联合室内光照治疗抑郁症疗效及对生理指标影响的对照研究  

A controlled study on the efficacy of combined indoor light therapy for depression and its effects on physiological indicators

作　　者：杨丽 任若佳 卢文婷[1] 赵天宇 郭世杰 刘不凡 黄凡凡 陈欢[1] 靳娜 许月航 林泉 王学义[1] Yang Li;Ren Ruojia;Lu Wenting;Zhao Tianyu;Guo Shijie;Liu Bufan;Huang Fanfan;Chen Huan;Jin Na;Xu Yuehang;Lin Quan;Wang Xueyi(Mental Health Center of the First Hospital of Hebei Medical University,Hebei Clinical Reasearch Center for Mental Disorders,Hebei Institute of Mental Health,Shijiazhuang 050031,China)

机构地区：[1]河北医科大学第一医院精神卫生中心、河北省精神心理疾病临床医学研究中心、河北省精神卫生研究所,石家庄050031

出　　处：《中华精神科杂志》2025年第3期211-219,共9页Chinese Journal of Psychiatry

基　　金：河北省省级科技计划资助项目(21377711D);河北省引进国外智力项目(YZ202306);河北省医学科学研究课题计划(20230617)。

摘　　要：目的探讨室内光照治疗抑郁症患者的抑郁情绪及睡眠问题的疗效,以及对生物节律相关生理指标的潜在影响。方法招募了2021年10月至2023年7月在河北医科大学第一医院精神卫生中心住院的急性期抑郁症患者共54例,按随机数字表法分配至药物联合强光治疗(强光组)36例,药物联合弱光治疗(弱光组)18例。2组均接受为期2周的光照治疗,强光组光照强度为10000 lx,弱光组为300 lx,均在每天早晨7:30—8:00进行30 min的光照治疗,并随访1周。分别在基线及治疗每周末采用17项汉密尔顿抑郁量表(17-item Hamilton Depression Rating Scale,HAMD_(17))评估患者的抑郁症状;匹兹堡睡眠质量指数量表(Pittsburgh Sleep Quality Index,PSQI)评估睡眠质量。在治疗2周末采用32项轻躁狂症状清单(32-item Hypomania Checklist,HCL-32)评估转躁风险。每天测量光照前后的体温、心率及血压,并评估记录与光照治疗相关的不良事件。采用配对t检验比较治疗前后的体温、心率及血压变化,采用重复测量方差分析比较2组临床症状变化的差异。结果(1)脱落情况:强光组和弱光组分别有31例、15例受试者完成本研究,2组脱落率差异无统计学意义(P>0.05)。(2)临床疗效:HAMD_(17)、PSQI评分组别与时间存在交互效应(F=5.51、4.11,均P<0.05)。2组在治疗基线、1周末、2周末及3周末的HAMD_(17)及PSQI评分下降且差异有统计学意义(均P<0.001)。(3)生理指标:强光组的体温治疗后较治疗前均有升高,在第1~4天、第7天及第12天差异有统计学意义(均P<0.05)。在第5天强光组的心率较治疗前升高,差异有统计学意义(P<0.05)。强光组的收缩压在第4、5、11天及第12天较治疗前下降,差异有统计学意义(均P<0.05),弱光组在治疗第11天收缩压较疗前升高,差异有统计学意义(P<0.05)。在治疗第1、5天及第6天强光组的舒张压较治疗前下降,差异有统计学意义(P<0.05)。(4)安全性:2组均无严Objective To investigate the efficacy of lightroom therapy on depressive mood and sleep problems in patients with depression,and the potential effects on physiological indices related to circadian rhythms.Methods From October 2021 to July 2023,54 patients with acute-phase depression hospitalized in the Mental Health Center of the First Hospital of Hebei Medical University were recruited.The participants were randomly assigned to either medication combined with the bright light therapy group(bright light group,n=36)or medication combined with the dim light therapy group(dim light group,n=18).Both groups received light therapy for 2 weeks,at 10000 lx in the bright light group and 300 lx in the dim light group.Both groups received 30 minutes of light therapy from 7:30-8:00 a.m daily over two weeks,followed up for 1 week post-treatment.The Hamilton Depression Rating Scale(HAMD_(17))was used to assess patients′depressive symptoms,and the Pittsburgh Sleep Quality Index(PSQI)was used to assess patients′sleep quality at baseline,at the end of every week.The 32-Item Hypomania Checklist(HCL-32)was used at the end of week 2 to assess the risk of manic switching after treatment.Daily measurements of body temperature,heart rate,and blood pressure were taken before and after light therapy,along with recording adverse events related to the therapy.Paired t-tests were used to compare changes in physiological indicators before and after treatment,and repeated measures ANOVA was applied to compare clinical symptom changes between the two groups.Results Thirty-one and fifteen patients completed this study in the bright light and dim light groups,respectively,with no statistically significant difference in dropout rates(P>0.05).There were significant interaction effects between the time and group for HAMD_(17) and PSQI score(F=5.51,4.11,both P<0.05).Both groups showed significant reductions in HAMD_(17) and PSQI scores at baseline,week 1,week 2,and week 3(P<0.001).In the bright light group,body temperature increased significantl

关 键 词：抑郁症 周期性 光疗法 光疗室 生理指标 

分 类 号：R749.4[医药卫生—神经病学与精神病学]