于爽　　高丽平　　丁兰

[摘要] 目的 通过分析中医介入的团队管理模式下对中青年人群失眠干预的临床疗效，探讨新模式的应用价值。 方法 本研究为前瞻性随机对照研究。选取2018年1—6月就诊于我中心的中青年失眠患者178例，随机分为对照组（传统家庭医生服务模式）与试验组（中医介入的团队管理模式）进行管理，每组各89例，采用重复测量方差分析评价两组患者的失眠程度（PSQI量表）及焦虑抑郁状态（PHQ-9量表）变化，同时对比两组患者的疗效。 结果 两组的PSQI及PHQ-9量表总分均随干预时间的延长而降低，且呈线性趋势（P<0.05）。干预3个月时，试验组的PSQI量表总分为（8.42±3.53）分及PHQ-9量表的总分为（4.96±0.96）分，均低于对照组[（9.44±3.34）分、（6.03±0.97）分]。6个月时，试验组的PSQI量表总分为（6.70±2.86）分、PHQ-9量表的总分为（4.26±0.51）分，均低于对照组的[（8.43±3.30）分、（5.45±0.67分）]，差异有统计学意义（P<0.05）。其中，干预3个月及6个月时，试验组入睡时间、睡眠效率及睡眠障碍单项得分较治療前的降低程度均大于对照组，差异有统计学意义（P<0.05）。治疗3个月及6个月时，试验组总有效率（73.03%、84.27%）均高于对照组（53.93%、62.92%），差异均有统计学意义（P<0.05）。 结论 中医介入的团队管理模式下对中青年患者失眠的干预疗效显著，焦虑抑郁状态改善明显，值得进一步推广。

[关键词] 中医;团队管理模式;中青年;失眠;干预

[中图分类号] R193.2          [文献标识码] B          [文章编号] 1673-9701（2021）21-0139-05

Efficacy of traditional Chinese medicine-involved team management mode on insomnia intervention in young and middle-aged patients

YU Shuang   GAO Liping   DING Lan

Department of Traditional Chinese Medicine， Yuetan Community Health Service Center， Fuxing Hospital， Capital Medical University， Beijing   100045，China

[Abstract] Objective To analyze the clinical efficacy of traditional Chinese medicine-involved team management mode on insomnia intervention in young and middle-aged patients， to explore the application value of the new mode. Methods  This study was a prospective randomized controlled study. A total of 178 young and middle-aged patients with insomnia treated in our center from January 2018 to June 2018 were selected and randomly divided into the control group （traditional family doctor service mode） and the experimental group （traditional Chinese medicine-involved team management mode）， with 89 patients in each group. Repeated measure analysis of variance was used to evaluate the changes in degree of insomnia （PSQI scale）， and anxiety and depression status （PHQ-9 scale） in the two groups. The efficacy was also compared between the two groups. Results The total scores of the PSQI and PHQ-9 scales of the two groups were decreased with the extension of the intervention time and showed a linear trend（P<0.05）.At 3 months after intervention， the total scores of the PSQI and PHQ-9 scales in the experimental group were （8.42±3.53）points and （4.96±0.96）points，which were lower than those in the control group as （9.44±3.34）points and （6.03±0.97）points. At 6 months after intervention， the total scores of the PSQI and PHQ-9 scales in the experimental group were （6.70±2.86）points and （4.26±0.51）points， which were lower than those in the control group as（8.43±3.30）points and （5.45±0.67）points， with statistically significant differences（P<0.05）. At 3 and 6 months after intervention， the decreases of individual scores of falling asleep time， sleep efficiency and sleep disturbance in the experimental group were lower than those in the control group， with statistically significant differences（P<0.05）. At 3 and 6 months after treatment， the total effective rates of the experimental group （73.03%，84.27%） were higher than those of the control group （53.93%，62.92%），with statistically significant differences（P<0.05）. Conclusion The traditional Chinese medicine-involved team management mode has significant efficacy on insomnia intervention in young and middle-aged patients， which can significantly improve anxiety and depression status. It is worthy of further promotion.