失眠认知行为治疗在脑卒中睡眠障碍患者中应用效果分析  

Effect analysis of cognitive behavioral therapy for insomnia in patients with sleep disorder after stroke

作　　者：黄清明 HUANG Qing-ming

机构地区：[1]武陟济民医院老年医学科,454000

出　　处：《中国疗养医学》2023年第2期152-156,共5页Chinese Journal of Convalescent Medicine

基　　金：河南省医学科技攻关项目(2020001701),认知行为对治疗脑卒中失眠患者的应用效果分析。

摘　　要：目的观察失眠认知行为治疗在脑卒中睡眠障碍患者中的应用效果。方法回顾性分析选取2021年3月至2022年3月期间至武陟济民医院接受治疗的260例脑卒中睡眠障碍患者为研究对象,采用抽签法将患者分为两组,将单独应用药物治疗的130例患者列为药物组,将采用失眠认知行为治疗联合药物干预的130例患者列为联合组,比较两组在不同治疗方式下的睡眠质量、神经递质、心理状态、脑神经功能及生活质量。结果治疗1、3、5、8周后,联合组的匹兹堡睡眠质量指数(PSQI)评分均低于药物组,褪黑素(MLT)、5-羟色胺(5-HT)等神经递质水平均高于对照组,多巴胺(DA)水平低于药物组,焦虑自评量表(SAS)、抑郁自评量表(SDS)评分低于药物组,改良Rakin量表(m RS)评分(3.36±0.25)分低于药物组(4.75±0.41)分、美国国立卫生研究院卒中量表(NIHSS)评分(20.25±0.31)分低于药物组(22.47±0.45)分,改良Barthel指数(MBI)评分(82.45±0.33)分高于药物组(80.16±0.25)分,简明健康生活状态量表(SF-36)各维度评分均高于药物组,差异具有高度统计学意义(P<0.001)。结论在予以脑卒中睡眠障碍常规药物干预同时联合实施失眠认知行为治疗可增强其治疗效果,对优化患者的睡眠质量、控制神经递质水平、改善心理状态及脑神经功能,并提升生活质量均有积极意义。Objective To observe the effect of cognitive behavior therapy on insomnia in patients with sleep disorder after stroke.Methods Retrospective analysis was adopted to select 260 patients with sleep disorder after stroke who were treated in Wuzhi Jimin Hospital from March 2021 to March 2022 as the research objects.The patients were divided into two groups by drawing lots,and 130 patients who were treated with drugs alone were included in the drug group.130 patients with insomnia treated by cognitive behavioral therapy combined with drug intervention were divided into the combined group,and the sleep quality,neurotransmitter,psychological state,brain nerve function and quality of life of the two groups were compared under different treatment methods.Results After1,3,5 and 8 weeks of treatment,the Pittsburgh Sleep Quality Index(PSQI)score of the combined group was lower than that of the drug group,the levels of melatonin(MLT),5-hydroxytryptamine(5-HT)and other neurotransmitters were higher than those of the control group,the level of dopamine(DA)was lower than that of the drug group,the scores of Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS)were lower than those of the drug group,and the score of the modified Rakin Scale(mRS)was(3.36±0.25),lower than that of the drug group(4.75±0.41).The NIHSS score(20.25±0.31)was lower than the drug group(22.47±0.45),the modified Barthel index(MBI)score(82.45±0.33)was higher than the drug group(80.16±0.25),and the SF-36 dimension score was higher than the drug group,with statistically significant differences(P<0.05).Conclusion The combination of conventional drug intervention and cognitive behavioral therapy for insomnia in patients with sleep disorders after stroke can enhance the therapeutic effect,which is of positive significance in optimizing the sleep quality of patients,controlling the level of neurotransmitters,improving the psychological state and brain nerve function,and improving the quality of life.

关 键 词：脑卒中 睡眠障碍 失眠认知行为治疗 神经递质 脑神经功能 应用效果 

分 类 号：R743.3[医药卫生—神经病学与精神病学]