不同强度光疗对老年帕金森病失眠病人睡眠质量的疗效分析  

Effects of different-intensity phototherapy on sleep quality in elderly patients with Parkinson’s disease and insomnia

作　　者：周翔[1] 相晓萍 ZHOU Xiang;XIANG Xiaoping(Department of Neurology,the First Affiliated Hospital with Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院神经内科,江苏省南京市210029

出　　处：《实用老年医学》2025年第4期401-405,410,共6页Practical Geriatrics

基　　金：江苏省人民医院2022年度“临床能力提升工程”护理项目(JSPH-NC-2022-22)。

摘　　要：目的探讨不同光照强度的光疗对老年帕金森病失眠病人睡眠质量的影响。方法选取2022年7月至2024年1月南京医科大学第一附属医院收治的伴有失眠的136例老年帕金森病病人为研究对象。采用随机数表法分为4组:高强光组、中等强光组、弱光组与对照组。对照组实施常规治疗及护理,3个光照组在对照组的基础上,每日16:30—17:00分别辅以10000 Lux、5000 Lux、1000 Lux光疗。于干预后1周、2周、1个月比较4组病人帕金森病睡眠量表(Parkinson Disease Sleep Scale,PDSS)和多导睡眠监测(polysomnography,PSG)情况。结果干预1周时,高强光组、中等强光组间PDSS评分、PSG结果差异无统计学意义(P>0.05),2组PDSS评分和PSG结果中的睡眠效率均显著高于弱光组及对照组,清醒时长、清醒次数低于弱光组及对照组(P<0.05);弱光组的PDSS评分、PSG结果与对照组比较,差异无统计学意义(P>0.05)。干预2周时,中等强光组、弱光组的PDSS评分、PSG结果差异无统计学意义(P>0.05),2组PDSS评分和睡眠效率高于对照组,清醒时长、清醒次数均低于对照组,差异有统计学意义(P<0.05);高强光组的PDSS评分和睡眠效率高于中等强光组、弱光组、对照组,清醒时长低于中等强光组、弱光组及对照组,差异有统计学意义(P<0.05)。干预1个月时,3个光照组的PDSS评分、PSG结果差异无统计学意义(P>0.05),3组睡眠效率高于对照组,清醒时长、清醒次数低于对照组,差异有统计学意义(P<0.05)。结论更高强度(5000 Lux及以上)的光疗可以使老年帕金森病失眠病人在短期内(1周)取得良好的治疗效果,且短期内光照强度越大,效应量越大。长期坚持每日30 min光疗,1000 Lux及以上光照强度均可改善睡眠质量。Objective To study the effects of different light intensity of phototherapy on the sleep quality of the elderly patients with Parkinson’s disease and insomnia.Methods A total of 136 elderly patients with Parkinson’s disease and insomnia at the First Affiliated Hospital with Nanjing Medical University from July 2022 to January 2024 were enrolled in this study.They were randomly divided into high-intensity light group,moderate-intensity light group,low-intensity light group and control group.The control group received routine treatment and nursing,and the three phototherapy groups received 10000 Lux,5000 Lux and 1000 Lux phototherapy from 16:30 to 17:00 every day additionally.The score of Parkinson’s Disease Sleep Scale(PDSS)and the polysomnography(PSG)parameters were compared among the four groups 1 week,2 weeks and 1 month after intervention.Results After one week of intervention,there was no significant difference in PDSS score and PSG paramenters between the high-intensity light group and the moderate-intensity light group(P>0.05),but the PDSS scores and the sleep efficiency,wake time and wake frequency were significantly different compared with the low-intensity light group and the control group(P<0.05).There was no significant difference in PDSS score and PSG parameters between the low-intensity light group and the control group(P>0.05).After two weeks of intervention,there was no significant difference in PDSS score and PSG parameters between the moderate-intensity light group and the low-intensity light group(P>0.05),but the PDSS scores and the sleep efficiency,wake time and wake frequency were different compared with the control group(P<0.05);The PDSS scores and the sleep efficiency,wake time of the high-intensity light group were significant different compared with the moderate-intensity light group,the low-intensity light group and the control group(P<0.05).One month after intervention,there was no significant difference in PDSS scores and PSG among the three phototherapy groups(P>0.05),but the sle

关 键 词：强光疗法 老年人 帕金森病 失眠 睡眠质量 

分 类 号：R749.1[医药卫生—神经病学与精神病学]