中国临床药理学杂志

睡眠认知行为疗法联合艾司西酞普兰治疗抑郁焦虑症患者的临床研究

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王思为 ¹^,² , 张味味 ¹^,² , 李苗苗 ¹^,² , 余艳芸 ¹^,² , 马琴 ³

中国临床药理学杂志 | 临床与基础桥接研究 2025,41(20): 2893-2898

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中国临床药理学杂志 |临床与基础桥接研究 2025 , 41 (20) : 2893 -2898

睡眠认知行为疗法联合艾司西酞普兰治疗抑郁焦虑症患者的临床研究

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王思为¹^,², 张味味¹^,², 李苗苗¹^,², 余艳芸¹^,², 马琴³

作者信息

^1.长江大学精神卫生中心，湖北荆州 434000

^2.荆州市精神卫生中心，湖北荆州 434000

^3.成都市第四人民医院精神科，四川成都 610000

通讯作者:

张味味，主治医师 MP: 13501508906 E-mail: 15671371818@163.com

作者简介:

王思为（1991-），女，主治医师，主要从事精神疾病心理治疗及老年心身睡眠病区研究

Clinical study of sleep cognitive-behavioral therapy combined with escitalopram in the treatment of depression and anxiety patients

Si-wei WANG¹^,², Wei-wei ZHANG¹^,², Miao-miao LI¹^,², Yan-yun YU¹^,², Qin MA³

Affiliations

^1.Changjiang University Mental Health Center, Jingzhou 434000, Hubei Province, China

^2.Jingzhou Mental Health Center, Jingzhou 434000, Hubei Province, China

^3.Department of Psychiatry, Chengdu Fourth People’s Hospital, Chengdu 610000, Sichuan Province, China

出版时间: 2025-10-28 doi: 10.13699/j.cnki.1001-6821.2025.20.008

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摘要

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目的

探究睡眠认知行为疗法联合艾司西酞普兰片对本院抑郁症合并焦虑症患者负性情绪及睡眠功能的影响。

方法

将2021年4月～2023年5月本院收治的抑郁症合并焦虑症患者，按治疗方法分为对照组与试验组。对照组给予艾司西酞普兰片，口服，每次10 mg qd，疗程8周；试验组在对照组基础上加用含睡眠卫生教育、刺激控制等模块的睡眠认知行为疗法（CBT-I），每周1次，每次60~90 min，疗程8周。比较2组患者的临床疗效、负性情绪评分[用汉密尔顿焦虑量表（HAMA）和汉密尔顿抑郁量表（HAMD）]、睡眠质量[用匹兹堡睡眠质量指数（PSQI）]、社会功能[用社会功能缺陷筛选量表（SDSS）]、认知功能[用简易精神状态评价量表（MMSE）]、血清神经元特异性烯醇化酶（NSE）和神经肽Y（NPY）水平、用药依从性（用Morisky用药依从性问卷）及复发率。

结果

共筛选126例抑郁症合并焦虑症患者，最终入组100例，对照组48例、试验组52例。治疗后，试验组和对照组的总有效率分别为82.69%（43例/52例）和62.50%（30例/48例），HAMA评分分别为（8.33±4.61）和（14.66±5.29）分；HAMD评分分别为（6.87±2.42）和（10.76±2.63）分；PSQI评分分别为（7.06±1.11）和（10.69±1.03）分；血清NSE水平为（10.35±1.46）和（12.26±1.55）μg·L^-1；NRY水平分别为（431.55±97.22）和（314.22±41.38）μg·L^-1，以上指标2组间比较在统计学上差异均有统计学意义（均P<0.05）；试验组与对照组的复发率分别为3.85%（2例/52例）和16.67%（8例/48例），在统计学上差异无统计学意义（P>0.05）。2组治疗期间均未发生严重不良事件，不良事件发生率在统计学上差异无统计学意义（P>0.05）。

结论

睡眠认知行为疗法联合艾司西酞普兰片可有效缓解本院抑郁症合并焦虑症患者的负性情绪，改善睡眠功能，降低复发率，临床疗效良好。

关键词

艾司西酞普兰片 / 睡眠认知行为疗法 / 抑郁症 / 焦虑症 / 临床研究

Abstract

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Objective

To explore the effects of sleep cognitive behavioral therapy combined with escitalopram tablets on negative emotions and sleep function of patients with depression and anxiety in our hospital.

Methods

From April 2021 to May 2023, patients with depression complicated with anxiety in our hospital were divided into control group and experimental group according to treatment methods. The control group was given escitalopram orally, 10 mg each time, qd for 8 weeks; in the experimental group, CBT-I (including sleep health education, stimulation control and other modules) was added on the basis of the control group, once a week for 60-90 min, and the course of treatment was 8 weeks. The clinical efficacy, negative emotional scores [using Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD)], sleep quality [using Pittsburgh Sleep Quality Index (PSQI)], social function [using Social Disability Screening Scale (SDSS)], cognitive function [using Mini-Mental State Examination (MMSE)], serum neuron-specific enolase (NSE) and neuropeptide Y (NPY) levels, medication compliance (using Morisky medication compliance questionnaire), and recurrence rate were compared between the two groups.

Results

A total of 126 patients with depression and anxiety were screened and 100 patients were enrolled, including 48 patients in the control group and 52 patients in the experimental group. After treatment, the total effective rate of the treatment group was 82.69% (43 cases /52 cases), which was significantly higher than that of the control group 62.50% (30 cases/48 cases) (P<0.05). The HAMA scores in the treatment group and control group were (8.33±4.61) and (14.66 ±5.29) scores, respectively; the HAMD scores were (6.87±2.42) and (10.76±2.63), respectively; the PSQI scores were (7.06±1.11) and (10.69±1.03), respectively; the serum NSE levels were (10.35±1.46) and (12.26±1.55) μg·L^-1; the NPY levels were (431.55±97.22) and (314.22±41.38) μg·L^-1, respectively. The above indexes in the treatment group were significantly lower than those in the control group (all P<0.05). The recurrence rate of the treatment group and control group was 3.85% (2 cases /52 cases) and 16.67% (8 cases /48 cases), respectively, without statistically significant difference (P>0.05). No serious adverse events occurred during the intervention period in both groups, and there was no significant difference in the incidence of adverse events (P>0.05).

Conclusion

Cognitive behavioral therapy for insomnia combined with escitalopram tablets can effectively alleviate negative emotions, improve sleep function and reduce recurrence rate in patients with depression complicated with anxiety in our hospital, with good clinical efficacy.

Key words

escitalopram tablets / sleep cognitive-behavioral therapy / depression / anxiety disorder / clinical research

引用本文

王思为, 张味味, 李苗苗, 余艳芸, 马琴. 睡眠认知行为疗法联合艾司西酞普兰治疗抑郁焦虑症患者的临床研究. 中国临床药理学杂志, 2025 , 41 (20) : 2893 -2898 . DOI: 10.13699/j.cnki.1001-6821.2025.20.008

Si-wei WANG, Wei-wei ZHANG, Miao-miao LI, Yan-yun YU, Qin MA. Clinical study of sleep cognitive-behavioral therapy combined with escitalopram in the treatment of depression and anxiety patients[J]. Chinese Journal of Clinical Pharmacology, 2025 , 41 (20) : 2893 -2898 . DOI: 10.13699/j.cnki.1001-6821.2025.20.008

基金

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四川省科学技术厅基金资助项目(22KJPX0047)

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2025年第41卷第20期

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文章信息

doi: 10.13699/j.cnki.1001-6821.2025.20.008

接收时间：2025-06-11
首发时间：2026-08-05
出版时间：2025-10-28

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收稿日期：2025-06-11

基金

四川省科学技术厅基金资助项目(22KJPX0047)

作者信息

^1.长江大学精神卫生中心，湖北荆州 434000

^2.荆州市精神卫生中心，湖北荆州 434000

^3.成都市第四人民医院精神科，四川成都 610000

通讯作者:

张味味，主治医师 MP: 13501508906 E-mail: 15671371818@163.com

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https://castjournals.cast.org.cn/joweb/zglcylxzz/CN/10.13699/j.cnki.1001-6821.2025.20.008

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2种不同金属材料的力学参数

科 Family	属数 Number of genus	种数 Number of species	占总种数比例 Percentage of total species (%)	属 Genus	种数 Number of species	占总种数比例 Percentage of total species (%)
鹅膏菌科Amanitaceae	2	11	5.26	鹅膏菌属 Amanita	10	4.78
小菇科 Mycenaceae	2	12	5.74	丝盖伞属 Inocybe	5	2.39
多孔菌科 Polyporaceae	8	14	6.70	蜡蘑属 Laccaria	5	2.39
红菇科 Russulaceae	3	23	11.00	小皮伞属 Marasmius	6	2.87
				小菇属 Mycena	11	5.26
				光柄菇属 Pluteus	5	2.39
				红菇属 Russula	17	8.13
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