百乐眠联合曲唑酮对老年失眠伴焦虑抑郁患者的效果及对血清5-HT、IL-1β、IL-17水平的影响  

Effect of paracetamol combined with trazodone on elderly patients with insomnia with anxiety and depression and its influence on serum levels of 5-HT,IL-1βand IL-17

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 Pandeng;DONG Liping;FU Yinyin(Department of geriatrics,the First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China)

机构地区：[1]河北北方学院附属第一医院老年病科,张家口075000

出　　处：《国际精神病学杂志》2023年第6期1342-1346,共5页Journal Of International Psychiatry

基　　金：河北省医学科学研究重点课题计划(编号:20200551)。

摘　　要：目的探讨百乐眠胶囊联合盐酸曲唑酮治疗老年失眠伴焦虑抑郁患者的临床疗效及对其多导睡眠图(Polysomnography,PSG)参数、单胺类神经递质、白细胞介素(Interleukin,IL)-1β、IL-17水平的影响。方法选择我院2019年6月~2021年6月收治的198例老年失眠伴焦虑抑郁患者,按数字随机表法分成两组,各99例。观察组采用百乐眠胶囊联合盐酸曲唑酮治疗,对照组单用盐酸曲唑酮治疗。观察两组疗效,比较两组治疗前后睡眠状况、血清5-羟色胺、IL-1β、IL-17水平以及抑郁、焦虑状况。结果观察组总有效率与对照组相比显著升高(P<0.05)。与治疗前相比,两组治疗后总睡眠时间(Total sleep time,TST)均显著延长(P<0.05),睡眠潜伏期(Sleep latency,SL)、快速眼动睡眠潜伏期(Rapid eye movement sleep latency,REM-SL)均显著缩短(P<0.05),睡眠效率(Sleep efficiency,SE)均显著提高(P<0.05),N1%、N2%均显著下降(P<0.05),N3%、快速眼动睡眠时间(Rapid eye movement sleep,REM-ST)%显著增加(P<0.05);且均以观察组的改善更显著(P<0.05)。两组治疗后血清5-羟色胺(5-hydroxytryptamine,5-HT)和5-羟吲哚乙酸(5-hydroxyindoleacetic acid,5-HIAA)水平均较治疗前显著升高(P<0.05),血清IL-1β、IL-17水平均较治疗前显著降低(P<0.05);且均以观察组的改善更显著(P<0.05)。两组治疗后24项汉密尔顿抑郁量表(HAMD-24)及汉密尔顿焦虑量表(HAMA)量表评分均较治疗前显著降低(P<0.05),且均以观察组的改善更显著(P<0.05)。结论百乐眠胶囊联合盐酸曲唑酮治疗老年失眠伴焦虑抑郁患者时,能有效缓解其焦虑及抑郁情绪,改善睡眠进程及睡眠结构,调节血清5-HT以及IL-1β、IL-17的表达水平。Objective To explore the clinical efficacy,polysomnography(PSG)parameters,Monoamine neurotransmitter,and interleukin of Bailemian capsule combined with Trazodone hydrochloride in the treatment of elderly patients with insomnia with anxiety and depression.Methods A total of 198 elderly patients with insomnia with anxiety and depression admitted to our hospital from June 2019 to June 2021 were selected and divided into two groups according to numerical random table method,with 99 cases in each group.The observation group was treated with Bailimian capsule combined with trazodone hydrochloride,and the control group was treated with trazodone hydrochloride alone.The effects of the two groups were observed,and the sleep status,blood list of amine neurotransmitters,IL-1βand IL-17 levels were compared before and after treatment.Results The total effective rate of the observation group was significantly higher than that of the control group(P<0.05).Compared with before treatment,the total sleep time(TST)was significantly prolonged(P<0.05),sleep latency(SL),rapid eye movement sleep latency(REM-SL)were significantly shortened(P<0.05),sleep efficiency(SE)was significantly improved(P<0.05),N1%,N2%were significantly decreased(P<0.05),N3%Rapid eye movement sleep(REM-ST)%significantly increased(P<0.05).And the improvement in the observation group was more significant(P<0.05).After treatment,the serum levels of 5-hydroxytryptamine(5-HT)and 5-neneneba hydroxyindole acetic acid(5-HIAA)in both groups were significantly higher than those before treatment(P<0.05).The levels of IL-1β,17 were significantly lower than before treatment(P<0.05).And the improvement in the observation group was more significant(P<0.05).Conclusion Bailemian capsule combined with trazodone hydrochloride can effectively improve depression and anxiety,improve the sleep process and sleep structure,regulation of serum 5-HT and IL-1β,IL-17 expression levels in elderly patients with insomnia with anxiety and depression.

关 键 词：百乐眠胶囊 盐酸曲唑酮 焦虑抑郁 老年 

分 类 号：R749.4[医药卫生—神经病学与精神病学]