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【目的】比较曲唑酮与阿普唑仑治疗首发脑卒中后急性失眠的临床效果。【方法】选择本院首发脑卒中后急性失眠患者173例，随机分为观察组90例和对照组83例；观察组应用曲唑酮片25～100mg／d，对照组应用阿普唑仑片0．4～0．8mg／d；分别记录两组在治疗前及治疗4周后阿森斯失眠量表（AIS）评分。【结果】治疗4周后AIS评分观察组（5．77±3．67）分较治疗前（16．78±3．32）分明显减少（P＜0．05）；且明显低于对照组治疗后（10．46±3．23）分（P＜0．05）；观察组治疗后总有效率为94．44％，明显高于对照组（81．93％）（χ2＝6．62，P＜0．05）。【结论】曲唑酮对首发脑卒中后急性失眠的治疗效果优于阿普唑仑。“,”[Objective]To compare the curative effects of two methods in treating post‐stroke acute insomnia .[Methods] A total of 173 patients with acute post‐stroke insomnia were randomly divided into observation ( n=90) and control ( n=83) groups .The control group received alprazolam 0 .4~0 .8 mg/day while the observation group took trazodone hydrochloride 25~100 mg/day .The AIS score before treatment and during a 4‐week follow‐up were observed .[Results] After treatment ,the Athens insomnia scale (AIS) score of observation group was (5 .77 ± 3 .67) versus(16 .78 ± 3 .32)before treatment .And the difference in AIS score before and after treatment was significant ( P<0 .05) .After treatment ,the AIS score of observation group was significantly lower than that of control group (5 . 77 ± 3 .67 vs 10 .46 ± 3 .23 ,P<0 .05) .The clinical efficacy rate was 94 .44% in observation group and it was obvi‐ously higher than 81 .93% in control group(χ2 =6 .62 ,P<0 .05) .[Conclusion] Trazodone hydrochloride is superior to alprazolam in the treatment of post‐stroke insomnia .