乌灵胶囊联合小剂量喹硫平用于失眠伴焦虑抑郁高龄老年患者的疗效分析  

Efficacy of Wuling capsules combined with low-dose quetiapine in the treatment of oldest-old patients with insomnia accompanied by anxiety and depression

作　　者：蔡传云 胡欣 朱华军 刘文竹 吴子幸 江伟 CAI Chuanyun;HU Xin;ZHU Huajun;LIU Wenzhu;WU Zixing;JIANG Wei(Dept.of General Medicine,the901st Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army,Hefei 230031,China)

机构地区：[1]中国人民解放军联勤保障部队第九〇一医院全科医学科,合肥230031

出　　处：《中国药房》2024年第12期1517-1521,共5页China Pharmacy

基　　金：安徽省重点研究与开发计划项目(No.202104j07020002);军队后勤科研项目(No.19BJZ16);安徽医科大学校科研基金项目(自然科学类)(No.2022xkj251)。

摘　　要：目的 探讨乌灵胶囊联合小剂量喹硫平治疗高龄老年失眠伴焦虑抑郁患者的疗效和安全性。方法 回顾性分析2020年6月-2022年12月在我院门诊就诊或住院治疗的96例失眠伴焦虑抑郁高龄老年(≥80岁)患者的临床资料。根据治疗方案的不同将患者分为乌灵胶囊组(0.99 g,每天3次,34例)、喹硫平组(25~50 mg,每晚1次,30例)和联合组(同时服用乌灵胶囊和喹硫平,用法用量同单药组,32例)。比较3组患者治疗前和治疗8周后的睡眠监测指标(总睡眠时间、睡眠效率、睡眠潜伏期、觉醒次数)、匹兹堡睡眠质量指数量表(PSQI)评分、14项汉密尔顿焦虑量表(HAMA-14)评分、17项汉密尔顿抑郁量表(HAMD-17)评分、简易智能精神状态量表(MMSE)评分、血清白细胞介素1β(IL-1β)和肿瘤坏死因子α(TNF-α)水平,以及疗效和不良反应发生情况。结果 与治疗前比较,3组患者治疗后的总睡眠时间、睡眠效率、MMSE评分均显著延长或升高(P<0.05),睡眠潜伏期、觉醒次数、PSQI评分、HAMA-14评分、HAMD-17评分、血清IL-1β和TNF-α水平均显著缩短或降低(P<0.05),喹硫平组患者的睡眠潜伏期、觉醒次数、HAMA-14评分、HAMD-17评分、血清TNF-α水平均明显短于或低于乌灵胶囊组,且联合组各定量指标均显著优于喹硫平组和乌灵胶囊组(P<0.05)。联合组患者的治疗总有效率显著高于喹硫平组和乌灵胶囊组(P<0.05),3组患者的总不良反应发生率比较差异无统计学意义(P>0.05)。结论 乌灵胶囊联合小剂量喹硫平用于高龄老年失眠伴焦虑抑郁患者的疗效优于各药单用,不良反应未见明显增加。OBJECTIVE To investigate the efficacy and safety of Wuling capsules combined with low-dose quetiapine in the treatment of oldest-old patients with insomnia accompanied by anxiety and depression.METHODS The clinical data of 96 oldestold patients(aged≥80 years) with insomnia accompanied by anxiety and depression who were attending outpatient clinics or hospitalized in our hospital from June 2020 to December 2022 were retrospectively analyzed.According to the different drug treatments,the patients were divided into Wuling capsules group(0.99 g,tid,34 cases),quetiapine group(25-50 mg,qn,30cases) and combination group(using Wuling capsules and quetiapine simultaneously,same as the single drug groups,32 cases).Before and after 8 weeks of treatment,the patients of three groups were compared in terms of photoplethysmography sleep monitoring indexes(total sleep duration,sleep efficiency,sleep latency,and the number of awakening),Pittsburgh sleep quality index(PSQI) score,14-item Hamilton anxiety scale(HAMA-14) score,17-item Hamilton depression scale(HAMD-17) score,mini-mental state examination(MMSE) score,and serum levels of interleukin-1β(IL-1β) and tumor necrosis factor-α(TNF-α);the therapeutic effects and adverse drug reactions of the three groups were observed and compared.RESULTS Compared with before treatment,the total sleep time,sleep efficiency and MMSE scores of the three groups were significantly longer or higher after treatment(P<0.05),while the sleep latency,number of awakening,PSQI score,HAMA-14 score,HAMD-17 score,serum IL-1β and TNF-α levels were significantly shorter or lower after treatment(P<0.05).Sleep latency,number of awakening,HAMA-14 score,HAMD-17 score and serum TNF-α level in quetiapine group were significantly shorter or lower than Wuling capsules group after treatment(P<0.05).Moreover,the above indexes in the combination group were significantly better than quetiapine group and Wuling capsules group(P<0.05).The total effective rate of treatment in the combination group was significantly

关 键 词：乌灵胶囊 小剂量喹硫平 失眠 焦虑 抑郁 高龄老年患者 

分 类 号：R749.92[医药卫生—神经病学与精神病学] R969[医药卫生—临床医学]