） and the 0-10 visual analog pain scale score were assessed before the treatment and after the treatment 1, 5 weeks. Results There were 1 case in each group fell out during the treatment. After the treatment 1 week, the scores of sleep onset latency, total sleep time, sleep quality, sleep efficiency and anxiety in intervention group were better than those in control group [（39±18） vs （65±28） min, （429±47） vs （413±70） min, （3.8±1.6） vs （3.5±1.5） scores, （73e13）% vs （66± 12）%, （7.0±3.5） vs （8.1±3.7） scores], the differences were statistically significant （P 〈 0.05）. After the treatment 5 weeks, the scores of sleep onset latency, total sleep time, sleep quality, sleep efficiency and anxiety in intervention group were better than those in control group [（35±12） vs （62±27） min, （440±52） vs （418±75）min, （3.9±1.8） vs （3.5±1.6） scores, （76±12）% vs （66±12）%, （6.5±2.4） vs （7.8±3.3） scores], the differences were statistically significant （P 〈 0.05）. Conclusion Short group cognitive behavior therapy for insomnia has continuous effect in treating insomnia with chronic back and neck pain.

关 键 词：认知行为治疗 失眠 慢性疼痛 匹兹堡睡眠质量指数 睡眠日志 医院焦虑抑郁量表 

分 类 号：R740[医药卫生—神经病学与精神病学]