右佐匹克隆合并艾司西肽普兰治疗广泛性焦虑伴失眠的对照研究简

目的：比较广泛性焦虑伴失眠患者在抗焦虑治疗（艾司西酞普兰）初期合用或不用右佐匹克隆对患者失眠、焦虑症状的疗效与安全性。方法：将100例符合“中国精神障碍分类与诊断标准（第三版）”（CCMD-3）广泛性焦虑伴有失眠的患者随机分为试验组（52例）和对照组（48例）。试验组给予艾司西酞普兰合并右佐匹克隆治疗,对照组单用艾司西酞普兰治疗,观察期为8周。用汉密尔顿焦虑量表（HAMA）评定患者焦虑症状及疗效,用睡眠障碍量表（SDRS）评定失眠症状和疗效,同时用不良反应量表（TESS）和实验室检查评估治疗安全性。结果：试验组在治疗第1周末HAMA评分明显下降（P〈0．01）,对照组在第2周末HAMA评分明显下降（P〈0．01）,试验组在治疗后第1、2、4、6周末HAMA总分均低于对照组（P〈0．05）,第8周末差异无统计学意义（P〉0．05）。2组在治疗后第1、2、4周末SDRS总分均低于治疗前（P〈0．01）。试验组在第1、2、4周末SDRS总分均低于对照组（P〈0．01）。试验组较对照组更易发生头痛、口苦、口干、恶心及困倦感（P〈0．05）。结论：艾司西酞普兰合并右佐匹克隆治疗广泛性焦虑伴失眠,有助于快速改善患者的失眠和焦虑症状,但副反应相对明显。     

右佐匹克隆联合氟哌噻吨/美利曲辛治疗失眠伴发抑郁和(或)焦虑状态的疗效观察

目的探讨右佐匹克隆联合氟哌噻吨/美利曲辛(商品名黛力新)治疗失眠伴有抑郁和(或)焦虑状态患者的有效性及安全性。方法 150例失眠伴有抑郁和(或)焦虑状态的患者随机分为右佐匹克隆联合黛力新组、单用黛力新组、单用右佐匹克隆组,每组50例,疗程8周。用匹茨堡睡眠质量指数量表(PSQI)、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评定疗效,用治疗中出现的症状量表(TESS)及8周末实验室检查评定治疗的安全性。结果在治疗第8周末与治疗前比较,右佐匹克隆组和黛力新组PSQI显著下降(P<0.05),合用药组PSQI极显著下降(P<0.01),右佐匹克隆组的HAMD、HAMA评分无显著下降(P>0.05),黛力新组和合用药组的HAMD、HAMA评分均明显下降(P<0.01)。治疗后3组间比较,合用药组PSQI评分显著低于右佐匹克隆组和黛力新单用药组(P<0.05),黛力新组和合用药的HAMD、HAMA评分比较差异无统计学意义(P>0.05),黛力新组和合用药的HAMD、HAMA评分均显著低于右佐匹克隆组(P<0.01)。3组间不良反应差异无统计学意义(P>0.05)。结论右佐匹克隆联合黛力新治疗失眠伴发的抑郁、焦虑疗效好,耐受性好,且无明显不良反应。     

右佐匹克隆与佐匹克隆辅助治疗抑郁症睡眠障碍对照研究

目的探讨右佐匹克隆辅助治疗抑郁发作睡眠障碍的疗效及安全性。方法选取符合ICD-10抑郁发作诊断标准的门诊抑郁发作伴失眠患者，按随机分为右佐匹克隆组和佐匹克隆组，两组均观察两周。两组患者均在治疗前、治疗后第二周末采用PSQI、HAMD、TESS评定。以PSQI的减分率判定疗效。结果右佐匹克隆组和佐匹克隆组治疗后PSQI评分经I检验差异无统计学意义（P〉0．05）；但两组各因子分比较，治疗后日间功能障碍因子右佐匹克隆组显著低于佐匹克隆组（P〈O．05）；两组不良反应发生率差异无统计学意义（P〉0．05）。结‘论右佐匹克隆辅助治疗抑郁发作睡眠障碍疗效显著，对日间功能的影响显著低于佐匹克隆，安全性好，耐受性高。     

浅谈右佐匹克隆在“失眠”治疗中的应用体会

右佐匹克隆（批准文号：国药准字H20070069,生产企业：江苏天士力帝益药业有限公司）能有效缓解失眠患者的焦虑抑郁情绪,对失眠能达到病因治疗。     

安乐片联合右佐匹克隆治疗女性失眠疗效观察

目的：观察安乐片联合右佐匹克隆治疗女性失眠疗效。方法将90例女性失眠患者随机分为治疗组50例和对照组40例。对照组予以右佐匹克隆口服,治疗组在对照组基础上加用安乐片口服。4周后评价临床疗效并观察不良反应。结果治疗组总有效率为92％高于对照组的65％,差异有统计学意义（ P＜0．01）。2组患者均无明显不良反应发生。结论安乐片联合右佐匹克隆治疗女性失眠有显著疗效。     

安神膏治疗心脾血虚失眠124例临床观察

目的观察安神膏与佐匹克隆治疗失眠症（心脾血虚型）的疗效对比。方法将124例失眠患者按随机数字表将入组病例分为两组,治疗组和对照组各62例。治疗组使用安神膏治疗,对照组使用佐匹克隆治疗,疗程均为6周。于治疗前和治疗第2、4、6周末及停药后第1、2、4周末采用匹兹堡睡眠质量指数量表评定临床疗效。结果经过6周治疗,两组患者的睡眠质量均得以改善,且无不良反应,停药后睡眠改善持续时间长。结论安神膏助眠疗效与佐匹克隆相近,与佐匹克隆相比,安神膏为纯中药制剂,可长期使用,不产生药物依赖性、成瘾性,减停无戒断反应。安神膏不仅有效改善患者睡眠,且改善患者心脾血虚体质,从而在停止服药后更加持久的改善其睡眠质量。组间差异无显著性（P〉0．05）。     

右佐匹克隆治疗失眠症的疗效

目的:观察右佐匹克隆治疗失眠症的临床疗效与不良反应。方法:140例失眠症患者随机分为治疗组(70)例和对照组(70)例。治疗组患者每晚睡前服用右佐匹克隆3~6 mg;对照组患者每晚睡前服用劳拉西泮1~2 mg。连续服用4周。在服药前、服药后1周末、第2周末、第4周末应用阿森斯失眠量表(ASDR)评定患者睡眠障碍的改善情况。应用副反应量表(TESS)评定药物的不良反应。结果:ASDR评分在治疗结束时,两组较基线均显著降低(P<0.01);研究组和对照组的有效率分别为81.4%和78.6%,两组比较无显著性差异(P>0.05)。但研究组患者的起效时间较对照组快,总的睡眠质量更好。研究组不良反应发生率低于对照组(P<0.01)。结论:右佐匹克隆治疗失眠症患者疗效好,且不良反应少,是一种治疗失眠症安全而有效的新药。     

右佐匹克隆治疗老年期失眠症的对照研究

目的评估右佐匹克隆治疗老年期失眠症的疗效和安全性。方法符合失眠症诊断标准,年龄≥65岁患者,共入组80例,研究组40例,对照组40例,分别服右佐匹克隆（3～6 mg）或阿普唑仑（0.4～0.8 mg）,共2周。用匹兹堡睡眠质量指数（PSQI）、汉密顿抑郁量表（HAMD）、汉密顿焦虑量表（HAMA）评估失眠严重程度和疗效,不良事件报告评价安全性。结果研究组有效率75.0%,对照组67.5%,两组无统计学意义（P〉0.05）。1周和2周末,两组PSQI因子分及总分、HAMD、HAMA、CGI-SI分较治疗前均显著降低（P〈0.01）,研究组睡眠潜伏期、睡眠效率、白天功能紊乱因子分及PSQI总分显著低于对照组（P〈0.05或P〈0.01）,PSQI平均减分率较对照组高（P〈0.05）。对照组不良反应高于研究组（P〈0.05）。结论右佐匹克隆治疗老年期失眠症安全、有效,改善主观睡眠质量优于阿普唑仑,不良反应少。     

阿普唑仑与右佐匹克隆对抑郁症失眠辅助治疗的临床效果观察

目的探讨阿普唑仑与右佐匹克隆对抑郁症失眠辅助治疗疗效及安全性。方法将60例伴有抑郁失眠有症患者根据随机数字表分为两组,观察组给予右佐匹克隆的治疗,对照组给予阿普唑仑治疗,两组患者均在治疗前、治疗后第3周末采用匹兹堡睡眠质量指数(PittsburghSleep Quality Index PSQI)应用汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)、汉密尔顿抑郁量表(Hamilton depression scale,HAMD)评定疗效、用副反应量表(treatment emergent symptom scale,TESS)评定治疗过程中的不良反应。疗程3周。结果治疗3周后,2组睡眠时间均显著延长,PSQI评分和PANSS评分显著下降(均P<0.01),2组间疗效无显著差异(P>0.05);右佐匹克隆组日间功能障碍的改善显著优于阿普唑仑组[(1.1±0.8)分vs.(1.5±0.6)分,P<0.05];2组TESS评分无显著差(P>0.05)。结论右佐匹克隆辅助治疗抑郁症睡眠障碍疗效显著,与阿普唑仑相比疗效没有多大有差异。对日间功能的影响显著低于阿普唑仑,不良反应发生率比阿普唑仑少。     

右佐匹克隆治疗慢性失眠患者的临床疗效及安全性

目的研究右佐匹克隆治疗慢性失眠患者的临床疗效及安全性。方法选取原发性慢性失眠患者80例,随机分为治疗组和对照组各40例。治疗组给予右佐匹克隆3 mg,睡前口服,对照组给予同等样式的安慰剂,治疗时间为8周。比较两组治疗前和治疗第2、 4、 8周末匹兹堡睡眠质量指数(PSQI)、汉密尔顿抑郁量表(HAMD)评分。观察和比较两组不良反应发生情况。结果对照组治疗后PSQI和HAMD评分有下降趋势,但与治疗前比较无显著差异(P> 0.05),治疗组在治疗第4、 8周末PSQI、HAMD评分明显降低(P <0.05, P <0.01),且与对照组有显著差异(P <0.05, P <0.01)。两组不良反应发生率无显著差异(P> 0.05)。结论右佐匹克隆治疗慢性失眠患者疗效显著,可改善患者的焦虑、抑郁情绪,且安全性较高。     

佐匹克隆与盐酸曲唑酮治疗睡眠障碍的临床疗效观察

目的 观察佐匹克隆与盐酸曲唑酮治疗睡眠障碍的临床疗效和安全性.方法 将100例睡眠障碍患者采用随机数字表的方法分为治疗组50例和对照组50例.治疗组给予佐匹克隆治疗,对照组给予盐酸曲唑酮治疗.两组均为睡前30 min给药,疗程4周.比较两组临床治疗效果.结果 治疗后,两种药品在延长患者总睡眠时间方面差异无统计学意义[(0.9±0.3)h比(0.9±0.7)h,P>0.05].佐匹克隆治疗睡眠障碍的入睡时间评分低于盐酸曲唑酮[(0.5±0.2)分比(1.3±0.4)分,P<0.05].问卷自评量表(self-rating scale of sleep,SRSS)评分与本组治疗前比较明显降低(P<0.05),但是治疗后两组组间比较差异无统计学意义(P>0.05).治疗组不良反应量表(TESS)低于对照组[(9.45±4.37)分比(12.56±4.62)分,P<0.05].结论 佐匹克隆与盐酸曲唑酮在睡眠障碍的治疗效果上疗效一致.但佐匹克隆药物不良反应更低,容易被患者接受.     

Double-blind,placebo-controlled study comparing effects of zopiclone and temazepam on cognitive functioning of insomniacs

The purpose of this study was to compare the cognitive effect of two medications frequently prescribed to patients suffering from insomnia. Using a double-blind design, we evaluated three parallel groups of 20 insomniac patients treated over a period of 3 weeks with zopiclone, temazepam and placebo, respectively. Our hypothesis was that the impact of zopiclone 7.5 mg/day on cognitive functioning would be minimal 12 h after administration and that temazepam 30 mg/day would affect explicit memory, as is the case with other benzodiazepines. Patients were assessed at baseline following a 1-week, single-blind placebo-intake period, and again at the end of each of the 3 weeks of the comparative phase. Then, in order to estimate the severity and duration of potential rebound insomnia, patients were again assessed following another 1-week, single-blind placebo-washout period at the end of the 3 weeks of treatment. The overall duration of the study for each patient was thus 5 weeks. The instruments of measure used were the Hamilton scale for anxiety, daily self-rating questionnaire for assessment of sleep onset, duration and quality, and two large batteries of psychometric tests. The first of these batteries assessed memory and included span tests for short-term memory, cued recall tasks for long-term explicit memory, and a word-completion task for implicit memory; the second measured attention and concentration through the assessment of alertness, sustained attention and divided attention. The sleep and anxiety results obtained confirm the findings of previous research. Zopiclone and temazepam possess a clinically significant hypnotic activity, with no rebound insomnia or anxiety, during the week of drug withdrawal. The results indicate that the two hypnotic drugs studied have little impact on cognitive functioning. We can therefore conclude that at the doses administered over the 3 weeks, the two hypnotic drugs in question are relatively safe and efficacious in the treatment of insomnia and enable patients to enjoy a good quality of life. Copyright © 1999 John Wiley & Sons, Ltd.     

女珍颗粒联合佐匹克隆治疗更年期失眠症的临床研究

目的 探讨女珍颗粒联合佐匹克隆片治疗更年期失眠症的临床疗效。方法 选取2016年3月—2018年10月在内蒙古自治区精神卫生中心进行治疗的82例更年期失眠患者为研究对象,根据用药的差别分为观察组（41例）和对照组（41例）。对照组给予佐匹克隆片,7.5 mg/次,1次/d,睡前服用;观察组在对照组基础上口服女珍颗粒,6 g/次,3次/d。两组均治疗4周后进行效果对比。结果 经治疗,对照组有效率为82.92%,显著低于治疗组95.12%（P<0.05）。经治疗,两组患者匹兹堡睡眠质量指数量表（PSQI）评分降低;多导睡眠监测（PSG）中入睡时间、觉醒时间降低,总睡眠时间增加,睡眠效率提高;睡眠结构中I期时间缩短,II、III期及快速动眼期时间延长（P<0.05）,且观察组睡眠情况显著优于对照组（P<0.05）。经治疗,两组患者血清中神经递质去甲肾上腺素（NE）、5-羟色胺（5-HT）、多巴胺（DA）水平显著升高（P<0.05）,且观察组神经递质水平显著高于对照组（P<0.05）。经治疗,两组焦虑自评量表评分（SAS）、抑郁自评量表评分（SDS）、SCL-90、Hamilton抑郁量表（HAMD）评分均显著降低（P<0.05）,且观察组上述评分显著低于对照组（P<0.05）。结论 女珍颗粒联合佐匹克隆片治疗更年期失眠症效果良好,可有效减轻失眠症状,改善患者负面情绪,提高患者生活质量,有着良好临床应用价值。     

阿立哌唑与利培酮治疗女性精神分裂症的疗效分析

目的：比较阿立哌唑与利培酮对女性精神分裂症患者的疗效和不良反应。方法：将符合入组条件的60例患者随机分成阿立哌唑组和利培酮组,分别口服阿立哌唑和利培酮治疗,观察8周。于治疗后2、4、8周末用阳性症状与阴性症状量表（PANSS）和副反应量表（TESS）评定疗效和不良反应。结果：治疗8周后,两组患者PANSS评分均明显下降（P〈0.01）。阿立哌唑组痊愈率为46.7%、有效率为90.0%,利培酮组痊愈率为46.7%、有效率为93.3%,两组比较差异无统计学意义（P〉0.05）。两组不良反应主要表现为锥体外系反应（EPS）、恶心呕吐、心电图异常、失眠、体重增加、月经紊乱等方面,其中阿立哌唑引发的锥体外系反应、体重增加、月经紊乱明显少于利培酮（P〈0.01）。结论：阿立哌唑和利培酮对女性精神分裂症患者疗效相当,阿立哌唑在EPS、体重增加和月经紊乱等方面的反应少于利培酮。     

A comparison of efficacy and tolerance of the short acting sedatives midazolam and zopiclone.

AIMS: To compare the efficacy and tolerance of midazolam, 15 mg and zopiclone 7.5 mg once daily for seven days in a prospective, double blind trial of 88 patients, aged 18 or over, with sleep disorders in general practice. METHODS: Efficacy was evaluated using the Leeds sleep evaluation questionnaire (LSEQ). Adverse reactions were recorded as volunteered. RESULTS: fifty-one patients completed all aspects of the trial without violation of the protocol. Patients taking zopiclone improved in all aspects of the Leeds questionnaire (p < 0.01). Patients taking midazolam improved in six out of 10 items (p < 0.01). Rebound insomnia was evident in the zopiclone group in five out of 10 items of the LSEQ. Rebound was not evident in the midazolam group. There were no significant differences between midazolam 15 mg, and zopiclone 7.5 mg, in comparison between groups. Thirty-eight patients suffered 49 adverse drug reactions and there were no differences between the groups. CONCLUSIONS: Zopiclone 7.5 mg daily improved more items on the LSEQ than midazolam 15 mg daily but was associated with significant rebound insomnia. Adverse reactions were frequent with both drugs.     

Zopiclone and triazolam in insomnia associated with generalized anxiety disorder: a placebo-controlled evaluation of efficacy and daytime anxiety

In a double-blind placebo-controlled study, following a 1 week washout, 75 outpatients suffering from generalized anxiety disorder with severe insomnia as the target symptom were randomly assigned to 4 weeks of treatment with zopiclone 7.5 mg, triazolam 0.5 mg or placebo at bedtime. Zopiclone was significantly better than placebo on most sleep parameters. Triazolam tended to be superior to placebo, but its superiority was significant only on the sleep induction factor. Triazolam-treated patients presented significantly more day-time-interdose anxiety than zopiclone as assessed by the weekly HARS and Clinical Global Assessment of Anxiety. Although daytime-interdose anxiety was observed with both drugs, this treatment emergent symptom was more frequent and severe with triazolam. Side-effects were of a mild to moderate intensity for both zopiclone and triazolam; however, taste perversion frequently appeared with zopiclone. Although both drugs share similar pharmacological properties and bind to benzodiazepine receptors, they differ significantly with respect to side-effects and daytime anxiety.     

A comparative assessment of the risks and benefits of zopiclone: a review of 15 years' clinical experience.

Zopiclone is a cyclopyrrolone hypnosedative that is chemically unrelated to the benzodiazepines but nevertheless potentiates gamma-aminobutyric acid-mediated neuronal inhibition, and has demonstrated proven efficacy and good tolerability in the treatment of insomnia over 15 years of use. Zopiclone is indicated for short term use, and should not be prescribed for more than 4 weeks. This review compares the efficacy of zopiclone with that of a number of commonly used short-, medium- and long-acting benzodiazepines. Zopiclone at dosages of 7.5 mg/day has demonstrated efficacy equivalent and in some cases greater to that of flurazepam 30 mg/day, nitrazepam 5 mg/day, flunitrazepam 1 to 2 mg/day, temazepam 20 mg/day, triazolam 0.125 to 0.5 mg/day and midazolam 15 mg/day. Zopiclone-treated patients reported themselves to be less impaired by daytime sedation than patients treated with the medium- and long-acting hypnosedatives flurazepam, nitrazepam and flunitrazepam. Zopiclone and temazepam showed similar effects on daytime behaviour while zopiclone appeared to have somewhat better effects on daytime well-being than the short-acting triazolam and midazolam. There has been no clinical comparison with the frequently used medium-acting benzodiazepines lormetazepam and brotizolam and the imidazopyridine hypnosedative zolpidem. Data from clinical trials, pooled analyses and postmarketing surveillance including over 30,000 patients showed that with the exception of bitter taste (reported by <10% of zopiclone recipients), the tolerability profile of zopiclone is similar to that of placebo. Clinical trials found no evidence for significant rebound insomnia and indicated that the risk of withdrawal reactions with therapeutic doses of zopiclone is very low. In addition, to date, dependency appears very low, although abuse potential should be considered following a history of addiction or psychiatric illness. Evaluation of the accumulated evidence from over 2.5 billion units dispensed in more than 30 countries indicates that zopiclone is effective, well tolerated and an excellent alternative to benzodiazepines in the short term treatment of insomnia.     

度罗西汀联合喹硫平治疗躯体形式障碍的疗效研究

目的：比较分析度罗西汀联合喹硫平治疗躯体形式障碍的疗效及不良反应。方法：选择2011年6月～2014年10月我院就诊的63名躯体形式障碍患者,随机分为两组,研究组以度罗西汀联合喹硫平进行治疗,对照组单用度罗西汀治疗,疗程均为8周。治疗前与治疗后第2周、4周、8周分别采用汉密尔顿焦虑量表（HAMA）评定患者的焦虑及躯体性焦虑情况;并在第2周、第8周采用抗抑郁药不良反应评定量表（SERS）评定不良反应。结果：治疗后两组HAMA总分及躯体性焦虑因子评分均显著降低,差异显著（P<0.05）,联合应用喹硫平组下降更为明显,治愈率高于单用度罗西汀组（16.7%,41.4%）,两组间差异有统计学意义（P<0.05）。且联合应用喹硫平组在治疗2周后起效快于单用度罗西汀组,差异显著（P<0.05）。两组间不良反应均表现较轻,大多出现在治疗早期,经对症治疗逐渐缓解。结论：度罗西汀联合喹硫平治疗躯体形式障碍较单用度罗西汀组疗效显著,起效快,且不良反应发生率低。     

帕罗西汀联合天王补心汤治疗伴焦虑症状抑郁症的效果观察

目的：探讨帕罗西汀联合中药天王补心汤治疗伴有焦虑症状抑郁症的临床效果及安全性。方法将98例伴有焦虑症状抑郁症患者随机分为研究组（n=49例）和对照组（n=49例）,研究组给予帕罗西汀联合天王补心汤治疗,对照组给予帕罗西汀治疗,治疗6周。采用汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）及副反应量表（TESS）评定药物的疗效及不良反应。结果研究组和对照组的有效率分别为91.8%和77.6%,两组比较差异有统计学意义（P〈0.05）;两组治疗后HAMD和HAMA评分较治疗前均显著下降（P〈0.01）;研究组在治疗2、4、6周末HAMD和HAMA评分下降较对照组显著（P〈0.05）;研究组发生口干、恶心和失眠的不良反应明显少于对照组（P〈0.05）。结论帕罗西汀联合天王补心汤治疗伴有焦虑症状的抑郁症的效果比单用帕罗西汀更显著,能较快缓解患者的抑郁、焦虑症状,且不良反应少,安全性高。     

西酞普兰对癌症抑郁患者生活质量的影响

目的：探讨西酞普兰对癌症患者抑郁、焦虑症状的疗效及安全性，并全面评价患者用药前后的生活质量。方法：对38例癌症抑郁患者进行8周的西酞普兰治疗，采用汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）、不良反应量表（TESS）和相关实验室检查评价西酞普兰对癌症抑郁患者抑郁、焦虑的疗效以及安全性，采用世界卫生组织生存质量评定量表（WHOQOL）评价患者用药前后的生活质量。结果：治疗后患者焦虑、抑郁症状比入组时明显降低（P〈0．01）；患者用药期间未出现明显药物不良反应；患者生活质量中的生理、心理、独立性3个领域有明显改善。结论：本研究结果显示西酞普兰能明显改善癌症患者的抑郁、焦虑症状，起效时间为2周；治疗期间不良反应较少；应用西酞普兰治疗患者抑郁症状的同时能明显提高患者的生活质量。