盐酸曲唑酮联合百乐眠胶囊治疗老年人慢性失眠伴焦虑抑郁的临床疗效观察及对患者血流动力学的影响  

Clinical observation of trazodone hydrochloride combined with Bailemian capsule in the treatment of senile chronic insomnia with anxiety and depression and its influence on hemodynamics

作　　者：黄攀登[1] 董利平[1] 傅银银 张友涛 谷伟[1] 高云鹰[1] 崔玉环[1] 赵宝民[1] HUANG Pan-deng;DONG Li-ping;FU Yin-yin;ZHANG You-tao;GU Wei;GAO Yun-ying;CUI Yu-huan;ZHAO Bao-min(Department of Geriatrics,the First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,Hebei China)

机构地区：[1]河北北方学院附属第一医院老年病科,河北张家口075000

出　　处：《川北医学院学报》2023年第3期328-332,共5页Journal of North Sichuan Medical College

基　　金：河北省医学科学研究重点课题计划(20200551)。

摘　　要：目的:探讨盐酸曲唑酮和百乐眠胶囊合用对慢性失眠合并焦虑抑郁的老年患者的疗效及其对患者血流动力学的影响。方法:选取204例老年睡眠障碍患者为研究对象,按照治疗方案不同分为对照组和观察组,每组各102例。对照组采用盐酸曲唑酮治疗;观察组采用盐酸曲唑酮联合百乐眠胶囊治疗,疗程均为8周。比较两组患者治疗效果、不良反应情况、睡眠状况[匹兹堡睡眠质量指数量表(PSQI)评分]、焦虑抑郁状况[14项汉密尔顿焦虑量表(HAMA14)和24项汉密尔顿抑郁量表(HAMD24)评分]、多导睡眠图[睡眠潜伏期(SL)、觉醒次数(AT)、总睡眠时间(TST)、REM睡眠潜伏期(REML)、慢波睡眠时间(SWS)及快波睡眠时间(REM)]、血流动力学参数[低切黏度、高切黏度、血浆黏度及血小板聚集率]及去甲肾上腺素(NE)、脑源性神经生长因子(BDNF)、血清神经肽Y(NPY)及P物质(SP)含量。结果:观察组患者总有效率高于对照组(91.18%vs.73.52%,P<0.05);两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。治疗后,两组患者PSQI、HAMD24及HAMA14评分均降低(P<0.05),且观察组低于对照组(P<0.05);睡眠质量均提升(P<0.05),且观察组SL、AT低于对照组(P<0.05),TST、REML、SWS及REM高于对照组(P<0.05);血流动力学均改善(P<0.05),且观察组低切黏度、高切黏度、血浆黏度及血小板聚集率均低于对照组(P<0.05)。两种治疗方法对神经递质均有一定影响,但观察组患者NE及SP均低于对照组(P<0.05),BDNF及NPY高于对照组(P<0.05)。结论:盐酸曲唑酮片联合百乐眠胶囊能更有效改善老年人慢性失眠伴焦虑抑郁症状,治疗效果好且安全性高,可能与改善患者血流动力学及干预血清中神经递质表达有关。Objective:To investigate the effect of trazodone hydrochloride combined with Bailemian Capsule on elderly patients with chronic insomnia complicated with anxiety and depression,and its influence on hemodynamics.Methods:204 elderly patients with sleep disorders were selected as the study subjects.They were divided into control group(trazodone hydrochloride)and observation group(trazodone hydrochloride combined with Bailemian capsule)according to different treatment schemes,with 102 cases in each group.The course of treatment was 8 weeks.The treatment effect,adverse reactions,sleep status[Pittsburgh Sleep Quality Index(PSQI)score],anxiety and depression status[14 Hamilton Anxiety Scale(HAMA14)and 24 Hamilton Depression Scale(HAMD24)scores],polysomnography[sleep latency(SL),arousal times(AT),total sleep time(TST),REM sleep latency(REML),Slow wave sleep time(SWS)and fast wave sleep time(REM)],hemodynamic parameters(low shear viscosity,high shear viscosity,plasma viscosity and platelet aggregation rate)and the contents of norepinephrine(NE),brain-derived nerve growth factor(BDNF),serum neuropeptide Y(NPY)and substance P(SP)of patients were compared between the two groups.Results:The total effective rate of the observation group was 91.18%,which was higher than 73.52%of the control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).The PSQI,HAMD24 and HAMA14 scores of the two groups were lower than those before treatment(P<0.05),and the observation group were lower than the control group(P<0.05).The sleep quality of the two groups were improved,and the SL and AT in the observation group were lower than those in the control group,while the TST,REML,slow SWS and REM in the observation group were higher than those in the control group(P<0.05).After treatment,the hemodynamics of the two groups were improved,and the low shear viscosity,high shear viscosity,plasma viscosity and platelet aggregation rate of the observation group were lower than

关 键 词：盐酸曲唑酮 失眠 焦虑抑郁 临床疗效 血流动力学 神经递质 

分 类 号：R740[医药卫生—神经病学与精神病学] R749[医药卫生—临床医学]