药物治疗联合道家认知疗法治疗中老年失眠症对照研究

目的：探讨药物治疗联合道家认知疗法治疗中老年失眠症的临床疗效。方法将101例中老年失眠症患者随机分为两组。两组均口服佐匹克隆治疗，研究组予以道家认知治疗，对照组予以常规健康教育。观察12周。于治疗前后采用匹兹堡睡眠质量指数评定睡眠状况，症状自评量表、社会支持量表、特质应对方式问卷评定临床症状、社会支持状况及应对方式。结果治疗6周末起两组匹兹堡睡眠质量指数总分较治疗前显著降低（P＜0．01），研究组显著低于对照组（P＜0．01）；治疗12周末研究组症状自评量表评分较治疗前显著降低（P＜0．01），社会支持量表主观支持、支持利用度维度分较治疗前显著升高（P＜0．01），特质应对方式问卷积极应对维度分较治疗前显著升高（P＜0．01），消极应对维度分较治疗前显著降低（P＜0．01），与对照组比较差异均有显著性（P＜0．05或0．01）。结论药物联合道家认知疗法能显著改善中老年失眠症患者的睡眠状况和躯体症状，对提高社会支持利用度，改善积极应对方式具有重要作用，显著优于单用药物治疗。

A control study of medication combined with Taoist cognitive therapy in the treat-ment of middle-aged and senile insomnia

Objective To explore the clinical efficacy of medication combined with Taoist cognitive therapy （TCT ） in the treatment of middle-aged and senile insomnia .Methods A total of 101 middle-aged and senile insomnia pa-tients were randomly divided into two groups .Both groups took orally zopiclone ,research group was plus TCT and control group plus routine health education for 12 weeks .Sleep states were assessed with the Pittsburgh Sleep Quality Index （PSQI） ,clinical symptoms ,social supports and coping styles with the Symptom Checklist-90 （SCL-90） ,Social Support Rating Scale （SSRS） and Trait Coping Style Questionnaire （TCSQ） before and after treat-ment .Results Since the end of the 6th week the total scores of the PSQI of both groups lowered more significantly compared with pretreatment （P〈0 .01） ,so did that in research than control group （P〈0 .01）;at the end of the 12th week SCL-90 score lowered more significantly （P〈0 .01） ,subjective support and support availability score of the SSRS heightened （P〈0 .01） ,active coping score of the TCSQ heightened （P〈0 .01） and passive coping score lowered （P〈0 .01） compared with pretreatment in research group ,those had significant differences from control group （P〈0 .05 or 0 .01） .Conclusion Medication plus TCT could significantly improve sleep status and somatic symptoms ,increase patients’ social support availability and active coping styles compared with single medication in middle-aged and senile insomnia patients .