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目的使用艾司西酞普兰治疗原发性失眠症,研究艾司西酞普兰对患者的睡眠的改善情况以及在治疗过程中对患者造成的不良反应情况。方法选择2014年6月—2015年6月接受治疗的80例睡眠有障碍的患者作为研究对象,在研究初期将80例患者随机分为观察组和对照组,每组各40例。观察组采用草酸艾司西酞普兰片的初始剂量为5 mg/d,在早饭之后服用,根据患者病情的加重逐步增到20 mg/d,唑吡坦片初始剂量为5~10 mg/d,睡前服用,疗程为8周。对照组仅采用唑吡坦片初始剂量为5~10 mg/d,睡前服用,疗程为8周。观察2组患者治疗前与治疗后第1周末、第4周末、第8周末的匹兹堡睡眠质量指数量表(PSQI)、患者健康问卷抑郁量表(PHQ-9)的指标变化以及不良反应情况,使用SPSS 18.0统计软件进行数据分析。结果 2组患者治疗后第1周末、第4周末、第8周末的PSQI总分与治疗前比较,均有下降(P<0.05)。在第8周末,观察组患者的PSQI总分比对照组低(P<0.05)。2组患者治疗后第1周末、第4周末、第8周末的PHQ-9总分与治疗前比较,均有下降(P<0.05)。在第8周末,观察组患者的PHQ-9总分比对照组低(P<0.05)。2组患者在治疗过程中出现的不良反应都不严重,观察组患者的不良反应发生率是32.5%,对照组为27.5%,2组比较差异无统计学意义(P>0.05)。结论通过艾司西酞普兰治疗原发性失眠,患者的睡眠得到有效改善,但是震颤、便秘等不良反应发生率较高,医护人员要高度重视。
Objectives Escitalopram was used in the treatment of primary insomnia to study the effect of escitalopram on patients’ sleep improvement and adverse reactions to patients during treatment. Methods Eighty patients with sleep disturbance who were treated in our hospital from June 2014 to June 2015 were selected as the study subjects. During the initial study, 80 patients were randomly divided into observation group and control group, 40 cases in each group. The initial dose of escitalopram oxalate in the observation group was 5 mg / d, taken after breakfast and gradually increased to 20 mg / d according to the patient’s condition. The initial dose of zolpidem tablets was 5 to 10 mg / d Take at bedtime, treatment for 8 weeks. The control group only with the initial dose of zolpidem 5 ~ 10 mg / d, taken before going to bed, treatment for 8 weeks. The changes of Pittsburgh sleep quality index (PSQI), patient health questionnaire depression scale (PHQ-9) and adverse reactions were observed before treatment and after treatment on the first weekend, the fourth weekend, the eighth weekend, Data analysis using SPSS 18.0 statistical software. Results The total score of PSQI at the first weekend, the fourth weekend and the end of the eighth week after treatment in both groups was significantly lower than that before treatment (P <0.05). At the end of the 8th week, the total PSQI score of the observation group was lower than that of the control group (P <0.05). The total score of PHQ-9 on the 1st, 4th, 8th week after treatment in both groups was significantly lower than that before treatment (P <0.05). At the end of the 8th week, the total score of PHQ-9 in the observation group was lower than that in the control group (P <0.05). Adverse reactions were not serious in the two groups. The incidence of adverse reactions in the observation group was 32.5% and in the control group was 27.5%. There was no significant difference between the two groups (P> 0.05). Conclusions Escitalopram treatment of primary insomnia, patients with sleep effectively improved, but tremor, constipation and other adverse reactions of higher incidence, health care workers should attach great importance.