融入中医特色的失眠认知行为治疗干预慢性失眠患者的临床疗效评价  

Clinical efficacy evaluation of insomnia cognitive behavior therapy combined with traditional Chinese medicine in patients with chronic insomnia

作　　者：麦润汝 徐碧云[1,2] 黄嘉瑜 蔡庆豪[1,2] 孙玉姣 杨志敏 MAI Runru;XU Biyun;HUANG Jiayu;CAI Qinghao;SUN Yujiao;YANG Zhimin(Key Discipline of Integrated Traditional Chinese and Western Medicine,Second Clinical College,Guangzhou University of Chinese Medicine,Guangzhou 510120,China;Department of Sleep Disorders,Fangcun Hospital,Guangdong Provincial Hospital of Chinese Medicine,Guangzhou 510120,China)

机构地区：[1]广州中医药大学第二附属医院,广东广州510120 [2]广东省中医院芳村医院睡眠障碍科,广东广州510120

出　　处：《广东药科大学学报》2021年第5期136-140,共5页Journal of Guangdong Pharmaceutical University

基　　金：杨志敏广东省名中医传承工作室建设项目[粤中医办函(2018)150号]。

摘　　要：目的观察融入中医的睡眠健康管理方式的失眠认知行为治疗对改善慢性失眠患者的临床疗效。方法回顾性分析符合入组标准的40例患者,进行失眠认知行为治疗,融入下列中医的睡眠健康管理方式:睡“子午觉”,食疗及卯时慢跑用于提升人体白天阳气,酉时沐足、穴位贴敷等宁神之法助眠。采用匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)评估患者的睡眠质量,症状自评量表(psychological symptom checklist,SCL-90)评估躯体疾病患者的精神症状,Epworth嗜睡量表(the epworth sleeping scale,ESS)评估患者的白天精力,睡眠信念与态度量表(dysfunctional beliefs and attitudes about sleep scale,DBAS-30)评估患者对睡眠的认知改善情况,分别于干预前、干预实施结束后各评定1次。治疗结束后1个月随访时再次评估PSQI以追踪评估患者的睡眠质量。结果(1)治疗后患者PSQI总分明显下降,差异有统计学意义(P<0.05)。PSQI量表中主观睡眠质量、睡眠潜伏期、睡眠持续性、睡眠效率、睡眠药物、白天功能紊乱6个因子评分方面均有改善,差异有统计学意义(P<0.05),而在睡眠紊乱因子上未见明显改善,差异无统计学意义(P>0.05)。(2)治疗后患者在DBAS-30总评分及量表中认知结果、睡眠控制、睡眠需求、归因方式及睡眠实践5个因子均有改善,差异有统计学意义(P<0.05)。(3)治疗后患者ESS未见明显改善,差异无统计学意义(P>0.05)。结论融入中医的睡眠健康管理方式的失眠认知行为治疗能够改善慢性失眠患者的睡眠质量、白天功能状态及睡眠认知。Objective To observe the clinical effect of insomnia cognitive behavior therapy integrated with sleep health management of traditional Chinese medicine(TCM)on patients with chronic insomnia.Methods 40 patients who met the inclusion criteria were analyzed retrospectively.They were treated with cognitive behavior therapy for insomnia and integrated into the following sleep health management methods of TCM:sleeping"midnight sleep",food therapy and Maoshi jogging were used to improve the body's Yang Qi during the day,Youshi foot bathing,acupoint application and other calming methods to help sleep.The Pittsburgh sleep quality index(PSQI)was used to evaluate the sleep quality of patients,the psychological symptom checklist(SCL-90)was used to evaluate the mental symptoms of patients with physical diseases,the Epworth sleeping scale(ESS)was used to evaluate the daytime energy of patients,and the sleep beliefs and attitudes about sleep scale(DBAS-30)was used to evaluate the cognitive improvement of patients on sleep,which was evaluated once before and after the intervention.PSQI was evaluated again at 1-month follow-up after treatment to track and evaluate the sleep quality of patients.Results(1)After treatment,the total scores of PSQI,subjective sleep quality,sleep latency,sleep duration,sleep efficiency,sleep medication and daytime dysfunction score were improved(P<0.05),but no significant improvement was found in sleep disorder(P>0.05).(2)After treatment,the scores of DBAS-30 and the five factors of cognitive results,sleep control,sleep demand,attribution style and sleep practice in DBAS 30 were improved(P<0.05).(3)There was no significant improvement in ESS(P>0.05).Conclusion Insomnia cognitive behavioral therapy integrated with sleep health management of TCM can improve sleep quality,daytime functional state and sleep cognition of patients with chronic insomnia.

关 键 词：认知行为治疗 慢性失眠 中医 睡眠健康管理 

分 类 号：R749.99[医药卫生—神经病学与精神病学]