首页|阿尔茨海默病102例睡眠障碍特点分析及中西医结合干预效果研究

阿尔茨海默病102例睡眠障碍特点分析及中西医结合干预效果研究

Characteristics of sleep disorders in 102 patients with Alzheimer's disease and the intervention effect of integrated traditional Chinese and western medicine

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目的 探讨阿尔茨海默病患者睡眠障碍特点及中西医结合干预效果.方法 选择2019年7月至2022年12月浙江中医药大学附属湖州中医院收治的阿尔茨海默病睡眠障碍患者102例为研究对象(观察组),另选取同期在该院健康体检老年人102例为对照组,进行随机对照研究.采用临床问诊法,对阿尔茨海默病患者的睡眠障碍类型进行统计,分析其睡眠障碍特点.根据随机数字表法将阿尔茨海默病睡眠障碍患者分为甲组和乙组,每组51例,甲组予以常规西医干预,乙组在甲组基础上增加中医干预.观察阿尔茨海默病睡眠障碍患者与健康体检老年人睡眠障碍类型;观察甲组及乙组患者干预前后中医证候评分及睡眠质量变化.结果 观察组尖叫、入眠困难、日间过度嗜睡、夜间躁动、阻塞性睡眠呼吸暂停综合征(OSAS)及片段睡眠发生率依次为13.73%(14/102)、58.82%(60/102)、49.02%(50/102)、49.02%(50/102)、24.51%(25/102)和 98.04%(100/102),均高于对照组的1.96%(2/102)、23.53%(24/102)、17.65%(18/102)、4.90%(5/102)、5.88%(6/102)和50.98%(52/102),差异均有统计学意义(x2=9.76、26.22、22.58、50.40、13.73、59.46,均P<0.05);乙组干预后失眠、头晕耳鸣、精神恍惚及健忘积分依次为1.00(0.00,1.00)、0.00(0.00,1.00)、0.00(0.00,1.00)和 1.00(1.00,1.00)分,均低于甲组的 1.00(1.00,2.00)、1.00(1.00,2.00)、1.00(0.00,1.00)和 1.00(1.00,2.00)分,差异均有统计学意义(Z=-1.86、-2.13、-2.36、-2.00,均P<0.0.5);乙组干预后匹兹堡睡眠质量指数(PSQI)评分、改良爱泼沃斯嗜睡量表(mESS)评分分别为(7.56±1.93)分、(13.02±2.06分),均低于甲组的(10.87± 2.21)分、(16.44±2.87)分,差异均有统计学意义(t=8.05、6.91,均P<0.001).结论 阿尔茨海默病患者睡眠障碍主要特点包括尖叫、入眠困难、日间过度嗜睡、夜间躁动、OSAS及片段睡眠,中西医结合干预可缓解阿尔茨海默病睡眠障碍患者临床症状,并改善其睡眠质量.
Objective To investigate the characteristics of sleep disorders in patients with Alzheimer's disease and the intervention effect of integrated traditional Chinese and Western medicine.Methods A total of 102 patients with Alzheimer's disease who had sleep disorders and received treatment at Huzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang University of Traditional Chinese Medicine were included in the observation group.A total of 102 patients who concurrently received physical examination in the same hospital were included in the control group.Clinical consultation was performed to analyze the types and characteristics of sleep disorders in patients with Alzheimer's disease.The included patients with Alzheimer's diseae were divided into group A and group B using the random number table method,with 51 patients per group.Group A received routine western medicine intervention,while group B received traditional Chinese medicine intervention and routine western medicine intervention.The types of sleep disorders were observed in patients with Alzheimer's disease and older adult patients who undergo physical examination.The changes in traditional Chinese medicine syndrome score and sleep quality were evaluated in groups A and B.Results The incidence rates of screaming,difficulty in falling asleep,excessive daytime sleepiness,nocturnal restlessness,obstructivesleep apnea syndrome,and fragmented sleep in the observation group were 13.73%(14/102),58.82%(60/102),49.02%(50/102),49.02%(50/102),24.51%(25/102)and 98.04%(100/102),respectively,which were significantly higher than 1.96%(2/102),23.53%(24/102),17.65%(18/102),4.90%(5/102),5.88%(6/102)and 50.98%(52/102),respectively in the control group(x2=9.76,26.22,22.58,50.40,13.73,59.46,all P<0.05).After intervention,the scores of insomnia,dizziness and tinnitus,mental confusion,and forgetfulness in group B were 1.0(0.00,1.00)point,0.00(0.00,1.00)point,0.00(0.00,1.00)point,and 1.00(1.00,1.00)point,respectively,which were significantly lower than(1.00,2.00)points,1.00(1.00,2.00)points,1.00(0.00,1.00)points,and 1.00(1.00,2.00)points in group A(Z=-1.86,-2.13,-2.36,-2.00,all P<0.05).After intervention,the Pittsburgh Sleep Quality Index score and the Modified Epworth Sleepiness Scale score in Group B were(7.56±1.93)points and(13.02±2.06)points,respectively,which were significantly lower than(10.87±2.21)points and(16.44±2.87)points in group A(t=8.05,6.91,both P<0.001).Conclusion The main characteristics of sleep disorders in patients with Alzheimer's disease include screaming,difficulty in falling asleep,excessive daytime sleepiness,nocturnal restlessness,obstructive sleep apnea syndrome,and fragmented sleep.Combined traditional Chinese and western medicine can alleviate clinical symptoms and improve sleep quality in patients with Alzheimer's disease who have sleep disorders.

Alzheimer diseaseSleep disorders,circadian rhythmCombined modality therapyMedicine,Chinese traditionalMoxibustionAuriculotherapyLethargySleep apnea,obstructive

潘权、肖娇、周琴

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浙江中医药大学附属湖州中医院脑病科,湖州 313000

阿尔茨海默病 睡眠障碍,昼夜节律性 综合疗法 医学,中国传统 灸法 耳穴疗法 嗜睡 睡眠呼吸暂停,阻塞性

浙江省湖州市科技计划

2020GYB54

2024

中国基层医药
中华医学会,安徽医科大学

中国基层医药

影响因子:1.003
ISSN:1008-6706
年,卷(期):2024.31(1)
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