吕园园 陈宝嫦 乔胜宇

[摘要]目的 探讨认知行为疗法治疗失眠症的效果，为临床治疗提供参考。方法 选取2016年3月～2017年9月我院收治的90例失眠症患者作为研究对象，随机分为对照组与观察组，每组各45例，对照组予以药物治疗，观察组在对照组治疗基础上加用认知行为疗法，比较两组患者治疗前后的睡眠障碍及睡眠质量评分。结果 两组患者治疗后的SDRS评分、PSQI评分均低于治疗前，且观察组治疗后的SDRS评分、PSQI评分低于对照组，差异有统计学意义（P<0.05）；两组患者治疗前的SDRS评分、PSQI评分比较，差异无统计学意义（P>0.05）。结论 在药物治疗基础上予以认知行为疗法有助于减轻失眠症患者的睡眠障碍，提高睡眠质量，值得在临床上推广应用。

[关键词]失眠症；认知行为治疗；睡眠障碍；睡眠质量

[中图分类号] R749 [文献标识码] A [文章编号] 1674-4721（2018）7（a）-0066-03

[Abstract]Objective To explore the effect of cognitive behavioral therapy in the treatment of insomnia，and to provide reference for clinical treatment.Methods Ninety patients with insomnia treated in our hospital from March 2016 to September 2017 were selected as the subjects，and randomly divided into the control group and the observation group，with 45 cases in each group.The control group was treated with drug therapy，and the observation group was treated with cognitive behavior therapy on the basis of the control group.The sleep disorders and quality of sleep were compared between the two groups before and after treatment.Results After treatment，the SDRS score and PSQI score in the two groups were lower than those before the treatment，and the SDRS score and PSQI score in the observation group were lower than those in the control group，the differences were statistically significant （P<0.05）.There was no significant difference in the SDRS scores and PSQI scores between the two groups before treatment （P>0.05）.Conclusion Cognitive-behavioral therapy based on drug therapy can reduce sleep disorders and improve sleep quality in insomniacs，which is worthy of clinical application.

[Key words]Insomnia；Cognitive behavior therapy；Sleep disorders；Quality of sleep

失眠症（insomnia）属于一种常见的睡眠障碍性疾病，临床症状主要包括入睡困难、早醒或睡眠维持困难等。既往研究指出，约1/4的成年人存在睡眠问题，约8%为慢性失眠症患者[1]。持续失眠可导致充血性心竭、高血压、焦虑、抑郁及自杀等不良事件，严重影响患者的生活质量，因此，及时、有效治疗失眠症具有重要意义[2]。目前临床上常采用唑吡坦、地西泮等药物治疗和认知行为治疗，其中认知行为治疗是针对患者认知行为的一种综合治疗手段，包括刺激控制疗法、睡眠限制疗法、睡眠卫生教育、认知及放松疗法。本研究探讨认知行为疗法治疗失眠症的临床效果，旨在寻找理想的治疗方法，现报道如下。

1资料与方法

1.1一般资料