氟哌噻吨美利曲辛对失眠患者胃电生理的影响

发布时间：2018-03-09 20:21

  本文选题：失眠　切入点：氟哌噻吨美利曲辛　出处：《重庆医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的精神心理因素对胃肠动力的影响日益受到重视,其机制尚未完全清楚,本研究通过观察伴精神心理异常失眠患者的胃电生理状况,以及氟哌噻吨美利曲辛对其胃电生理的影响,初步探讨精神心理因素影响胃动力的可能机制。方法1.采用匹兹堡睡眠质量指数量表筛选失眠患者,依据Zung焦虑自评量表及Zung抑郁自评量表的检测结果将失眠患者分为焦虑组、抑郁组及焦虑抑郁组。2.采用HIT-IMG100P阻抗式胃动力检测仪检测失眠患者的胃电及胃阻抗。3.观察氟哌噻吨美利曲辛(10.5mg bid×4周)对失眠患者的睡眠质量、心理状态及胃电生理的影响。结果1.共收集失眠患者45例,其中焦虑组21例(46.67%)、抑郁组14例(31.11%)、焦虑抑郁组10例(22.22%),各组患者性别、年龄、教育年限及职业等无显著差异(P0.05)。2.氟哌噻吨美利曲辛治疗4周睡眠改善总有效率(69.37%)较2周(28.09%)显著增加(p0.05),三组间有效率无显著性差异(p0.05)。3.氟哌噻吨美利曲辛治疗4周抗焦虑总有效率及抗抑郁总有效率(70.72%、70.72%)较2周(31.76%、37.86%)显著增加(p0.05);同一时间段焦虑组及焦虑抑郁组的抗焦虑有效率无显著性差异(p0.05),抑郁组及焦虑抑郁组的抗抑郁有效率无显著性差异(p0.05)。4.与我们前期实验胃动力正常的健康志愿者胃电参数相比,治疗前焦虑组、抑郁组及焦虑抑郁组胃电低频百分比显著增加(p0.05),中频百分比显著下降(p0.05),高频百分比无显著差异(p0.05)。与我们前期实验胃动力正常的健康志愿者胃阻抗参数相比,治疗前三组患者胃阻抗低频百分比均显著增加(p0.05),中频百分比显著下降(p0.05),高频百分比无显著差异(p0.05)。三组间胃电及胃阻抗各频参数无统计学差异(p0.05)。5.以我们前期实验胃动力正常的健康志愿者胃电及胃阻抗参数95%ci为参考指标,治疗前焦虑组、抑郁组及焦虑抑郁组胃电异常比例分别为71.43%、71.43%及70.00%,以胃电过缓为主,三组间无统计学差异(p0.05);胃阻抗异常比例分别为61.90%、64.29%及60.00%,以胃动力减慢为主,三组间无统计学差异(p0.05)。6.氟哌噻吨美利曲辛治疗后2周,三组患者胃电低频百分比下降(p0.05),中频百分比增加(p0.05),高频百分比无显著差异(p0.05);与2周相比,治疗4周各组患者胃电低频百分比进一步下降(p0.05),中频百分比进一步增加(P0.05),高频百分比无显著差异(P0.05)。7.氟哌噻吨美利曲辛治疗后2周,三组患者胃阻抗低频、中频及高频百分比较治疗前无显著差异(P0.05);治疗4周后各组患者胃阻抗低频百分比显著下降(P0.05),中频百分比显著增加(P0.05)。8.氟哌噻吨美利曲辛治疗后2周,胃电异常比例焦虑组[(38.10%)vs(71.43%)]、抑郁组[(42.86%)vs(71.43%)]及焦虑抑郁组[(40.00%)vs(70.00%)]显著下降(P0.05);与2周相比,治疗4周胃电异常比例焦虑组[(23.81%)vs(38.10%)]、抑郁组[(21.43%)vs(42.86%)]及焦虑抑郁组[(20.00%)vs(40.00%)]进一步下降(P0.05)。9.氟哌噻吨美利曲辛治疗后2周,三组患者胃阻抗异常比例较治疗前无显著差异(P0.05);治疗后4周胃阻抗异常比例焦虑组[(28.57%)vs(52.38%)]、抑郁组[(28.57%)vs(57.14%)]及焦虑抑郁组[(30.00%)vs(50.00%)]显著下降(P0.05)。结论1.伴精神心理异常的失眠患者存在胃电生理节律紊乱,主要表现为胃电过缓及胃阻抗过缓。2.氟哌噻吨美利曲辛可改善伴精神心理异常失眠患者的胃电生理状况。3.氟哌噻吨美利曲辛可改善失眠患者的睡眠质量及焦虑抑郁状态。
[Abstract]:Effect of psychological factors on gastrointestinal motility have received increasing attention, the mechanism is not entirely clear, gastric electrical physiological status of this study through the observation with psychological abnormalities in patients with insomnia, and the effect of Flupentixol and melitracen on gastric electrophysiology, preliminary study on psychological factors affecting the mechanism of gastric motility. 1. the Pittsburgh sleep quality index scale screening of insomnia patients, according to the Zung self rating Anxiety Scale and self rating depression scale Zung detection results of insomnia patients were divided into anxiety group, depression group and anxiety depression group.2. by HIT-IMG100P impedance gastric motility detection of egg and gastric impedance.3. patients with insomnia were fluoride Flupentixol and melitracen (10.5mg bid * 4 weeks) on sleep quality in patients with insomnia, mental status and gastric electrophysiology. Results 1. were collected from 45 cases of insomnia patients, including 21 cases of anxiety group (46.67% ),鎶戦儊缁，

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