本文選題：失眠　切入點(diǎn)：氟哌噻噸美利曲辛　出處：《重慶醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的精神心理因素對胃腸動(dòng)力的影響日益受到重視,其機(jī)制尚未完全清楚,本研究通過觀察伴精神心理異常失眠患者的胃電生理狀況,以及氟哌噻噸美利曲辛對其胃電生理的影響,初步探討精神心理因素影響胃動(dòng)力的可能機(jī)制。方法1.采用匹茲堡睡眠質(zhì)量指數(shù)量表篩選失眠患者,依據(jù)Zung焦慮自評量表及Zung抑郁自評量表的檢測結(jié)果將失眠患者分為焦慮組、抑郁組及焦慮抑郁組。2.采用HIT-IMG100P阻抗式胃動(dòng)力檢測儀檢測失眠患者的胃電及胃阻抗。3.觀察氟哌噻噸美利曲辛(10.5mg bid×4周)對失眠患者的睡眠質(zhì)量、心理狀態(tài)及胃電生理的影響。結(jié)果1.共收集失眠患者45例,其中焦慮組21例(46.67%)、抑郁組14例(31.11%)、焦慮抑郁組10例(22.22%),各組患者性別、年齡、教育年限及職業(yè)等無顯著差異(P0.05)。2.氟哌噻噸美利曲辛治療4周睡眠改善總有效率(69.37%)較2周(28.09%)顯著增加(p0.05),三組間有效率無顯著性差異(p0.05)。3.氟哌噻噸美利曲辛治療4周抗焦慮總有效率及抗抑郁總有效率(70.72%、70.72%)較2周(31.76%、37.86%)顯著增加(p0.05);同一時(shí)間段焦慮組及焦慮抑郁組的抗焦慮有效率無顯著性差異(p0.05),抑郁組及焦慮抑郁組的抗抑郁有效率無顯著性差異(p0.05)。4.與我們前期實(shí)驗(yàn)胃動(dòng)力正常的健康志愿者胃電參數(shù)相比,治療前焦慮組、抑郁組及焦慮抑郁組胃電低頻百分比顯著增加(p0.05),中頻百分比顯著下降(p0.05),高頻百分比無顯著差異(p0.05)。與我們前期實(shí)驗(yàn)胃動(dòng)力正常的健康志愿者胃阻抗參數(shù)相比,治療前三組患者胃阻抗低頻百分比均顯著增加(p0.05),中頻百分比顯著下降(p0.05),高頻百分比無顯著差異(p0.05)。三組間胃電及胃阻抗各頻參數(shù)無統(tǒng)計(jì)學(xué)差異(p0.05)。5.以我們前期實(shí)驗(yàn)胃動(dòng)力正常的健康志愿者胃電及胃阻抗參數(shù)95%ci為參考指標(biāo),治療前焦慮組、抑郁組及焦慮抑郁組胃電異常比例分別為71.43%、71.43%及70.00%,以胃電過緩為主,三組間無統(tǒng)計(jì)學(xué)差異(p0.05);胃阻抗異常比例分別為61.90%、64.29%及60.00%,以胃動(dòng)力減慢為主,三組間無統(tǒng)計(jì)學(xué)差異(p0.05)。6.氟哌噻噸美利曲辛治療后2周,三組患者胃電低頻百分比下降(p0.05),中頻百分比增加(p0.05),高頻百分比無顯著差異(p0.05);與2周相比,治療4周各組患者胃電低頻百分比進(jìn)一步下降(p0.05),中頻百分比進(jìn)一步增加(P0.05),高頻百分比無顯著差異(P0.05)。7.氟哌噻噸美利曲辛治療后2周,三組患者胃阻抗低頻、中頻及高頻百分比較治療前無顯著差異(P0.05);治療4周后各組患者胃阻抗低頻百分比顯著下降(P0.05),中頻百分比顯著增加(P0.05)。8.氟哌噻噸美利曲辛治療后2周,胃電異常比例焦慮組[(38.10%)vs(71.43%)]、抑郁組[(42.86%)vs(71.43%)]及焦慮抑郁組[(40.00%)vs(70.00%)]顯著下降(P0.05);與2周相比,治療4周胃電異常比例焦慮組[(23.81%)vs(38.10%)]、抑郁組[(21.43%)vs(42.86%)]及焦慮抑郁組[(20.00%)vs(40.00%)]進(jìn)一步下降(P0.05)。9.氟哌噻噸美利曲辛治療后2周,三組患者胃阻抗異常比例較治療前無顯著差異(P0.05);治療后4周胃阻抗異常比例焦慮組[(28.57%)vs(52.38%)]、抑郁組[(28.57%)vs(57.14%)]及焦慮抑郁組[(30.00%)vs(50.00%)]顯著下降(P0.05)。結(jié)論1.伴精神心理異常的失眠患者存在胃電生理節(jié)律紊亂,主要表現(xiàn)為胃電過緩及胃阻抗過緩。2.氟哌噻噸美利曲辛可改善伴精神心理異常失眠患者的胃電生理狀況。3.氟哌噻噸美利曲辛可改善失眠患者的睡眠質(zhì)量及焦慮抑郁狀態(tài)。
[Abstract]:Effect of psychological factors on gastrointestinal motility have received increasing attention, the mechanism is not entirely clear, gastric electrical physiological status of this study through the observation with psychological abnormalities in patients with insomnia, and the effect of Flupentixol and melitracen on gastric electrophysiology, preliminary study on psychological factors affecting the mechanism of gastric motility. 1. the Pittsburgh sleep quality index scale screening of insomnia patients, according to the Zung self rating Anxiety Scale and self rating depression scale Zung detection results of insomnia patients were divided into anxiety group, depression group and anxiety depression group.2. by HIT-IMG100P impedance gastric motility detection of egg and gastric impedance.3. patients with insomnia were fluoride Flupentixol and melitracen (10.5mg bid * 4 weeks) on sleep quality in patients with insomnia, mental status and gastric electrophysiology. Results 1. were collected from 45 cases of insomnia patients, including 21 cases of anxiety group (46.67% ),鎶戦儊緇，

本文編號：1590102