摘要
目的探讨音乐疗法、呼吸训练配合多奈哌齐治疗神经衰弱失眠伴认知障碍的临床效果。方法选取温州市第七人民医院2019年4月-2021年4月收治的120例神经衰弱失眠伴认知障碍患者,根据随机数字表法分为对照组和观察组,每组60例;对照组单用多奈哌齐治疗,观察组使用音乐疗法、呼吸训练配合多奈哌齐治疗,治疗1个月后比较两组临床疗效、匹茨堡睡眠质量指数量表(PSQI)评分、蒙特利尔认知评估量表(MoCA)评分、洛文斯顿认知评定量表(LOTCA)评分、世界卫生组织生存质量测定量表-100(WHOQOL-100))评分、血清学指标[硫化氢(H2S)、神经元特异性烯醇化酶(NSE)、多巴胺(DA)、5-羟色胺(5-HT)]及不良反应发生情况。结果观察组治疗总有效率为93.33%,明显高于对照组的80.00%(P<0.05);观察组治疗后PSQI评分低于对照组,MoCA评分以及LOTCA相关项评分高于对照组,WHOQOL-100中6个领域及一般健康状况与生存质量评分高于对照组(均P<0.05);H_(2)S水平高于对照组,NSE、DA、5-HT水平低于对照组(均P<0.05);两组不良反应发生率比较差异无统计学意义(P>0.05)。结论相比单用多奈哌齐治疗,音乐疗法、呼吸训练配合多奈哌齐治疗神经衰弱失眠伴认知障碍临床疗效更好,且不增加不良反应风险。
Objective To investigate the efficacy of music therapy and breathing training with donepezil in the treatment of neurasthenia patients with insomnia and cognitive impairment.Methods One hundred and twenty neurasthenia patients with insomnia and cognitive impairment admitted to Wenzhou Seventh People’s Hospital from April 2019 to April 2021were randomly divided into control group and study group with 60 cases in each group.The control group was given donepezil alone,and the study group received music therapy and breathing training in addition to donepezil.The clinical outcomes,Pittsburgh Sleep Quality Index(PSQI)scores,Montreal Cognitive Assessment Inventory(MoCA)scores,Lovingston Cognitive Assessment Scale(LOTCA)scores,World Health Organization Quality of Living Scale-100(WHOQOL-100)scores,serological indicators[hydrogen sulphide(H2S),neuron-specific enolase(NSE),dopamine(DA),5-hydroxytryptamine(5-HT)]and the occurrence of adverse effects were compared between the two groups after treatment.Results The total effective rate of treatment in the study group was significantly higher than that in the control group(93.33%vs.80.00%,P<0.05).The PSQI score of study group was lower than that of the control group,MoCA score and LOTCA-related items score were higher than those of the control group,6 domains in WHOQOL-100 and general health status and quality of survival score in study group were higher than those of the control group(all P<0.05).H_(2)S level in study group was higher than that of the control group,and NSE,DA and 5-HT levels were lower than those in the control group(all P<0.05).There was no significance difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Compared to donepezil alone,music therapy and breathing exercises in combination with donepezil are more effective in treatment of patients with neuroleptic insomnia and cognitive impairment without an increased risk of adverse effects.
作者
黄春海
陶海娃
土文珍
夏王斌
HUANG Chunhai;TAO Haiwa;TU Wenzhen;XIA Wangbin(Department of Psychiatry,Wenzhou Seventh People's Hospital,Wenzhou 325000,China)
出处
《浙江医学》
CAS
2022年第17期1837-1841,共5页
Zhejiang Medical Journal
基金
浙江省医药卫生科技计划(2020KY925)。
关键词
音乐疗法
呼吸训练
多奈哌齐
神经衰弱
失眠
认知障碍
Music therapy
Breathing training
Donepezil
Neurasthenia
Insomnia
Cognitive impairment
作者简介
通信作者:陶海娃,E-mail:huangchunhai1234@163.com。
