[1]韩容,赵媛,雷洋梅,等.催眠联合失眠的认知行为治疗对伴有焦虑的慢性失眠患者的疗效观察[J].第三军医大学学报,2019,41(04):394-399.
 HAN Rong,ZHAO Yuan,LEI Yangmei,et al.Efficacy of hypnosis combined with cognitive behavior therapy for insomnia for intervention of chronic insomnia with anxiety [J].J Third Mil Med Univ,2019,41(04):394-399.
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催眠联合失眠的认知行为治疗对伴有焦虑的慢性失眠患者的疗效观察(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
41卷
期数:
2019年第04期
页码:
394-399
栏目:
医学心理学
出版日期:
2019-02-28

文章信息/Info

Title:
Efficacy of hypnosis combined with cognitive behavior therapy for insomnia for intervention of chronic insomnia with anxiety
 
作者:
韩容赵媛雷洋梅于江游蒋成刚
重庆市妇幼保健院心理科
Author(s):
HAN Rong ZHAO Yuan LEI Yangmei YU Jiangyou JIANG Chenggang

Department of Psychology, Chongqing Health Center for Women and Children, Chongqing, 400021, China
 

关键词:
催眠失眠的认知行为治疗失眠焦虑治疗效果
Keywords:
hypnosis cognitive behavior therapy for insomnia insomnia anxiety treatment outcome
分类号:
R256.23; R338.63; R395.5
文献标志码:
A
摘要:

目的 探讨失眠的认知行为治疗(cognitive behavior therapy for insomnia, CBT-I)联合催眠治疗对伴有焦虑的慢性失眠患者的治疗效果。方法 将重庆市妇幼保健院心理门诊2018年3-5月的轻中度焦虑的慢性失眠患者48例按照随机数字表法分为观察组和对照组,每组各24例,观察组和对照组分别给予6周催眠联合CBT-I治疗和传统CBT-I治疗,在干预前,干预结束后即刻、1个月、3个月,采用宗氏焦虑自评量表(SelfRating Anxiety Scale, SAS)和匹兹堡睡眠指数(Pittsburgh Sleep Quality Index, PSQI)量表对患者焦虑情绪及睡眠状况进行调查,并使用心肺耦合睡眠质量评估系统(Cardiopulmonary Coupling Sleep Quality Assessment System, CPC)对患者睡眠潜伏期(sleep onset latency, SOL)、在床时间(time in bed, TIB)、总睡眠时间(total sleep time, TST)及睡眠效率(sleep efficiency, SE)情况进行评估记录。结果 T检验结果显示,干预后观察组各时段SAS、PSQI评分均低于对照组;重复测量方差分析结果显示,观察组干预后各时段SAS、PSQI评分低于干预前(P<0.05);对照组各时段SAS评分差异无统计学意义(P>0.05),干预结束后即刻和干预结束后1个月PSQI评分低于干预前 (P<0.01),而干预结束后3个月则与干预前差异无统计学意义(P>0.05)。CPC结果显示,干预后观察组各时段TST、SE均高于对照组,SOL低于对照组(P<0.01),对照组SOL在干预结束后即刻降低(P<0.01),在干预结束后1、3个月SOL较干预结束后即刻有所增加(P<0.01),且干预结束后3个月TST及SE与干预前比较差异无统计学意义(P>0.05)。结论 失眠的认知行为治疗对焦虑情绪的改善作用不佳,且对睡眠的改善作用不稳定;与传统失眠的认知行为治疗相比,催眠联合失眠的认知行为治疗能显著改善失眠患者焦虑情绪及睡眠质量,且具有更长期、稳定的治疗效果,值得临床推广使用。


 

Abstract:

Objective To evaluate the efficacy of hypnosis combined with cognitive behavior therapy for insomnia (CBT-I) in improving the symptoms of patients with chronic insomnia and anxiety. Methods Between March and May, 2018, 48 patients with chronic insomnia and moderate anxiety were recruited from the Psychology Clinic of our center and randomized into the observation group and control group. The patients in the observation group received hypnosis therapy combined with CBT-I for 6 weeks, and those in the control group were treated with CBT-I only. The patients were assessed for anxiety level and sleep quality using Self-Rating Anxiety Scale (SAS) and Pittsburg Sleep Quality Index (PSQI) before and immediately after the intervention, and at 1 month and 3 months after the intervention; Cardiopulmonary Coupling Sleep Quality Assessment System (CPC) was used to measure the sleep onset latency (SOL), time in bed (TIB), total sleep time (TST) and sleep efficiency (SE) of the patients at the same time points. Results At each of the time points after intervention, the patients in the observation group had lower SAS and PSQI scores than those in the control group. Repeated measures analysis of variance showed that the patients in the observation group had significantly better improvement in the anxiety level and sleep quality than the control patients (P<0.05). The combined therapies also significantly reduced the SOL and increased TST and SE as compared with CBTI only (P<0.05). Conclusion Intervention with CBT-I alone has a poor effect on anxiety and an unstable effect on insomnia. The combination of CBT-I with hypnosis can achieve significant improvements in the anxiety level and sleep quality of the patients with long-lasting and stable effects.

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更新日期/Last Update: 2019-02-22