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| 失眠认知行为疗法联合星状神经节阻滞对新型冠状病毒感染后失眠的影响 |
| Effect of cognitive behavioural therapy for insomnia combined with stellate ganglion block on insomnia after corona virus disease-2019 |
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| DOI：10.12089/jca.2024.08.011 |
| 中文关键词: 失眠认知行为疗法 星状神经节阻滞 新型冠状病毒 失眠 匹兹堡睡眠指数 |
| 英文关键词: Cognitive behavioral therapy for insomnia Stellate ganglion block Corona virus disease-2019 Insomnia Pittsburgh sleep index |
| 基金项目:江西省中医药管理局科技计划(2023A0261) |
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| 中文摘要: |
目的：观察失眠认知行为疗法（CBT-I）联合星状神经节阻滞（SGB）对新型冠状病毒感染后失眠的治疗效果。
方法：选择麻醉睡眠门诊中新型冠状病毒感染后失眠患者84例，男26例，女58例，年龄18～64岁，BMI 20～32 kg/m2。采用随机数字表法将患者分为两组: CBT-I联合SGB组（S组）和CBT-I组（C组），每组42例。两组患者均执行6周相同的CBT-I方案。S组在第1周每日左右侧交替行SGB，注入1%利多卡因3 ml，维生素B1 1 ml（50 mg），维生素 B6 1 ml（50 mg），共5 ml。第2至6周每周行1次SGB，共计12次。C组不行SGB。记录治疗前、治疗后6周、3个月和6个月的匹兹堡睡眠质量指数（PSQI）评分。记录治疗前、治疗后1周、6周的失眠严重程度指数（ISI）、阿森斯（AIS）失眠量表评分、血清皮质醇（Cor）和5-羟色胺（5-HT）浓度。记录患者对治疗方案的依从性。
结果：与治疗前比较，治疗后6周、3个月和6个月两组PSQI评分明显降低（P＜0.05），S组治疗后1和6周的ISI评分、AIS评分和血清Cor 浓度均明显降低（P＜0.05），血清5-HT浓度明显升高（P＜0.05），C组治疗后6周ISI评分、AIS评分和血清Cor浓度明显降低（P＜0.05），血清5-HT浓度明显升高（P＜0.05）。与C组比较，S组治疗后6周PSQI评分明显降低（P＜0.05），治疗后1周、6周ISI评分、AIS评分和血清Cor浓度明显降低（P＜0.05），血清5-HT浓度明显升高（P＜0.05），S组对治疗方案的依从性明显升高（P＜0.05）。
结论：失眠认知行为疗法联合星状神经节阻滞可改善新型冠状病毒感染后失眠患者的短期睡眠质量，并能提高患者对治疗方案的依从性。 |
| 英文摘要: |
Objective: To observe the effect of cognitive behavioural therapy for insomnia (CBT-I) combined with stellate ganglion block (SGB) on insomnia after corona virus disease-2019(COVID-19).
Methods: Eighty-four patients with insomnia after COVID-19 were selected from the anesthesia sleep clinic, 26 males and 58 females, aged 18-64 years, BMI 20-32 kg/m2. The patients were randomly divided into two groups: CBT-I combined with SGB (group S) and CBT-I (group C), 42 patients in each group. Both groups of patients underwent the same CBT-I regimen for 6 weeks. Patients in group S underwent SGB alternately on both sides every day in the first week, inject 3 ml of 1% lidocaine, 1 ml of vitamin B1 (50 mg), and 1 ml of vitamin B6 (50 mg), totaling 5 ml, and SGB was performed once a week from week 2 to week 6, for a total of 12 times. Group C patients cannot undergo SGB. Record the Pittsburgh sleep quality index (PSQI) scores of patients before treatment, 6 weeks, 3 months, and 6 months after treatment. Record the insomnia severity index (ISI), Athens insomnia scale (AIS) scores, and serum concentrations of cortisol(Cor) and serotonin(5-HT) before and 1 week and 6 weeks after treatment. Record the patient's compliance with the treatment plan.
Results: Compared with before treatment, the PSQI scores of the two groups of patients significantly decreased at 6 weeks, 3 months, and 6 months after treatment (P < 0.05), the ISI score, AIS score, and serum Cor concentration in group S were significantly reduced after 1 week and 6 weeks of treatment (P < 0.05), while the serum 5-HT concentration was significantly increased (P < 0.05), the ISI score, AIS score, and serum Cor concentration in group C were significantly reduced after 6 weeks of treatment (P < 0.05), while the serum 5-HT concentration was significantly increased (P < 0.05). Compared with group C, patients in group S showed a significant decrease in PSQI scores 6 weeks after treatment (P < 0.05), the ISI score, AIS score, and serum Cor concentration in group S were significantly reduced after 1 week and 6 weeks of treatment (P < 0.05), while the serum 5-HT concentration was significantly increased (P < 0.05), patients in group S showed a significant increase in adherence to the treatment plan (P < 0.05).
Conclusion: CBT-I combined with SGB can improve short-term sleep quality after COVID-19, and improve patients' compliance with the treatment plan. |
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