艾司西酞普兰联合唑吡坦对失眠障碍患者睡眠质量、焦虑抑郁状态及血清神经递质的影响

摘要 目的：探讨艾司西酞普兰联合唑吡坦对失眠障碍患者睡眠质量、焦虑抑郁状态及血清神经递质的影响。方法：选取2018年1月~2020年12月期间我院收治的失眠障碍患者100例为研究对象。根据随机数字表法分为对照组（唑吡坦治疗，n=50）和研究组（对照组的基础上联合艾司西酞普兰治疗，n=50），比较两组患者睡眠质量、焦虑抑郁状态、血清神经递质及不良反应情况。结果：治疗4周后，研究组睡眠效率高于对照组，睡眠总时间长于对照组，醒觉时间、入睡时间短于对照组（P<0.05）。治疗4周后，研究组匹兹堡睡眠质量指数（PSQI）、汉密顿抑郁评估量表（HAMD）、汉密顿焦虑评估量表(HAMA)低于对照组（P<0.05）。治疗4周后，研究组5-羟色胺（5-HT）、r-氨基丁酸（GABA）水平高于对照组，去甲肾上腺素（NE）水平低于对照组（P<0.05）。两组不良反应发生率比较无差异（P>0.05）。结论：失眠障碍患者接受唑吡坦、艾司西酞普兰联合治疗，可有效改善患者焦虑抑郁状态、睡眠质量以及血清神经递质水平，安全性较好。

Effects of Escitalopram Combined with Zolpidem on Sleep Quality, Anxiety and Depression State and Serum Neurotransmitters in Patients with Primary Insomnia

ABSTRACT Objective: To investigate the effect of escitalopram combined with zolpidem on sleep quality, anxiety and depression state and serum neurotransmitter in patients with primary insomnia. Methods: 100 cases of primary insomnia admitted to our hospital from January 2018 to December 2020 were selected as the study object. The above patients were divided into control group (treated with zolpidem, n=50) and study group (treated with escitalopram on the basis of the control group, n=50,) according to the random number table method. The sleep quality, anxiety and depression state, serum neurotransmitter and adverse reactions of the two groups were compared. Results: 4 weeks after treatment, the sleep efficiency of the study group were higher than those of the control group, the total sleep time were longer than those of the control group, while the wake-up time and sleep time of the study group were shorter than those of the control group (P<0.05). 4 weeks after treatment, the pittsburgh sleep quality index (PSQI), hamilton Depression Rating Scale (HAMD) and hamilton Anxiety Rating Scale (HAMA) of the study group were lower than those of the control group (P<0.05). 4 weeks after treatment, the levels of 5-hydroxytryptamine (5-HT), r-aminobutyric acid (GABA) in the study group were higher than those in the control group, and the levels of norepinephrine(NE) in the study group were lower than those in the control group (P<0.05). There was no difference in adverse reactions between the two groups (P>0.05). Conclusion: Esmcitalopram combined with zolpidem can effectively improve the sleep quality, anxiety and depression of patients with primary insomnia, and improve the serum 5-HT, NE, CRH, with good safety.