卢美枚 裴清华 许芳 许静 金紫晨

摘要 目的：探索原发性失眠患者睡眠质量与心理健康状况的关系。方法：采用横断面的研究方法，选取2015年7月至2017年7月北京中医药大学第三附属医院收治的符合纳入标准的原发性失眠患者308例作为研究对象，以PSQI、SCL-90采集原发性失眠患者的睡眠质量、心理健康状况等资料进行统计分析。结果：308例失眠患者的PSQI总分均值为（]12.65±3.04），241例SCL-90筛选阳性。失眠患者SCL-90各因子测评结果除偏执、敌对外均与全国常模比较差异有统计学意义（P<0.01）。睡眠、饮食方面不适的患者211例，伴强迫者144例，伴焦虑者86例。睡眠质量、催眠药物、PSQI总分与SCL-90各因子显著正相关，此外强迫与睡眠障碍呈中度正相关。结论：失眠患者的心理健康水平较正常人差。失眠患者伴有最多的3种自觉症状为睡眠饮食不适感、强迫及焦虑。失眠患者的睡眠质量、药物使用情况及睡眠整体状况与其心理障碍相互影响，强迫与睡眠障碍有较强的相关性。

关键词  原发性失眠;睡眠质量;心理健康状况;相关性分析;匹兹堡睡眠质量指数;症状自评量表;肝郁脾虚;强迫思维

Study on the Correlation Between Sleep Quality and Mental Health of Insomniacs

LU Meimei，PEI Qinghua，XU Fang，XU Jing，JIN Zichen

（Third Affiliated Hospital of Beijing University of Chinese Medicine，Beijing 100029，China）

Abstract Objective：To study the relationship between sleep quality and mental health in patients with primary insomnia.Methods：Cross-sectional study was used.A total of 308 patients admitted to the Third Affiliated Hospital of Beijing University of Chinese Medicine were selected.PSQI and SCL-90 were evaluated，and the sleep quality and mental health status of patients with primary insomnia were collected for statistical analysis.Results：The total mean PSQI score of patients was （12.65±3.04），and 241 patients were positive for SCL-90 screening.The results of various factors of SCL-90 in insomniacs were significantly different from the national norm except for paranoia and hostility （P<0.01）.There were 211 patients with discomfort in sleep and diet，144 with compulsion and 86 with anxiety.Sleep quality，hypnotic drugs and total score of PSQI were significantly positively correlated with factors of SCL-90.Besides，compulsion was moderately positively associated with sleep disorders.Conclusion：The mental health level of insomniacs is worse than the normal.Insomnia patients accompanied by the most of the 3 self-conscious symptoms are eating and sleeping discomfort，compulsion and anxiety.The quality of sleep，drug use and the overall state of insomniacs with psychological disorder affect each other.Compulsion has a strong connection with sleep disorder.

Keywords Primary insomnia; Sleep quality; Mental health; Correlation analysis; Pittsburgh sleep quality index; Symptom self checklist table; Stagnation of liver qi and spleen deficiency; Obsessive thoughts

中图分类号：R256.23;R395 文献标识码：A doi：10.3969/j.issn.1673-7202.2020.08.025

流行病学资料提示，在我国自然人群中10%～15%左右的人患有原发性失眠，其中以入睡困难、易醒、多梦等为主要表现[1]。随着人们生活节奏的加快、电子科学技术的发展及工作压力的增大，失眠已成为世界性的公共卫生问题，也是诱发各种心理健康问题的主要因素[2]。研究表明原发性失眠患者多伴有不同程度的心理健康问题，大约有一半患者存在焦虑或抑郁状态[3]。本次研究采用匹兹堡睡眠质量指数（Pittsburgh Sleep Quality Index，PSQI）及90項症状自评量表（Symptom Checklist 90，SCL-90）研究308例失眠患者睡眠质量与心理健康状况的相]关性。

1 资料与方法

1.1 一般资料

选取2015年7月至2017年7月北京中医药大学第三附属医院收治的符合纳入标准的原发性失眠患者308例作为研究对象，其中男104例（34%），女204例（66%）;已婚217例（70%），未婚81例（26%）;年龄20～75岁，平均年龄（46.32±16.23）岁;大专及本科以上教育程度165例（54%），高中及中专以下教育程度143例（46%）。……