认知行为治疗对催眠药物依赖型失眠患者药物戒断及生命质量的影响  

Effect of Cognitive Behavioral Therapy on Drug Withdrawal and Quality of Life in Patients with Hypnotic Drug-dependent Insomnia

作　　者：郑书传 杨林霖 韦璇 赖鹏 金凤 ZHENG Shuchuan;YANG Linlin;WEI Xuan;LAI Peng;JIN Feng(Xiamen Xianyue Hospital Sleep Medical Center,Xiamen 361012,China;Department of brain function,the First Affiliated Hospital of Hebei Medical University,Shijiazhuang 050031,China)

机构地区：[1]厦门市仙岳医院睡眠医学中心,厦门361012 [2]河北医科大学附属第一医院脑功能科,石家庄050031

出　　处：《世界睡眠医学杂志》2020年第3期532-536,共5页World Journal of Sleep Medicine

基　　金：福建省科技厅青年创新项目(2017D0012)。

摘　　要：目的:考察认知行为治疗对催眠药物依赖型失眠患者睡眠质量、药物戒断和生命质量的影响。方法:选取2015年7月至2018年3月在厦门市仙岳医院睡眠医学中心就诊的慢性失眠患者86例患者作为研究对象,入组标准符合《国际睡眠障碍分类第三版》成人慢性失眠的诊断标准,连续用药6个月以上并≥3次/周,且不伴有其他精神障碍。对入组的患者进行为期5周,共计6次,2.5 h/次的认知行为治疗。治疗结束后进行1年的随访。采用匹兹堡睡眠指数量表(PSQI),贝克抑郁量表(BDI),贝克焦虑量表(BAI),健康状况调查问卷(SF-36)对患者进行评估。结果:治疗结束后PSQI总分阴性(7分以下)人数逐渐增加,1年以后达到56(65.11%)人。通过5周治疗,83.72%的患者不再使用催眠药物,1年后达到79(91.86%);抗焦虑抑郁药物出组时减药率达到67.85%,一年后达到了87.50%。治疗结束后,失眠患者的焦虑水平、抑郁水平,生命质量得到显著改善(P<0.001)。结论:认知行为治疗可以显著改善药物依赖型失眠患者的睡眠,戒断患者对药物的依赖,改善患者的抑郁焦虑水平,提高其生命质量。Objective:To investigate the effects of cognitive behavioral therapy on sleep quality,drug withdrawal and quality of life in patients with hypnotic drug-dependent insomnia.Methods:Eighty-six patients with chronic insomnia were enrolled in the Sleep Medicine Center of Xiamen Xianyue Hospital from July 2015 to March 2018.The criteria for enrollment met the diagnostic criteria for adult chronic insomnia in the International Classification of Sleep Disorders Third Edition.Medications for more than 6 months and≥3 times/week without other mental disorders.The enrolled patients were treated for 5 weeks for a total of 6 sessions and 2.5 hours of cognitive behavioral therapy.One year follow-up after treatment.Pittsburgh Sleep Index Number Scale(PSQI),Baker Depression Scale(BDI),Baker Anxiety Scale(BAI),and Health Status Questionnaire(SF-36)were used to assess patients.Results:After the end of treatment,the number of PSQI total scores(below 7 points)gradually increased,reaching 56(65.11%)people after 1 year.After 5 weeks of treatment,83.72%of patients no longer used hypnotic drugs,and reached 79(11.86%)after one year;anti-anxiety and depression drugs had a drug-reducing rate of 67.85%when they came out,and 87.50%after one year.After the treatment,the anxiety level,depression level,and quality of life of insomnia patients were significantly improved(P<0.001).Conclusion:Cognitive-behavioural therapy can significantly improve sleep in patients with drug-dependent insomnia,withdrawal from dependence on drugs,improve patients′levels of depression and anxiety,and improve their quality of life.

关 键 词：认知行为治疗 失眠 药物戒断 生命质量 

分 类 号：R338.63[医药卫生—人体生理学]