摘要
目的观察正念疗法对慢性失眠症(chronic insomnia disorder,CID)患者的认知功能和睡眠质量及炎症介质水平的影响,分析疗效的相关影响因素,以期为临床治疗提供指导。方法随机数字表法将62例CID患者分为对照组(予以常规药物治疗)与观察组(在常规药物治疗的基础上予以正念疗法)各31例,比较2组治疗前后的炎症介质水平及匹兹堡睡眠质量量表(PSQI)、蒙特利尔认知评估量表(MOCA)、汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)评分;采用单因素和多因素分析疗效的影响因素。结果观察组治疗后总有效率(83.87%)高于对照组(61.29%),失眠复发率(7.69%)低于对照组(31.57%),差异均有统计学意义(均P<0.05)。干预后8周、12周、24周,观察组PSQI、HAMA、HAMD评分低于对照组,MOCA评分高于对照组,差异均有统计学意义(P<0.05);2组IL-1β、TNF-α、CRP、NFκB不同时点比较,差异有统计学意义(P<0.05),而组间、交互比较,差异无统计学意义(P>0.05);2组HAMA评分的不同时点、组间比较,差异均有统计学意义(P<0.05)。单因素和多因素分析显示,年龄≥60岁、女性、小学及以下学历、病程>5年、抗失眠药物应用不合理是影响疗效的独立危险因素(P<0.05)。结论正念疗法有利于改善CID患者认知功能、睡眠质量,并降低炎症介质水平,在正念疗法实施过程中需重点关注年龄较大、女性、低学历、病程较长、用药不合理的患者。
Objective To investigate the impact of mindfulness therapy on cognitive function,sleep quality,and levels of inflammatory mediators in patients with chronic insomnia disorder(CID),as well as to analyze the relevant factors influencing therapeutic efficacy,thereby providing clinical guidance for treatment.Methods Total 62 patients diagnosed with CID were randomly assigned to either a control group receiving conventional drug therapy or an observation group receiving mindfulness therapy in addition to conventional drug therapy,with 31 patients in each group.The levels of inflammatory mediators and scores on the Pittsburgh Sleep Quality Scale(PSQI),Montreal Cognitive Assessment Scale(MOCA),Hamilton Anxiety Scale(HAMA),and Hamilton Depression Scale(HAMD)were compared before and after treatment between the two groups.The influencing factors of curative effect were analyzed by univariate and multivariate analysis.Results The total effective rate in the observation group(83.87%)was significantly higher than that of the control group(61.29%),and the recurrence rate of insomnia(7.69%)was significantly lower than that of the control group(31.57%)with a statistically significant difference observed at P<0.05.At 8,12,and 24 weeks post-intervention,the observation group exhibited significantly lower PSQI,HAMA,and HAMD scores compared to the control group while demonstrating higher MOCA scores(P<0.05).The levels of IL-1β,TNF-α,CRP and NFκB showed statistically significant differences between the two groups at different time points(P<0.05),while no significant differences were observed between the two groups(P>0.05).The HAMA scores were compared between the two groups at different time points and significant differences(P<0.05)were observed both within and between groups.Univariate and multivariate analyses revealed that being aged≥60 years,female gender,having a primary school education or lower,experiencing disease for>5 years,and engaging in inappropriate use of anti-insomnia drugs were independent risk factors signific
作者
陶海娃
林小容
叶晓洁
安雪微
陈浩然
郑存庆
吴志鹏
TAO Haiwa;LIN Xiaorong;YE Xiaojie;AN Xuewei;CHEN Haoran;ZHENG Cunqing;WU Zhipeng(Department of Infection Management,Wenzhou Seventh People's Hospital,Wenzhou 325000,China;Department of Behavioral Medicine,Wenzhou Seventh People's Hospital,Wenzhou 325000,China;Department of Laboratory Medicine Center,Wenzhou Seventh People's Hospital,Wenzhou 325000,China;Department of Neurology,Wenzhou Integrated Traditional Chinese and Western Medicine Hospital,Wenzhou 325088,China)
出处
《健康研究》
CAS
2023年第3期291-295,共5页
Health Research
基金
浙江省医药卫生科技计划项目(2020KY925)。
关键词
正念疗法
慢性失眠症
炎症介质
认知功能
mindfulness therapy
chronic insomnia disorder
inflammatory mediators
cognitive function
