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[老年脑卒中患者睡眠障碍相关因素分析及中药与艾司唑仑治疗效果的对比研究]

[Analysis on somnipathy related factors in elderly patients with stroke and comparative study on the efficacy of treatment by traditional Chinese medicine and by estazolam].

作者信息

Li Hai-cong, Chen Xiao-guang, Tian Xin

机构信息

Department of Geriatrics, China-Japan Friendship Hospital, Beijing.

出版信息

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2009 Mar;29(3):204-7.

Abstract

OBJECTIVE

To analyze the somnipathy related factors in elderly patients with stroke and to compare effects of traditional Chinese medicine and estazolam on sleep and the followed nervous function.

METHODS

The somnipathy related factors in 336 elderly patients with stroke, 221 accompanied with somnipathy and 115 with normal sleep, were studied and analyzed. Moreover, the 221 patients with somnipathy were assigned to two groups, 112 in the treated group treated with TCM according to syndrome differentiation, and 109 in the control group treated with estazolam. Changes of scores rated by neurological deficit scale (NDS), sleep dysfunction rating scale (SDRS), Hamilton anxiety rating scale (HAMA), Hamilton depression scale (HAMD), and treatment emergent symptom scale (TESS) were observed before and after treatment.

RESULTS

The occurrence of somnipathy in patients with cerebral hemorrhage was significantly higher than in those with cerebral infarction; it was higher in patients with lesion in brain stem, cerebral hemisphere (frontal lobe), or basal ganglion than in those with lesion in other sites; and patients with severe neurological deficit were more liable to having somnipathy. TCM showed a significant effect in improving the insomnia symptoms in patients, with the total effective rate reaching 81.25% (91/112), which was higher than that in the control group, 65.14% (71/109, P < 0.01). Along with the improving of sleep, marked recovery of the nervous function was shown in both groups, with NDS score reduced significantly (P < 0.05).

CONCLUSION

The occurrence of somnipathy in stroke patients was closely related with the property and site of lesion, and the neurological deficit degree of patients. Better sleep is surely favorable for recovery of the nervous function, and TCM shows a favorable efficacy on somnipathy.

摘要

目的

分析老年脑卒中患者睡眠障碍的相关因素,并比较中药与艾司唑仑对睡眠及后续神经功能的影响。

方法

对336例老年脑卒中患者进行研究分析,其中221例伴有睡眠障碍,115例睡眠正常。将221例睡眠障碍患者分为两组,治疗组112例采用中医辨证论治,对照组109例采用艾司唑仑治疗。观察治疗前后神经功能缺损量表(NDS)、睡眠障碍评定量表(SDRS)、汉密尔顿焦虑评定量表(HAMA)、汉密尔顿抑郁量表(HAMD)及治疗中出现的症状量表(TESS)评分的变化。

结果

脑出血患者睡眠障碍的发生率显著高于脑梗死患者;脑干、大脑半球(额叶)或基底节病变患者的发生率高于其他部位病变患者;神经功能缺损严重的患者更容易出现睡眠障碍。中药在改善患者失眠症状方面有显著效果,总有效率达81.25%(91/112),高于对照组的65.14%(71/109,P<0.01)。随着睡眠的改善,两组神经功能均有明显恢复,NDS评分显著降低(P<0.05)。

结论

脑卒中患者睡眠障碍的发生与病变性质、部位及患者神经功能缺损程度密切相关。良好的睡眠有利于神经功能的恢复,中药对睡眠障碍有良好疗效。

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