失眠认知行为疗法结合中药辨证施治对失眠障碍疗效分析  

Analysis of the Effect of Cognitive Behavioral Therapy for Insomnia Combined with TCM Treatment Based on Syndrome Differentiation

作　　者：谢玉艳 孙菊光[1] XIE Yuyan;SUN Juguang(Department of Neurology,Xuzhou Hospital of traditional Chinese Medicine Affiliated to Nanjing University of traditional Chinese,Xuzhou 221000,China)

机构地区：[1]南京中医药大学附属徐州市中医院神经内科,徐州221000

出　　处：《世界睡眠医学杂志》2023年第9期2053-2057,共5页World Journal of Sleep Medicine

摘　　要：目的:研究分析失眠认知行为疗法(CBT-I)结合中药辨证施治对失眠障碍的治疗效果及对失眠相关躯体、精神症状及日间功能损害的影响。方法:选取2022年10月至2023年7月徐州市中医院神经内科及心理门诊就诊的失眠患者30例作为研究对象,给予CBT-I,同时配合中药辨证施治,总疗程8周。采用匹兹堡睡眠质量指数量表(PSQI)分别于治疗前、治疗后(8周)、治疗后1个月(12周)各评定1次,以此评估睡眠质量;采用Epworth嗜睡量表(ESS)和症状自评量表(SCL-90)评估患者的日间嗜睡程度以及躯体精神症状,上述2个量表分别于治疗前、治疗后1个月(12周)各评定1次。结果:经治疗8周后,患者PSQI总分及除使用睡眠药物以外的6个因子分均有明显降低,差异有统计学意义(P<0.05)。治疗后1个月(12周)复诊,PSQI总分及除睡眠紊乱和使用睡眠药物以外的5项因子分仍较治疗前有明显降低,差异有统计学意义(P<0.05);ESS评分较治疗前有明显降低,差异有统计学意义(P<0.05);SCL-90总分及躯体化、强迫、人际关系敏感、抑郁、焦虑、偏执、精神病性、饮食睡眠等因子分较治疗前相比有明显下降,差异有统计学意义(P<0.05)。结论:CBT-I结合中药辨证施治能够有效改善失眠患者的睡眠质量、日间功能状态及失眠相关躯体及精神症状,且短期及长期持续效果均较好。Objective:To explore and analyze the effect of Cognitive Behavioral Therapy for insomnia(CBT-I)combined with treatment based on syndrome differentiation of traditional Chinese medicine on insomnia and insomnia-related somatic symptom,mental symptoms and daytime disfunction.Methods:A total of 30 patients with insomnia in the Department of Neurology and Psychological Clinic of Xuzhou Hospital of traditional Chinese Medicine from October 2022 to July 2023 were treated with CBT-I combined with TCM treatment based on syndrome differentiation for 8 weeks.The Pittsburgh sleep quality Index(PSQI)was used to evaluate the sleep quality of patients before treatment,after treatment(8 weeks)and 1 month after treatment(12 weeks).The psychological symptom checklist-90(SCL-90)was used to evaluate the somatic and mental symptoms and the Epworth sleepiness scale(ESS)was used to evaluate the daytime drowsiness of patients before treatment and 1 month after treatment(12 weeks).Results:The total score of PSQI and the scores of subjective sleep quality,sleep latency,sleep persistence,sleep efficiency,sleep disorder and daytime dysfunction were significantly decreased after 8 weeks treatment,the difference was statistically significant,(P<0.05).One month after treatment(12 weeks),the total score of PSQI and the factor scores of subjective sleep quality,sleep latency,sleep persistence,sleep efficiency and daytime dysfunction were still significantly lower than those before treatment,the difference was statistically significant,(P<0.05).ESS score was significantly lower than that before treatment,and the difference was statistically significant(P<0.05).The total score of SCL-90 and the factor scores of somatization,obsessive-compulsive,interpersonal sensitivity,depression,anxiety,paranoid ideation,psychoticism,diet and sleep decreased significantly compared with those before treatment,the difference was statistically significant,(P<0.05).Conclusion:CBT-I combined with TCM treatment based on syndrome differentiation can effectively improv

关 键 词：失眠 失眠认知行为疗法 中药 辨证施治 长期疗效 

分 类 号：R24[医药卫生—中医临床基础] R338.63[医药卫生—中医学]