远程认知行为治疗对高血压共病性失眠的疗效研究

发布时间：2018-02-26 10:05

本文关键词： 失眠症高血压认知疗法　出处：《解放军医学杂志》2017年04期 　论文类型：期刊论文

【摘要】：目的观察远程认知行为治疗(CBT-I)对高血压共病性失眠的疗效。方法收集符合JNC-8高血压诊断标准和DSM-5失眠诊断标准的高血压共病性失眠患者106例,随机分为远程CBTI治疗组(n=53)和常规高血压治疗组(n=53),进行8周治疗,观察8周后两组收缩压(SBP)、舒张压(DBP)的下降幅度、睡眠参数及焦虑抑郁状态水平的差异。结果与治疗前相比,治疗8周后两组SBP、DBP均下降(P0.01),远程CBTI组SBP下降幅度较常规高血压治疗组明显(P0.01)。在睡眠指标上,治疗8周后,远程CBTI组睡眠潜伏期(44.49±22.75min)、睡眠效率(72.31%±9.15%)、睡眠时间(302.65±43.76min)、焦虑水平评分(17.14±6.45)均较常规高血压治疗组改善更为显著(55.50±34.96min、57.70%±11.53%、262.70±50.64min、21.02±6.64),差异具有统计学意义(P0.05)。结论远程CBTI能有效缩短睡眠潜伏期、改善睡眠效率、延长睡眠时间、改善焦虑情绪,同时通过CBT-I优化睡眠能有效降低高血压共病性失眠患者的血压。
[Abstract]:Objective to observe the efficacy of remote cognitive behavior therapy (CBT-I) in the treatment of hypertension and syndromic insomnia. Methods 106 patients with hypertension and DSM-5 insomnia who met the criteria of hypertension diagnosis and DSM-5 insomnia were collected. After 8 weeks of treatment, the decrease of SBP, DBP, sleep parameters and the level of anxiety and depression in the two groups were observed. After 8 weeks of treatment, the levels of SBP in both groups were significantly lower than those in the control group, and the decrease of SBP in the remote CBTI group was significantly higher than that in the conventional hypertension treatment group. In terms of sleep index, after 8 weeks of treatment, the SBP in the remote CBTI group was significantly lower than that in the conventional hypertension treatment group. The sleep latency and sleep efficiency of remote CBTI group were 44.49 卤22.75 min, 72.31% 卤9.15 min, 302.65 卤43.76 min and 17.14 卤6.45, respectively, which were significantly better than those of routine hypertension group (55.50 卤34.96 min, 57.70% 卤11.53262.70 卤50.64 min, 21.02 卤6.64 min, P 0.05). Conclusion remote CBTI can effectively shorten sleep latency and improve sleep efficiency. Prolonging sleep time, improving anxiety and optimizing sleep by CBT-I can effectively reduce blood pressure of patients with hypertension and syndromic insomnia.
【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】：R749.7

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