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目的研究米氮平和rTMS联合治疗伴睡眠障碍的老年焦虑症患者的疗效。方法选取2014年9月至2016年9月于我院医治的98例焦虑症并睡眠障碍老年患者,分为米氮平治疗对照组和rTMS、米氮平联合治疗组,每组49例,对比两组的SAS评分、PSQI评分及多导图睡眠检测。结果治疗前两组患者SAS评分无统计学差异(P=0.898)。治疗后观察组患者SAS评分显著低于对照组(P=0.000)。两组患者在治疗前睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、催眠药物、日间功能障碍和PSQI总分等差异均无统计学意义(P>0.05)。治疗后观察组患者睡眠质量、入睡时间、睡眠时间、催眠药物、日间功能障碍和PSQI总分均显著低于对照组(P<0.05)。两组患者在治疗前睡眠潜伏期、REM潜伏期、睡眠总时长、睡眠效率和夜晚睡醒次等均无统计学差异(P>0.05)。与对照组比较,治疗后观察组患者睡眠潜伏期显著缩短(P<0.05);REM潜伏期显著缩短(P<0.05);睡眠总时长显著增加(P<0.05);睡眠效率显著增加(P<0.05);夜晚睡醒次显著减少(P<0.05)。结论米氮平联合rTMS治疗可以显著改善焦虑症伴睡眠障碍老年患者的焦虑情绪及睡眠质量。
Objective To study the curative effect of mirtazapine and rTMS in the treatment of elderly anxiety patients with sleep disorders. Methods Ninety-nine elderly patients with anxiety and sleep disorders who were treated in our hospital from September 2014 to September 2016 were divided into two groups: mirtazapine control group and rTMS and mirtazapine combined treatment group, with 49 cases in each group Two groups of SAS scores, PSQI score and polysomnography sleep detection. Results There was no significant difference in SAS scores between the two groups before treatment (P = 0.898). After treatment, SAS scores in observation group were significantly lower than those in control group (P = 0.000). There were no significant differences in quality of sleep, time to fall asleep, sleep time, sleep efficiency, sleep disorders, hypnotic drugs, daytime dysfunction and total score of PSQI before treatment in both groups (P> 0.05). After treatment, the quality of sleep, sleep time, sleep time, hypnotic drugs, daytime dysfunction and PSQI score in observation group were significantly lower than those in control group (P <0.05). There was no significant difference between the two groups in pre-treatment sleep latency, REM latency, total sleep duration, sleep efficiency and sleepiness at night (P> 0.05). Compared with the control group, the latency to sleep in the observation group was significantly shorter (P <0.05), the latent period of REM was significantly shorter (P <0.05), the total sleep duration was significantly increased (P <0.05), and the sleep efficiency was significantly increased (P <0.05) ; Night waking times were significantly reduced (P <0.05). Conclusion Mirtazapine combined with rTMS can significantly improve the anxiety and sleep quality of elderly patients with anxiety and sleep disorders.