失眠认知行为疗法联合艾司唑仑治疗失眠伴焦虑的临床疗效观察  

Efficacy of cognitive-behavioral therapy for insomnia combined with estazolam for insomnia patients with anxiety

作　　者：张弛[1] 刘文娟 韩莉 杨莉莉 ZHANG Chi;LIU Wenjuan;HAN Li;YANG Lili(the First Department of Psychosomatics,Affiliated Mental Health Center&Hangzhou Seventh People's Hospital,Zhejiang University School of Medicine,Hangzhou 310013,China)

机构地区：[1]浙江大学医学院附属精神卫生中心/杭州市第七人民医院心身一科,310013

出　　处：《浙江医学》2025年第6期629-633,共5页Zhejiang Medical Journal

基　　金：杭州市医药卫生科技项目(A20210156)。

摘　　要：目的探讨失眠认知行为疗法(CBT-I)联合艾司唑仑治疗失眠伴焦虑患者失眠的临床疗效,并分析其对患者焦虑情绪、睡眠质量及生活质量的影响。方法回顾性选取2023年3月至2024年3月杭州市第七人民医院诊治的失眠伴焦虑患者80例。其中41例患者采用CBT-I联合艾司唑仑治疗,为观察组;39例患者采用单独艾司唑仑治疗,为对照组。两组患者治疗疗程均为8周。比较两组患者失眠的疗效及治疗前后汉密尔顿焦虑量表(HAMA14)、焦虑自评量表(SAS)评分、失眠严重程度指数(ISI)、匹兹堡睡眠质量指数(PSQI)评分、简明健康状况调查表(SF-36)各量表评分。结果观察组患者治疗失眠总有效率高于对照组(92.68%比74.36%,P<0.05)。治疗后两组患者HAMA14、SAS评分均低于治疗前(均P<0.05),且观察组均低于对照组(均P<0.05);ISI、PSQI评分均低于治疗前(均P<0.05),且观察组评分均低于对照组(均P<0.05);SF-36各量表评分均高于治疗前(均P<0.05),且观察组均高于对照组(均P<0.05)。结论CBT-I联合艾司唑仑治疗失眠伴焦虑患者失眠的疗效显著,可减轻患者焦虑情绪,改善其睡眠质量及生活质量。Objective To explore the clinical efficacy of cognitive-behavioral therapy for insomnia(CBT-I)combined with estazolam for insomnia patients with anxiety.Methods Clinical data of 80 patients with insomnia and anxiety treated at Hangzhou Seventh People's Hospital from March 2023 to March 2024 were retrospectively analyzed,including 41 patients receiving CBT-I combined with estazolam(study group)and 39 patients receiving estazolam alone(control group)for a treatment course of 8 weeks in both groups.The Hamilton Anxiety Scale(HAMA14),Self Rating Anxiety Scale(SAS)scores,insomnia severity index(ISI),Pittsburgh sleep quality index(PSQI),and the MOS item Short Form Health Survey(SF-36)were assessed in two groups before and after treatment.Results The total effective rate in the study group was significantly higher than that in the control group(92.68%vs.74.36%,P<0.05).After treatment,the scors of HAMA14,SAS,ISI and PSQI in both groups were significantely lower than those before treatment(all P<0.05),while the scores in the study group were significantly lower than those in the control group(all P<0.05).After treatment,the SF-36 scores in both group were significantly higher than those before treatment(both P<0.05),while the scores in the study group were significantly higher than those in the control group(both P<0.05).Conclusion The combination of CBT-I and estazolam has better therapeutic effects for insomnia patients with anxiety than monotherapy of estazolam.

关 键 词：失眠认知行为疗法 艾司唑仑 失眠 焦虑 睡眠质量 生活质量 

分 类 号：R47[医药卫生—护理学]