目的 :探讨吡拉西坦 胆碱、氯硝西泮昼夜交替服用治疗失眠症的临床方案。方法 :将 55例重度失眠病人随机分为 (A ,B) 2组 ,30例正常人为C组。A组 2 8例日间 0 7:0 0 ,11:0 0服吡拉西坦 胆碱胶囊各 3粒 (每粒含吡拉西坦 0 .114g ,胆碱0 .2 86 g) ,夜间睡前 30min服氯硝西泮 2mg ,B组2 7例夜间睡前 30min服氯硝西泮 2mg ;疗程均为 1mo ,C组不服药。结果 :A组总有效率 89% ;B组总有效率 6 3% (P <0 .0 5) ,2个治疗组的夜间睡眠时间与日间觉醒时间比值、匹滋堡睡眠质量指数及睡眠调查表评分比较显示 ,治疗后A组各量表评分值优于B组。结论 :昼夜交替服用吡拉西坦 胆碱 ,氯硝西泮治疗失眠症疗效好 ,更符合人体睡眠觉醒周期 Objective: To investigate the clinical regimen of piracetam cholinergic and clonazepam alternating day and night for the treatment of insomnia. Methods: 55 cases of severe insomnia were randomly divided into two groups (A and B), and 30 normal subjects were C group. A group of 28 cases of day 0 7: 0 0, 11: 0 0 serving piracetam choline capsules three (each containing piracetam 0.114g, choline 0.266g) at night Serum clonazepam 2mg 30 minutes before going to bed, group B 27 cases of clonazepam 30mg at night before going to bed service 2mg; course of treatment were 1mo, C group did not take medication. Results: The total effective rate in group A was 89%; the total effective rate in group B was 63% (P <0.05); the ratio of nighttime sleep time to daytime awakening time, Pittsburgh sleep quality index and sleep Questionnaire score comparison showed that after treatment, the score of each scale in group A was better than that in group B. CONCLUSION: Piracetam choline and clonazepam are effective in treating insomnia alternating day and night, which is more in line with human sleep awakening cycle