瑞马唑仑诱导睡眠平衡术在慢性失眠中的临床应用效果  

The clinical efficacy evaluation of remimazolam-induced sleeping balance in chronic insomnia

作　　者：胡淇云 徐森 刘雨思 李万文 韩亮[4] 王文元[4] HU Qi-yun;XU Sen;LIU Yu-si;LI Wan-wen;HAN Liang;WANG Wen-yuan(Zhejiang Chinese Medical University,Hangzhou 310053,China;Jinzhou Medical University,Jinzhou 121001,China;Affiliated Mental Health Center,Zhejiang University School of Medicine,Hangzhou 310063,China;Zhejiang Provincial People's Hospital,Affiliated People's Hospital,Hangzhou Medical College,Hangzhou 310014,China)

机构地区：[1]浙江中医药大学,杭州310053 [2]锦州医科大学,锦州121001 [3]浙江大学附属精神卫生中心,杭州310063 [4]浙江省人民医院/杭州医学院附属人民医院,杭州310014

出　　处：《中国新药杂志》2024年第12期1256-1261,共6页Chinese Journal of New Drugs

摘　　要：目的:评价瑞马唑仑诱导睡眠平衡术在慢性失眠患者中的临床应用效果。方法:选取慢性失眠患者120例,年龄18~65岁,按照随机数字表法将患者分为两组:丙泊酚组(P组)和瑞马唑仑组(R组)。利用麻醉诱导睡眠平衡术对患者进行治疗,观察两组患者的睡眠指标(PSQI和ISI量表)、焦虑指标(HAMA量表)及认知功能指标(MMSE和MoCA量表)的变化。检测两组患者治疗前后的血清皮质醇水平,监测治疗过程中血流动力学状态及不良反应,并综合评估两组的临床疗效。结果:两组患者的一般资料及各评估量表的基础值无统计学差异(P>0.05)。两组患者的睡眠指标比治疗前明显改善(P<0.05),组间比较无统计学差异(P>0.05)。R组的焦虑指标比治疗前明显改善(P<0.05),P组与治疗前比较无明显差异(P>0.05)。R组治疗后的MMSE及MoCA评分较P组明显提高(P<0.05)。R组治疗后的血清皮质醇水平明显降低(P<0.05),P组与治疗前比较无明显差异(P>0.05)。治疗过程中R组患者的血流动力学更平稳,不良反应发生率比P组明显减少(P<0.05)。两组总有效率无明显差异(P>0.05)。结论:瑞马唑仑诱导睡眠平衡术能显著改善慢性失眠患者的睡眠质量、焦虑水平以及认知功能,同时治疗过程安全平稳,不良反应较少。Objective:To evaluate the clinical efficacy of remimazolam-induced sleeping balance in chronic insomnia.Methods:One hundred and twenty patients with chronic insomnia aged 18~65 years were randomly divided into two groups,propofol(P)group and remimazolam(R)group.All patients were treated with anesthesia-induced sleeping balance therapy.The Pittsburgh sleep quality index(PSQI),insomnia severity index(ISI),Hamilton anxiety scale(HAMA),mini-mental state examination(MMSE)and Montreal cognitive assessment(MoCA)were conducted to evaluate the sleep quality of participants.The serum levels of cortisol were detected before and after each treatment session.The hemodynamic state and side effects were monitored during therapy.The clinical efficacy was also evaluated.Results:The demographic data and basal levels of all evaluated scales had no difference between the two groups(P>0.05).The PSQI and ISI scores of both groups were significantly improved compared with baseline(P<0.05),although there was no difference between the two groups after treatment(P>0.05).The HAMA score of R group,but not P group,was remarkably ameliorated(P<0.05).The MMSE and MoCA scores of R group after treatment were significantly enhanced when compared with those of P group(P<0.05).The serum cortisol levels of R group,but not P group,were dramatically decreased after therapy(P<0.05).The hemodynamic state of R group was more stable,and the side effects were less than those of P group(P<0.05).The clinical efficacy was similar between the two groups(P>0.05).Conclusion:Remimazolam-induced sleeping balance significantly improves sleep quality,anxious level,and cognitive functions of patients with chronic insomnia.The treatment process is safe and stable with less side effects.

关 键 词：瑞马唑仑 慢性失眠 睡眠平衡术 焦虑 认知功能 

分 类 号：R971.4[医药卫生—药品] R969.4[医药卫生—药学]