团体认知行为治疗及佐匹克隆对原发性失眠患者睡眠质量影响的比较  

Effect comparison of group cognitive behavioral therapy and zopiclone on sleep quality in patients with primary insomnia

作　　者：徐莲莲[1] 薛闯[1] 毛洪京[1] 尹岩[1] 刘文娟[1] 刘义[1] XU Lian-lian;XUE Chuang;MAO Hong-jing;YIN Yan;LIU Wen-juan;LIU Yi(Clinical Psychology Department,the Seventh People's Hospital of Hangzhou,Hangzhou 310013,China)

机构地区：[1]杭州市第七人民医院临床心理科,310013

出　　处：《临床精神医学杂志》2021年第1期64-67,共4页Journal of Clinical Psychiatry

基　　金：杭州市科技发展计划项目(20170533B52)。

摘　　要：目的:探讨团体认知行为治疗(GCBT)及佐匹克隆对原发性失眠患者睡眠质量影响的比较。方法:90例原发性失眠患者随机分为GCBT组及佐匹克隆组,每组45例;GCBT组采用GCBT、佐匹克隆组口服佐匹克隆7.5 mg;疗程均为12周。治疗前后分别进行匹兹堡睡眠质量指数(PSQI)、睡眠状况自评量表(SRSS)、症状自评量表(SCL-90)评估,应用多导睡眠监测(PSG)睡眠指标。结果:治疗前两组PSQI、SRSS评分、PSG指标、SCL-90评分差异无统计学意义;治疗后,两组PSQI评分均较治疗前明显下降(P均<0.05),GCBT组睡眠质量、入睡时间、睡眠时间、睡眠效率、催眠药物因子分及总分明显低于佐匹克隆组(P<0.05或P<0.01);两组除服药助眠评分外,SRSS各因子评分较治疗前明显下降(P均<0.05),GCBT组时间不足、休息质量、觉醒不够、入睡困难、睡眠不稳、早醒、多梦夜惊、服药助眠因子分及总分明显低于佐匹克隆组(P<0.05或P<0.01);两组PSG各项指标与治疗前有明显变化(P均<0.05);GCBT组睡眠总时间(SPT)、总卧床时间(TIB)、非快动眼睡眠(NREM)1、NREM2、NREM3、快速动眼睡眠(REM)、缺乏慢波睡眠(SWS)与佐匹克隆组比较差异有统计学意义(P均<0.01);GCBT组SCL-90评分躯体化、人际关系敏感、强迫症状因子评分明显低于佐匹克隆组(P<0.05或P<0.01)。结论:与口服佐匹克隆比较,GCBT改善原发性失眠患者的睡眠质量的疗效更好。Objective:To compare the effects of group cognitive behavioral therapy(GCBT)and zopiclone on sleep quality in patients with primary insomnia.Method:90 patients with primary insomnia were randomly divided into GCBT group(n=45)and zopiclone group(n=45).GCBT group and zopiclone group were treated with GCBT and oral zopiclone 7.5 mg for 12 weeks,respectively.Before and after treatment,the Pittsburgh Sleep Quality Index(PSQI),Sleep Condition Self-Assessment Scale(SRSS),and Symptom Self-Assessment Scale(SCL-90)were evaluated,and polysomnography(PSG)sleep indicators were used.Results:There were no statistically significant differences in PSQI,SRSS,PSG and SCL-90 scores between the two groups at baseline.After treatment,PSQI scores of the two groups were significantly lower than those before treatment(all P<0.05);the scores of sleep quality,entering into sleep time,sleep time,sleep efficiency,hypnotic drugs and the total score in the GCBT group were significantly lower than those in the zopiclone group(P<0.05 or P<0.01).Except for the drug-assisted sleep score,the score of each factor of SRSS was significantly lower than that before treatment(all P<0.05);the scores of lack of time,quality of rest,insufficient awakening,difficulty in falling asleep,unstable sleep,early wake up,multiple dreams and night terrors,taking medicine to help sleep and the total score in the GCBT group were significantly lower than those in the zopiclone group(P<0.05 or P<0.01).The PSG indicators of the two groups had significant changes(P<0.05);the differences were statistically significant in total sleep time(SPT),total bed time(TIB),non-rapid-eye movement sleep(NREM)1,NREM2,NREM3,rapid eye movement sleep(REM),lack of slow wave sleep(SWS)between the two groups(all P<0.01).Somatization,interpersonal sensitivity and obsessive-compulsive factor scores of SCL-90 scores in the GCBT group were significantly lower than those in the zopiclone group(P<0.05 or P<0.01).Conclusion:GCBT has better effect than oral zopiclone in the patients with primary insom

关 键 词：原发性失眠 团体认知行为治疗 佐匹克隆 匹兹堡睡眠量表 

分 类 号：R749.7[医药卫生—神经病学与精神病学]