失眠症的网络化认知行为治疗疗效研究

发布时间：2018-06-14 12:22

本文选题：失眠症 + 认知行为疗法　；参考：《解放军医学杂志》2016年04期

【摘要】：目的比较网络化认知行为治疗(ICBT)、传统面对面认知行为治疗(CBT)及药物治疗对失眠症患者睡眠参数及焦虑和抑郁水平的影响,了解ICBT对失眠症的治疗效果。方法选取符合DSM-5诊断标准的失眠症患者79例,随机分为ICBT组(n=27)、CBT组(n=26)、药物治疗组(n=26),各组均进行连续8周的治疗。比较3组治疗前、治疗第4周、治疗结束时睡眠参数、焦虑及抑郁水平的差异。结果与治疗前相比,治疗第4周、治疗结束时3组睡眠参数明显改善,焦虑及抑郁水平明显下降,差异均有统计学意义(P0.05)。治疗第4周,药物治疗组入睡潜伏期、总睡眠时间、入睡后觉醒时间等与ICBT、CBT组比较差异有统计学意义(P0.05)。治疗结束时,ICBT组、CBT组的入睡潜伏期、焦虑及抑郁水平均低于药物治疗组,差异有统计学意义(P0.05),而ICBT组与CBT组比较,除抑郁水平外,焦虑水平及睡眠参数两组比较差异均无统计学意义(P0.05)。结论 ICBT对失眠症的改善速度较药物治疗慢,但是治疗结束时,其疗效优于药物治疗且与传统的面对面CBT效果差异不大。
[Abstract]:Objective to compare the effects of online cognitive behavior therapy (ICBT), traditional face to face cognitive behavior therapy (CBT) and drug therapy on sleep parameters, anxiety and depression levels in patients with insomnia, and to understand the effect of ICBT on insomnia. Methods Seventy-nine patients with insomnia according to DSM-5 criteria were randomly divided into two groups: ICBT group (n = 27), CBT group (n = 26) and drug treatment group (n = 26). Each group was treated continuously for 8 weeks. The differences of sleep parameters, anxiety and depression levels before, 4 weeks and at the end of treatment were compared among the three groups. Results at the end of the 4th week of treatment, the sleep parameters of the three groups were significantly improved, and the levels of anxiety and depression were significantly decreased (P 0.05). In the 4th week of treatment, the latency of sleep, the total sleep time and the awakening time after falling asleep in the drug treatment group were significantly different from those in the ICBTT CBT group (P 0.05). At the end of the treatment, the latency of sleep, anxiety and depression levels in the ICBT group were lower than those in the drug treatment group, and the difference was statistically significant (P 0.05). In addition to the depression level, the ICBT group was compared with the CBT group. There was no significant difference in anxiety level and sleep parameters between the two groups (P 0.05). Conclusion the improvement rate of ICBT on insomnia is slower than that of drug therapy, but at the end of the treatment, the curative effect is better than that of traditional face-to-face CBT.
【作者单位】：第三军医大学大坪医院野战外科研究所神经内科;
【基金】：第三军医大学转化基金项目(2014XHZ10)~~
【分类号】：R740

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