正念治疗与失眠症的认知行为治疗对门诊慢性失眠症患者治疗效果比较的临床观察  

Clinical Observation of Comparing the Treatment Effect on Chronic Insomnia in Outpatient Clinic Between Mindfulness Therapy and Cognitive Behavioral Therapy for Insomnia

作　　者：王彦婷 江灿 刘凤 张婷 WANG Yanting;JIANG Can;LIU Feng;ZHANG Ting(Department of Sleep and Psychology,Daping Hospital,Research Institute of Surgery,Army Medical University of PLA,Chongqing 400010,China)

机构地区：[1]陆军军医大学第三附属医院(所)睡眠心理中心,重庆400010

出　　处：《重庆理工大学学报（自然科学）》2018年第8期142-146,共5页Journal of Chongqing University of Technology：Natural Science

基　　金：国家自然科学基金资助项目(31171006)

摘　　要：比较正念治疗(mindfulness therapy)和失眠症的认知行为治疗(cognitive behavior therapy for insomnia,CBTI)对门诊慢性失眠症患者的疗效。在门诊收集符合纳入和排除标准的慢性失眠症患者60例,按随机双盲的方法分为正念治疗组(MG)30例和失眠症的认知行为治疗组(CG)30例。在入组当天、治疗第8周周末分别使用使用GDA-7、PHQ-9量表评估焦虑情绪,在入组当天、治疗第2周周末、第4周周末及第8周周末分别使用PSQI、ISI量表评估患者主观睡眠质量情况。结果表明:两组患者在年龄、性别、受教育程度、病程等方面差异均无显著性;入组当天两组患者GAD-7、PHQ-9、PSQI、ISI比较分别为(4.500±1.042 vs 4.700±1.055)、(4.167±1.392 vs 4.500±1.592)、(21.467±4.790 vs 21.433±4.014)、(16.467±3.758 vs 16.633±3.459),P>0.05,差异均无显著性;治疗第2周周末两组患者PSQI、ISI比较分别为(20.667±4.604 vs 13.200±5.416)、(16.200±3.605 vs 11.633±4.230),P<0.05,差异有显著性;治疗第4周周末两组患者PSQI、ISI比较分别为(13.967±4.038 vs 10.033±3.157)、(10.800±3.231 vs 7.700±2.793),P<0.05,差异有显著性;治疗第8周周末两组患者PSQI、ISI比较分别为(11.700±3.669 vs 10.633±3.489)、(7.900±2.564 vs 7.067±2.348),P>0.05,差异无显著性;治疗第8周周末两组患者GAD-7、PHQ-9比较分别为(3.433±1.382 vs 4.400±1.354)、(3.200±1.215 vs 3.900±1.373),P<0.05,差异有显著性。由此可见:正念治疗与失眠症的认知行为治疗对慢性失眠症患者较远期疗效相当,但正念治疗比失眠症认知行为治疗起效慢,正念治疗能改善慢性失眠症患者焦虑抑郁情绪。This paper aims to compare the treatment effect on chronic insomnia in outpatient clinic between mindfulness therapy and cognitive behavioral therapy for Insomnia. A total of 60 patients with chronic insomnia who met the inclusion and exclusion criteria were collected at the clinic. They were divided into 30 cases in the mindfulness therapy group（ MG） and the cognitive behavior therapy group（ CG） of insomnia through the randomized double-blind method. Anxiety and depression were assessed on the day of enrollment and in the end of the 8 th week by using the GDA-7 and PHQ-9 scale respectively. On the day of enrollment,in the end of the 4 th and 8 th week using the PSQI and ISI scale to assess the patient ＇s subjective sleep quality respectively. There were no significant differences between the two groups in terms of age,gender,degree of education,duration of disease,etc.,and the patients in both groups were enrolled on the day of enrollment also had no significant differences,with the results of（ 4. 500 ± 1. 042 vs 4. 700 ± 1. 055）,（ 4. 167 ± 1. 392 vs 4. 500 ±1. 592）,（ 21. 467 ± 4. 790 vs 21. 433 ± 4. 014）,（ 16. 467 ± 3. 758 vs 16. 633 ± 3. 459）,P 〉0. 05 by using the scale of GAD-7,PHQ-9,PSQI and ISI respectively. In the end of the second week with the treatment,the patients in both groups displayed the compared results of（ 20. 667 ± 4. 604 vs13. 200 ± 5. 416）,（ 16. 200 ± 3. 605 vs 11. 633 ± 4. 230）,P 〈0. 05 by using the scale of PSQI and ISI respectively, and the differences were significant. In the end of the fourth week with the treatment,the patients in both groups displayed the compared results of（ 13. 967 ± 4. 038 vs10. 033 ± 3. 157）,（ 10. 800 ± 3. 231 vs 7. 700 ± 2. 793）,P 〈0. 05 by using the scale of PSQI and ISI respectively,and the differences were significant. In the end of the eighth week with the treatment,the patients in both groups displayed the compared results of（ 11. 700 ± 3. 669 vs 10. 633 ± 3. 489）,（ 7. 900 ± 2. 564 vs 7.

关 键 词：失眠症 正念治疗 失眠症认知行为治疗 

分 类 号：R749[医药卫生—神经病学与精神病学]