门诊森田疗法与认知行为疗法辅助治疗慢性失眠的对照研究

  目的   对比门诊森田疗法与失眠的认知行为疗法(CBT-I)对慢性失眠的疗效，了解2种疗法的差异，促进门诊森田疗法在临床中的推广与应用。   方法   选择2019年6月—2020年11月于芜湖市第四人民医院复诊的慢性失眠患者60例，通过随机数字表法分为研究组与对照组，各30例，分别采用门诊森田疗法和CBT-I, 比较2组患者干预前后主观睡眠质量、被束缚症状及焦虑症状。   结果   干预后研究组匹兹堡睡眠质量指数量表(PSQI)评分除催眠药物外，其余各项得分与治疗前比较差异均有统计学意义，对照组除入睡时间和催眠药物外得分均低于治疗前，且研究组干预后的睡眠质量(1.47±0.63)分、入睡时间(1.73±0.91)分、日间功能障碍(1.37±0.93)分及PSQI总分(12.23±4.18)分显著低于对照组(1.80±0.48)分、(2.67±0.66)分、(2.03±0.77)分、(14.23±3.07)分]；研究组中文版神经症被束缚自评量表(SSTN)各维度与总分均较干预前显著减少，对照组仅症状受容性维度与治疗前差异有统计学意义；干预后，研究组汉密尔顿焦虑量表(HAMA)评分为(3.50±2.86)分，对照组为(4.73±2.46)分，均显著低于干预前，2组间得分比较差异无统计学意义(P=0.079)。   结论   2种疗法均对慢性失眠有疗效，门诊森田疗法在睡眠质量、入睡时间、日间功能障碍及总体的睡眠评价上的疗效优于CBT-I，且门诊森田疗法能缓解患者的被束缚症状，可以在临床推广门诊森田疗法。 

Control study on outpatient Morita therapy and cognitive behavioural therapy in the adjuvant treatment of chronic insomnia

  Objective   To compare the efficacy of outpatient Morita therapy and cognitive behavioural therapy (CBT-I) in the treatment of chronic insomnia and to understand the difference between the two therapies and to promote the clinical application of outpatient Morita therapy.   Methods   Sixty patients with chronic insomnia who returned to the Fourth People's Hospital of Wuhu City from June 2019 to November 2019 were included and divided into the study and control groups by random number table method. The subjective sleep quality, constraint symptoms and anxiety symptoms of the two groups were compared before and after intervention by Morita therapy and CBT-I.   Results   After the intervention, the scores of the study group except those for hypnotic drugs were found to be significantly different from the scores obtained before the treatment. The scores of the control group were lower after treatment than before the treatment, except the scores for sleeping time and hypnotic drugs. After intervention, sleep quality (1.47±0.63), sleep time (1.73±0.91), daytime dysfunction (1.37±0.93) and total score of PSDI (12.23±4.18) in the study group were significantly lower than those in the control group (1.80±0.48), (2.67±0.66), (2.03±0.77), (14.23±3.07)]. In SSTN, each dimension and total score of the study group were significantly reduced compared with before the intervention, whereas only symptom tolerance dimension of the control group differed from that before the treatment. In HAMA, after the intervention, the scores of the study group (3.50±2.86) and the control group (4.73±2.46) were significantly lower than before treatment, and no significant difference was found between the two groups before and after treatment.   Conclusion   Both treatments are effective for chronic insomnia. Outpatient Morita therapy is better than CBT-I in terms of sleep quality, time to fall asleep, daytime dysfunction and overall sleep evaluation. Outpatient Morita therapy can relieve the symptoms of confinement in patients and can be promoted in clinic.