CAJ | 학술논문

目的：评价曲唑酮治疗老年期痴呆睡眠障碍（SD）的临床效果。方法2012年1月至2012年12月，选择在长海医院接受治疗的老年期痴呆SD患者63例，年龄60～80（79.1±7.4）岁，随机分配到曲唑酮组、氯硝西泮组和阿米替林组，每组21例，分别采用各自药物进行治疗4周。于治疗前、后评估睡眠改善情况，并采用汉密尔顿焦虑量表（HAMA）和汉密尔顿抑郁量表（HAMD）评价临床疗效，同时采用副作用量表即治疗急诊症状量表（TESS）评价不良反应，并进行比较分析。结果曲唑酮组总有效率85.7%，高于阿米替林组（76.2%）和氯硝西泮组（66.7%，c2＝6.860，P＜0.05）；曲唑酮组与氯硝西泮组比较，HAMA、HAMD评分均显著降低（t＝4.21，5.13；P＜0.05），曲唑酮组与阿米替林组比较，HAMA、HAMD评分均显著降低（t＝6.47，7.24；P＜0.05）；曲唑酮组不良反应发生率低，程度轻，患者耐受性好。结论曲唑酮能有效缓解老年期痴呆SD及伴随的焦虑、抑郁情绪，不良反应小，值得临床进一步研究。
목적：평개곡서동치료노년기치태수면장애（SD）적림상효과。방법2012년1월지2012년12월，선택재장해의원접수치료적노년기치태SD환자63례，년령60～80（79.1±7.4）세，수궤분배도곡서동조、록초서반조화아미체림조，매조21례，분별채용각자약물진행치료4주。우치료전、후평고수면개선정황，병채용한밀이돈초필량표（HAMA）화한밀이돈억욱량표（HAMD）평개림상료효，동시채용부작용량표즉치료급진증상량표（TESS）평개불량반응，병진행비교분석。결과곡서동조총유효솔85.7%，고우아미체림조（76.2%）화록초서반조（66.7%，c2＝6.860，P＜0.05）；곡서동조여록초서반조비교，HAMA、HAMD평분균현저강저（t＝4.21，5.13；P＜0.05），곡서동조여아미체림조비교，HAMA、HAMD평분균현저강저（t＝6.47，7.24；P＜0.05）；곡서동조불량반응발생솔저，정도경，환자내수성호。결론곡서동능유효완해노년기치태SD급반수적초필、억욱정서，불량반응소，치득림상진일보연구。
Objective To evaluate the clinical efficacy of trazodone in the treatment of sleep disorders (SD) in the senile dementia patients. Methods A total of 63 elderly dementia patients admitted in Changhai Hospital from January to December 2012, aged 60 to 80 (79.1±7.4) years, presenting SD, were randomly divided into trazodone group (n=21), clonazepam group (n=21) and amitriptyline group (n=21). The course of therapy was 4 weeks for the 3 groups. The patients’ sleep status was assessed before and after treatment. The clinical efficacy was evaluated by Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale Rating (HAMD). The adverse effects were assessed by Treatment Emergent Symptom Scale (TESS). Results The total efficiency was 85.7% in trazodone group, significantly higher than that of amitriptyline group (76.2%) and clonazepam group (66.7%, Chi-sqaure=6.860, P<0.05). The HAMA and HAMD were dramatically lower in trazodone group than in clonazepam group (t=4.21, 5.13; P<0.05) and amitriptyline group(t=6.47, 7.24; P<0.05). The trazodone group had lower incidence of adverse reactions, milder side effects and better tolerance. Conclusion Trazodone can effectively relieve SD and accompanying anxiety and depression in the senile dementia patients only with mild side effect, which is worth to further clinical study.