目的 观察不同光照时间全光谱治疗对阿尔茨海默病(Alzheimer's disease,AD)患者睡眠障碍的临床疗效和安全性.方法 将127例AD伴发睡眠障碍的患者按随机数字表法分为空白组34例、30min光照组31例、60 min光照组33例和120 min光照组29例,通过10 000 lux全光谱光照治疗1个月后,采用匹兹堡睡眠质量指数量表(PQSI)、爱泼沃斯嗜睡量表(ESS)、神经精神问卷(NPI)、简易智能状态量表(MMSE)和总体衰退量表(GDS)等评分作为主要评价指标,比较光照前后患者的睡眠质量、日间过度嗜睡、认知功能、精神状况和痴呆程度的变化.结果 (1)与治疗前相比,30 min组、60 min组和120 min组的PQSI,ESS,NPI评分差异有统计学意义[30 min组:(14.4±5.2)分vs(11.7±4.9)分,(14.4±4.1)分vs(11.8±3.7)分,(14.2±1.3)分vs(10.9±1.7)分,t=2.071,2.609,8.446,P=0.043,0.011,0.000.60 min组:(13.4±4.0)分vs(8.1±3.7)分,(14.5±3 0)分vs(9.4±2.0)分,(13.7±5.8)分vs(8.7±4.3)分,t=5.650,8.209,3.902,均P＜0.01.120 min组:(14.0±3.2)分vs(7.0±2.3)分,(14.7±2.3)分vs(7.0±1.9)分,(14.9±3.6)分vs(8.1±3.7)分,t=9.474,13.926,7.062,均P＜0.01],MMSE,GDS评分差异无统计学意义(均P＞0.05).(2)与空白组相比,30 min组、60 min组和120 min组的PQSI,NPI,ESS评分差异有统计学意义(30 min组:t=1.936,4.524,2.482,P=0.031,0.000,0.016. 60 min组:t=5.945,5.153,7.319,均P=0.000. 120 min组:t=7.896,6.767,10.776,均P=0.000),MMSE,GDS评分差异无统计学意义(均P＞0.05).(3)与30 min组相比,60 min组和120 min组PQSI,NPI,ESS评分差异有统计学意义(60 min组:t=3.288,2.694,3.354,P=0.002,0.009,0.001.120 min组:t=4.615,3.930,6 303,均P=0.000).MMSE,GDS评分差异无统计学意义(均P＞0.05);与60 min组相比,120 min组的ESS评分差异有统计学意义(t=4.854,P=0.000),PQSI、NPI、MMSE、GDS评分差异无统计学意义(均P＞0.05).各光照组不良反应发生率与空白组相比差异无统计学意义(均P＞0.05).结论 光照疗法能有效改善AD患者睡眠质量、日间过度嗜睡、神经精神症状,而且光照时间60min和120 min优于30 min,光照时间120 min改善日间过度嗜睡优于60 min;光照疗法对AD患者的认知能力及痴呆程度没有明显的影响,治疗过程中未出现明显不良反应.
目的 觀察不同光照時間全光譜治療對阿爾茨海默病(Alzheimer's disease,AD)患者睡眠障礙的臨床療效和安全性.方法 將127例AD伴髮睡眠障礙的患者按隨機數字錶法分為空白組34例、30min光照組31例、60 min光照組33例和120 min光照組29例,通過10 000 lux全光譜光照治療1箇月後,採用匹玆堡睡眠質量指數量錶(PQSI)、愛潑沃斯嗜睡量錶(ESS)、神經精神問捲(NPI)、簡易智能狀態量錶(MMSE)和總體衰退量錶(GDS)等評分作為主要評價指標,比較光照前後患者的睡眠質量、日間過度嗜睡、認知功能、精神狀況和癡呆程度的變化.結果 (1)與治療前相比,30 min組、60 min組和120 min組的PQSI,ESS,NPI評分差異有統計學意義[30 min組:(14.4±5.2)分vs(11.7±4.9)分,(14.4±4.1)分vs(11.8±3.7)分,(14.2±1.3)分vs(10.9±1.7)分,t=2.071,2.609,8.446,P=0.043,0.011,0.000.60 min組:(13.4±4.0)分vs(8.1±3.7)分,(14.5±3 0)分vs(9.4±2.0)分,(13.7±5.8)分vs(8.7±4.3)分,t=5.650,8.209,3.902,均P＜0.01.120 min組:(14.0±3.2)分vs(7.0±2.3)分,(14.7±2.3)分vs(7.0±1.9)分,(14.9±3.6)分vs(8.1±3.7)分,t=9.474,13.926,7.062,均P＜0.01],MMSE,GDS評分差異無統計學意義(均P＞0.05).(2)與空白組相比,30 min組、60 min組和120 min組的PQSI,NPI,ESS評分差異有統計學意義(30 min組:t=1.936,4.524,2.482,P=0.031,0.000,0.016. 60 min組:t=5.945,5.153,7.319,均P=0.000. 120 min組:t=7.896,6.767,10.776,均P=0.000),MMSE,GDS評分差異無統計學意義(均P＞0.05).(3)與30 min組相比,60 min組和120 min組PQSI,NPI,ESS評分差異有統計學意義(60 min組:t=3.288,2.694,3.354,P=0.002,0.009,0.001.120 min組:t=4.615,3.930,6 303,均P=0.000).MMSE,GDS評分差異無統計學意義(均P＞0.05);與60 min組相比,120 min組的ESS評分差異有統計學意義(t=4.854,P=0.000),PQSI、NPI、MMSE、GDS評分差異無統計學意義(均P＞0.05).各光照組不良反應髮生率與空白組相比差異無統計學意義(均P＞0.05).結論 光照療法能有效改善AD患者睡眠質量、日間過度嗜睡、神經精神癥狀,而且光照時間60min和120 min優于30 min,光照時間120 min改善日間過度嗜睡優于60 min;光照療法對AD患者的認知能力及癡呆程度沒有明顯的影響,治療過程中未齣現明顯不良反應.
목적 관찰불동광조시간전광보치료대아이자해묵병(Alzheimer's disease,AD)환자수면장애적림상료효화안전성.방법 장127례AD반발수면장애적환자안수궤수자표법분위공백조34례、30min광조조31례、60 min광조조33례화120 min광조조29례,통과10 000 lux전광보광조치료1개월후,채용필자보수면질량지수량표(PQSI)、애발옥사기수량표(ESS)、신경정신문권(NPI)、간역지능상태량표(MMSE)화총체쇠퇴량표(GDS)등평분작위주요평개지표,비교광조전후환자적수면질량、일간과도기수、인지공능、정신상황화치태정도적변화.결과 (1)여치료전상비,30 min조、60 min조화120 min조적PQSI,ESS,NPI평분차이유통계학의의[30 min조:(14.4±5.2)분vs(11.7±4.9)분,(14.4±4.1)분vs(11.8±3.7)분,(14.2±1.3)분vs(10.9±1.7)분,t=2.071,2.609,8.446,P=0.043,0.011,0.000.60 min조:(13.4±4.0)분vs(8.1±3.7)분,(14.5±3 0)분vs(9.4±2.0)분,(13.7±5.8)분vs(8.7±4.3)분,t=5.650,8.209,3.902,균P＜0.01.120 min조:(14.0±3.2)분vs(7.0±2.3)분,(14.7±2.3)분vs(7.0±1.9)분,(14.9±3.6)분vs(8.1±3.7)분,t=9.474,13.926,7.062,균P＜0.01],MMSE,GDS평분차이무통계학의의(균P＞0.05).(2)여공백조상비,30 min조、60 min조화120 min조적PQSI,NPI,ESS평분차이유통계학의의(30 min조:t=1.936,4.524,2.482,P=0.031,0.000,0.016. 60 min조:t=5.945,5.153,7.319,균P=0.000. 120 min조:t=7.896,6.767,10.776,균P=0.000),MMSE,GDS평분차이무통계학의의(균P＞0.05).(3)여30 min조상비,60 min조화120 min조PQSI,NPI,ESS평분차이유통계학의의(60 min조:t=3.288,2.694,3.354,P=0.002,0.009,0.001.120 min조:t=4.615,3.930,6 303,균P=0.000).MMSE,GDS평분차이무통계학의의(균P＞0.05);여60 min조상비,120 min조적ESS평분차이유통계학의의(t=4.854,P=0.000),PQSI、NPI、MMSE、GDS평분차이무통계학의의(균P＞0.05).각광조조불량반응발생솔여공백조상비차이무통계학의의(균P＞0.05).결론 광조요법능유효개선AD환자수면질량、일간과도기수、신경정신증상,이차광조시간60min화120 min우우30 min,광조시간120 min개선일간과도기수우우60 min;광조요법대AD환자적인지능력급치태정도몰유명현적영향,치료과정중미출현명현불량반응.
Objective To evaluate the clinical efficacy and safety of different full spectrum light times in treating patients with Alzheimer's disease (AD).Methods A total of 127 AD patients with sleep disorder were randomly divided into a blank group (n=34),a 30 min group (n=31),a 60 min group (n=33) and a 120 min group (n=29).After one month treatment by 10 000 lux full spectrum fluorescent light,the improvements of sleep quality,excessive daytime sleepiness,cognitive ability,mental state,dementia degree were graded by Pittsburgh sleep quality index (PQSI),Epworth sleepiness scale (ESS),Neuropsychiatric inventory (NPI),mini-mental state examination (MMSE),global deterioration scale (GDS).The scores were compared among the groups before the treatment and after the treatment respectively.Results (1) Compared with before treatment,the scores of PQSI,ESS,NPI of the 30 min group,60min group and 120min group were statistically significant (in 30 min group 14.4 ±5.2vs 11.7±4.9,14.4±4.1 vs 11.8±3.7,14.2±1.3 vs 10.9±1.7,t=2.071,2.609,8.446.P=0.043,0.011,0.000; in 60 min group13.4±4.0 vs 8.1±3.7,14.5±3.0 vs 9.4±2.0,13.7±5.8 vs 8.7±4.3,t=5.650,8.209,3.902,all P＜0.01 ;in 120 min group 14.0±3.2 vs 7.0±2.3,14.7-±2.3 vs 7.0± 1.9,14.9±3.6 vs 8.1±3.7,t=9.474,13.926,7.062,all P＜0.01),but the scores of MMSE,GDS were not statistical significances(all P＞0.05).(2)Compared with the blank group,the scores of PQSI,ESS,NPI of 30 min group,60 min group and 120 min group were statistically significant (30 min group t=1.936,4.524,2.482,P=0.031,0.000,0.016.60 min group t=5.945,5.153,7.319,all P=0.000.120 min group t=7.896,6.767,10.776,all P=0.000), but the scores of MMSE,GDS were not statistical significances(all P＞0.05).(3)Compared with the 30 min group,the scores of PQSI,ESS,NPI of 60 min group and 120 min group were statistically significances (60 min group t =3.288,2.694,3.354,P=0.002,0.009,0.001.120 min group t=4.615,3.930,6.303,all P =0.000),the scores of MMSE,GDS were not statistical significances (all P＞0.05).Compared with the 60 min group,the scores of ESS of 120 min group was statistically significant(t=4.854,P=0.000),but the scores of PQSI,NPI,MMSE,GDS were not statistical significances (all P ＞ 0.05).Conclusion It is demonstrated good curative effects that light therapy treat patients on AD patients in the matter of sleep quality,excessive daytime sleepiness,mental state,but have not apparent effect for their cognitive ability and dementia degree.And the effect of light therapy with 60 or 120 minutes is better than that of 30 minute,illumination time of 120 minutes is superior to that of 60 minutes in improving excessive daytime sleepiness.Light therapy has no obvious impacts in the cognitive ability and the degree of dementia in the patients with AD and has not appear obvious adverse reaction in the process of treatment.
