An open-label study of quetiapine in the treatment of fibromyalgia

The aim of this exploratory study was to systematically assess the potential effectiveness and tolerability of quetiapine, an atypical antipsychotic, for the treatment of patients with fibromyalgia. This was a unicentre, open-label study conducted in thirty-five outpatients, 18 years or older, who met the ACR criteria for fibromyalgia and who had not satisfactorily responded to their previous fibromyalgia treatment. Quetiapine, flexibly dosed (25-100 mg/day), was added to their original treatment regimen for 12 weeks. The primary outcome measure was the mean change from baseline to endpoint in the Fibromyalgia Impact Questionnaire (FIQ) total score. Secondary efficacy measures included mean changes from baseline to endpoint in the scores of the Clinical Global Impression (CGI) of Severity scale, Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), 12-Item Short Form Health Survey (SF-12), and individual items of the FIQ. Thirty (85.7%) patients (mean age 47+/-7.9, 93.3% females) had a postbaseline evaluation and constituted the intent-to-treat efficacy sample. Mean FIQ total score decreased significantly by 10.2 points from a baseline of 63.2 to 53.0 at study endpoint (p<0.001). A statistically significant reduction was observed in FIQ stiffness and FIQ fatigue subscores but not in FIQ pain subscore. Large effect sizes were observed for the FIQ total (1.04), CGI-severity (1.00) and PSQI (1.07), while moderate effect sizes (i.e.> or =0.50) were encountered in the FIQ fatigue, FIQ stiffness and SF-12 mental component summary. Quetiapine was safely administered and well tolerated. Despite the lack of effect on pain, the significant and relevant improvement in overall efficacy measures and quality of life suggests that quetiapine may be a valuable drug for treatment of patients with fibromyalgia that should be further tested in double-blind, placebo-controlled trials.     

黄豆苷元片联合巴曲酶治疗突发性耳聋耳鸣的疗效观察

目的探讨黄豆苷元片联合巴曲酶注射液治疗突发性耳聋耳鸣的临床疗效。方法选择2018年3月—2020年3月在郑州大学第二附属医院治疗的98例突发性耳聋耳鸣患者,根据药物使用的差别分成对照组和治疗组,每组各49例。对照组静脉滴注巴曲酶注射液,首次20 BU加入生理盐水100 mL,1次/2 d,维持剂量5 BU;治疗组在对照组基础上口服黄豆苷元片,50mg/次,3次/d。两组患者均经3周治疗。观察两组患者临床疗效,比较治疗前后两组患者临床症状改善时间,血液流变学指标全血高切黏度、全血低切黏度、血浆黏度和红细胞压积水平,及PSQI、THI和SF-36评分。结果经治疗,治疗组总有效率为97.96%,显著高于对照组的83.67%(P0.05)。经治疗,治疗组耳鸣、眩晕、耳闷改善时间均早于对照组(P0.05)。经治疗,两组全血高切黏度、全血低切黏度、血浆黏度及红细胞压积均显著降低(P0.05),且治疗组降低最显著(P0.05)。治疗后,两组患者PSQI评分和THI量表评分显著降低,而SF-36评分显著升高(P0.05),且治疗组这些评分明显好于对照组(P0.05)。结论黄豆苷元片联合巴曲酶注射液治疗突发性耳聋耳鸣有着显著疗效,同时还能改善患者血液流变学和生活质量,具有一定的临床推广应用价值。     

体动记录仪在非器质性失眠症诊断中的作用

目的 评价体动记录仪(Actigraphy)在非器质性失眠症诊断中的作用.方法 选择非器质性失眠症患者34例,对照组20例.采用体动记录仪评价睡眠效果,同时,采用匹茨睡眠质量指数量表评定受试者最近1个月睡眠质量.结果 非器质性失眠症患者与对照组相比,实际觉醒时间、睡眠潜伏期、平均每次觉醒时间显著延长(P＜0.01),睡眠效率、平均静息状态时长显著降低(P＜0.01),同时平均活动分数和割裂指数显著升高(P＜0.05).PSQI评定结果发现,非器质性失眠症患者PSQI均＞7,达到16.88±4.56;对照组PSQI均＜7,为4.53±1.69,二者相比差异有统计学意义(P＜0.01).结论 非器质性失眠症的诊断方法中,体动记录仪可以成为一种有效辅助方法.     

Can an inert sleeping pill affect sleep? Effects on polysomnographic,behavioral and subjective measures

RATIONALE: Since two recent meta-analyses on sleep changes associated with placebo in clinical trials suggested a beneficial effect of placebo treatments, pointing to a dissociation between subjective and objective measures of sleep, the current experiment was directly aimed to assess the effects of an inert compound, administered with the suggestion that it was a hypnotic substance in subjects with mild sleep complaints. OBJECTIVES: The aim of this study was to compare subjective, behavioral, polysomnographic (PSG), and quantitative electroencephalographic (EEG) changes during a night preceded or not by the intake of two 50-mg lactose capsules. METHODS: Ten female students, selected by the Pittsburgh Sleep Quality Index, slept for three consecutive nights in a sleep laboratory, with the experimental (EXP) night defined by the administration of two 50-mg lactose pills. Self-ratings of sleep quality and performance were assessed upon morning awakening of baseline (BSL) and EXP nights. RESULTS: The EXP nights were self-rated as more restful and characterized by a decreased number of nocturnal awakenings than the BSL nights. PSG measures showed that wakefulness after sleep onset significantly decreased during the EXP night as compared to the BSL night. The EXP nights also showed an increase of 0.5-4.0 Hz power during nonrapid eye movement sleep and a decrease of EEG activity in the beta frequency range during rapid eye movement sleep only at central brain sites. A specific improvement of behavioral measures was also found upon morning awakening after the EXP night compared to the BSL night. CONCLUSIONS: The administration of an inert pill improves both the subjective and objective quality of sleep. The reduced sleep fragmentation and the effects on some quantitative EEG markers of sleep homeostasis suggest that the experimental manipulation induced coherent changes in the subsequent sleep, resembling an enhancement of sleep pressure. The regional differences of EEG activity suggest the involvement of a specific physiological mechanism distinct from that of effective treatments.     

Explaining social inequalities in health by sleep: the Japanese civil servants study

BACKGROUND: Individuals of low socioeconomic status (SES) are likely to have poor sleep and poor health. This study aims to evaluate whether and how much of the socioeconomic differences in health are explained by sleep. METHODS: The subjects were 3684 (2471 males and 1213 females) employees aged 20-65 working in local government in Japan. A questionnaire survey was conducted in January 2003. Analysis of covariance (ANCOVA) was performed to examine the association of employment-grade with sleep, measured by the Pittsburgh Sleep Quality Index (PSQI), and with health, measured by the Physical and Mental Component Summary Scales (PCS and MCS) of the Short Form-36 (SF-36). RESULTS: In men, higher grade employees had better sleep and better health. The age-adjusted difference between the highest and the lowest grade employees was 1.9 points (95% confidence interval = 1.0-3.0) in the PCS and 3.4 points (1.8-4.9) in the MCS. The grade difference in health reduced to 1.5 points (0.5-2.5) in the PCS (21.1% reduction) and 2.0 points (0.6-3.4) in the MCS (41.2% reduction), when the PSQI global score was adjusted for. The grade differences in sleep quality contributed more to the health inequalities than sleep quantity. Among women, no significant grade differences were observed in the PSQI global score. The grade differences in the PCS and MCS were weaker and less consistent than those of men, and the differences hardly changed when the PSQI global score was adjusted for. CONCLUSION: Sleep quality may mediate the relationship between SES and physical and, in particular, mental health in men.     

不同部位电刺激治疗带状疱疹神经痛的疗效分析

目的:对治疗带状疱疹神经痛(zoster-related neuralgia,ZRN)的短时程背根神经电刺激与脊髓电刺激两种方法的手术时间、放射暴露剂量、疗效及花费进行比较。方法:本文采用回顾性分析方法,对202例在DSA(digital subtraction angiography)引导下使用短时程电刺激治疗的带状疱疹神经痛病人(其中64例采用背根神经电刺激,138例采用脊髓电刺激),记录手术操作时间及每一例手术的辐射剂量,术后病人的程控次数,术前及术后1、2、3月等各时间段病人的疼痛程度,生活质量以及医疗耗材费等信息,并进行分析比较。结果:在3个月的随访期间,所有病人在两种方法治疗后疼痛视觉模拟评分法(visual analogue scale,VAS)评分和匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PQSI)显著下降,而生活质量(SF-36健康调查简表)评分显著上升(P<0.01),且两种方法之间无统计学差异,然而背根神经电刺激病人的手术时间和术中辐射量明显少于脊髓电刺激组(P<0.05);且术后平均程控次数以及医疗耗材费用也明显少于脊髓电刺激组(P<0.05)。结论:短时程背根神经电刺激和脊髓电刺激都能有效治疗带状疱疹神经痛,但背根神经电刺激具有程控次数少、覆盖好、花费少等优点。     

关于医学大学生睡眠状况的调查分析与研究

目的：了解医学大学生睡眠质量情况,为高校大学生实施健康管理提供参考。方法：使用匹兹堡睡眠质量指数（PSQI）对5313名医大学生进行睡眠质量调查,并与非医学大学生进行比较。结论：应重视医学大学生的睡眠问题,有针对性地加强健康宣教,改善管理方式。     

内功一指禅推拿治疗失眠症疗效观察

目的观察内功一指禅推拿治疗失眠症的临床疗效。方法将80例失眠症患者随机分为推拿组和对照组（各40例）,分别采用内功一指禅推拿和艾司唑仑片口服治疗,疗程20天。观察两组临床疗效和治疗前后匹兹堡睡眠质量指数量表（PSQI）评分变化情况。结果推拿组总有效率为95%,对照组为85%;推拿组临床疗效优于对照组（P〈0.05）;治疗后两组PSQI评分均较治疗前明显降低（P〈0.05）,且推拿组低于对照组（P〈0.05）。结论内功一指禅推拿治疗失眠症疗效确切。     

宁神贴敷脐治疗失眠症

目的探讨宁神贴敷脐治疗失眠症的疗效。方法将66例患者随机分为治疗组(34例)和对照组(32例)。治疗组以宁神贴贴敷神阙穴(每晚贴1次),对照组口服阿普唑仑(0.8 mg/d,睡前0.5 h服),共观察28 d。采用匹兹堡睡眠质量指数量表评定临床疗效。结果 2组治疗后患者的PSQI总分及各因子评分较治疗前均有改善,差异有统计学意义(P<0.05);治疗后2组睡眠时间、睡眠效率比较,差异有统计学意义(P<0.05)。结论宁神贴敷脐疗法可滋阴潜阳、交通心肾、镇惊安神,能更好的改善患者睡眠时间、睡眠效率。