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乌灵胶囊联合小剂量喹硫平用于失眠伴焦虑抑郁高龄老年患者

          的疗效分析
                           Δ

                *
          蔡传云 ,胡 欣,朱华军,刘文竹,吴子幸,江 伟(中国人民解放军联勤保障部队第九〇一医院全科医学科,
                                                       #
          合肥 230031)

          中图分类号  R749.92;R969      文献标志码  A      文章编号  1001-0408(2024)12-1517-05
          DOI  10.6039/j.issn.1001-0408.2024.12.18

          摘  要  目的  探讨乌灵胶囊联合小剂量喹硫平治疗高龄老年失眠伴焦虑抑郁患者的疗效和安全性。方法  回顾性分析2020年6
          月-2022年12月在我院门诊就诊或住院治疗的96例失眠伴焦虑抑郁高龄老年(≥80岁)患者的临床资料。根据治疗方案的不同
          将患者分为乌灵胶囊组(0.99 g,每天3次,34例)、喹硫平组(25~50 mg,每晚1次,30例)和联合组(同时服用乌灵胶囊和喹硫平,
          用法用量同单药组,32例)。比较3组患者治疗前和治疗8周后的睡眠监测指标(总睡眠时间、睡眠效率、睡眠潜伏期、觉醒次数)、
          匹兹堡睡眠质量指数量表(PSQI)评分、14项汉密尔顿焦虑量表(HAMA-14)评分、17项汉密尔顿抑郁量表(HAMD-17)评分、简易
          智能精神状态量表(MMSE)评分、血清白细胞介素 1β(IL-1β)和肿瘤坏死因子 α(TNF-α)水平,以及疗效和不良反应发生情况。
          结果  与治疗前比较,3组患者治疗后的总睡眠时间、睡眠效率、MMSE评分均显著延长或升高(P<0.05),睡眠潜伏期、觉醒次数、
          PSQI评分、HAMA-14评分、HAMD-17评分、血清IL-1β和TNF-α水平均显著缩短或降低(P<0.05),喹硫平组患者的睡眠潜伏期、
          觉醒次数、HAMA-14评分、HAMD-17评分、血清TNF-α水平均明显短于或低于乌灵胶囊组,且联合组各定量指标均显著优于喹硫
          平组和乌灵胶囊组(P<0.05)。联合组患者的治疗总有效率显著高于喹硫平组和乌灵胶囊组(P<0.05),3组患者的总不良反应发
          生率比较差异无统计学意义(P>0.05)。结论  乌灵胶囊联合小剂量喹硫平用于高龄老年失眠伴焦虑抑郁患者的疗效优于各药单
          用,不良反应未见明显增加。
          关键词  乌灵胶囊;小剂量喹硫平;失眠;焦虑;抑郁;高龄老年患者

          Efficacy of Wuling capsules combined with low-dose quetiapine in the treatment of oldest-old patients with
          insomnia accompanied by anxiety and depression
          CAI Chuanyun,HU Xin,ZHU Huajun,LIU Wenzhu,WU Zixing,JIANG Wei(Dept.  of  General  Medicine,  the
          901st  Hospital  of  the  Joint  Logistics  Support  Force  of  the  Chinese  People’s  Liberation  Army,  Hefei  230031,
          China)

          ABSTRACT   OBJECTIVE  To  investigate  the  efficacy  and  safety  of  Wuling  capsules  combined  with  low-dose  quetiapine  in  the
          treatment  of  oldest-old  patients  with  insomnia  accompanied  by  anxiety  and  depression.  METHODS  The  clinical  data  of  96  oldest-
          old  patients (aged≥80  years)  with  insomnia  accompanied  by  anxiety  and  depression  who  were  attending  outpatient  clinics  or
          hospitalized  in  our  hospital  from  June  2020  to  December  2022  were  retrospectively  analyzed.  According  to  the  different  drug
          treatments,  the  patients  were  divided  into  Wuling  capsules  group (0.99  g,  tid,  34  cases),  quetiapine  group (25-50  mg,  qn,  30
          cases)  and  combination  group (using  Wuling  capsules  and  quetiapine  simultaneously,  same  as  the  single  drug  groups,  32  cases).
          Before  and  after  8  weeks  of  treatment,  the  patients  of  three  groups  were  compared  in  terms  of  photoplethysmography  sleep
          monitoring  indexes (total  sleep  duration,  sleep  efficiency,  sleep  latency,  and  the  number  of  awakening),  Pittsburgh  sleep  quality
          index (PSQI)  score,  14-item  Hamilton  anxiety  scale (HAMA-14)  score,  17-item  Hamilton  depression  scale (HAMD-17)  score,
          mini-mental state examination (MMSE) score, and serum levels of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α);
          the  therapeutic  effects  and  adverse  drug  reactions  of  the  three  groups  were  observed  and  compared.  RESULTS  Compared  with
          before  treatment,  the  total  sleep  time,  sleep  efficiency  and  MMSE  scores  of  the  three  groups  were  significantly  longer  or  higher
          after treatment (P<0.05), while the sleep latency, number of awakening, PSQI score, HAMA-14 score, HAMD-17 score, serum
          IL-1β  and  TNF- α  levels  were  significantly  shorter  or  lower  after  treatment (P<0.05).  Sleep  latency,  number  of  awakening,
          HAMA-14  score,  HAMD-17  score  and  serum  TNF-α  level  in  quetiapine  group  were  significantly  shorter  or  lower  than  Wuling
                                                             capsules  group  after  treatment  (P<0.05).  Moreover,  the
             Δ 基金项目 安徽省重点研究与开发计划项目(No.202104j07020-
                                                             above  indexes  in  the  combination  group  were  significantly
          002);军队后勤科研项目(No.19BJZ16);安徽医科大学校科研基金项
                                                             better  than  quetiapine  group  and  Wuling  capsules  group (P<
          目(自然科学类)(No.2022xkj251)
             *第一作者 医师,硕士。研究方向:老年睡眠障碍。E-mail:                 0.05).  The  total  effective  rate  of  treatment  in  the  combination
          1731786794@qq.com                                  group  was  significantly  higher  than  the  other  two  groups (P<
             # 通信作者 副主任医师,博士。研究方向:老年睡眠障碍。E-                  0.05).  There  was  no  significant  difference  in  the  incidence  of
          mail:2408797210@qq.com                             adverse  drug  reactions  among  the  three  groups (P>0.05).


          中国药房  2024年第35卷第12期                                              China Pharmacy  2024 Vol. 35  No. 12    · 1517 ·
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