■Y?T?,E-mail:jiangxiaojiang@hotmail.com。
·Dy5 ?·
>
?t ?í
??￥
! ?D5 ?
钟代曲,蒋晓江■,曹婷,陶媛
(第三军医大学大坪医院野战外科研究所神经内三科,重庆400042)
?ms ?|:R197.39óDS
M
?:AócI|:1671-8348(2009)10-1181-02
>
?(insomnia)
^Kèn￥B?
¤
?p??%h,
^ ?
x8、ú
??1%h
? μ￥èn
"5?。 ?
@?hD
?°''
V
ü,ZSE?35.2%￥|μ?]?￥
>
?,á
S
>
?
q9úr10%～20%[1]。V
>
?í
￥C ? A,?
?b
?4μ?
3V
?¨、 8?、00?、????μ?
￥2B?[2],
Pd0tí
?1|
ì
?×
j。'' S
>
?
??￥í
?|0tDt ?M2?￥8??í
m
,
l?
zrT, 1M￥
LlV??,T??C
>
???￥t ?í
#ya￥5 ???
r÷×1,''?2007M3? ?
>
?t ?í
??,C|f ?o
?/。
1
>
?t ?í
??￥
! ?D5 ?
1.1
>
?t ?í
??￥|?￥?#F?ˉ3??μ
>
?
S??1,μ3
>
?t ?í
???
?yT, AE
ê?
#?y
>
???￥??,??í
Hq￥??
l?
>
?t ?
í
??;?íD
=1,μ3 ???í
??8?í
Z?
￥??( ?0tí
#t ?í
)Z)#??;tyD
=1
,μ3 8í
Z?￥
L
@#h?:
c,??ya￥
?`
yT;t ?í
=1,μ3 ?
¤
?S?、7è
3tQ ?í
、l7??èOí
?;? ?í
=1,μ3??
¤
??
3?
M??[3-5],??￥?1a?T
[6-7],? ?&?、
¤
?#f
?M1?°V￥??s[8],? ?í
yT;
>
? SyTü
?3M[
1
V2,μ3??￥¨: ó
?í`、xù??í
#1 ?yT;5 ?|?1,μ3??￥5 ?x?yT,p
í
￥
¨ ? 7Z。￥!|? ( !~?￥
>
?M1?
M#í
/?,?? ???
¤
??
3?
M??。
???ê??
ü?
￥ˉ3,ò
3ˉ,Mo￥?,]??
?μ??￥t ?í
。
1.2
>
?t ?í
??￥N
!!￥?
>
?t ?í
??
'' Seμh\
!!￥$
,9
!t ?í
i1W,í
5
4f,í
U6f,×iZ ?D
!!
34￥ES-100H
>
?í
N4
?,ES-100D
>
?í
N6
?,ES-100Lz
T
>
?
í
N12
?,
Z￥?D
!!
34￥l7??èO
í
N2
?,b?￡|
34￥SK-A7h
3 ?í
N1
?,
¤
?S?
i2W,?[?A</
?ù????/￥YH-
2000A? ?
¤
?S?N1
?,?
?7èS?N1,? ?&
?
i1W,?1??T
i1W,?
i1W,[#
>
?¨
V、y ?。
1.3
>
?t ?í
??￥?
>
?t ?í
???1??
??"0tí
?￥
?μt ?í
, ?
¤
??
3?
M??、
? ?&?#í
、 ?
¤
?S?、?
?7è?S?、
3tèO
í
、?1??T
?。?? ?'' S
ity
>
???、?
y??￥ty
>
???#
ê?ü?￥
>
???,??? %??
?￥
lí。?? ???a,1
VSz¨:yT,?íD
=Dt
yD
=????
@
3 8f ?,??í
Z?,tyD
=
8??3?í
,μ3h?￥5 ?,??ya￥
?`yT。
0tí
''h\??D
e??￥0
dBé?,
e Sty
??&"0
)Zí? S
i??,
ê???5?
ê?|0?D
?¨0。t ?í
=? D??? ?
¤
?S?、?
?7è
?S?、
3tèOí
?yT。? ?í
=??
¤
?#f?
M1?°V￥??s、??￥?1??T
?,μ? ?ù
5￥??é?? ?&?#? ?í
,
??
1/? 7Z
¤
?p?
?? óq?,??
¤
??
3?a,
¤
?p?í
?éZo
,?
?W￥8??
@?=?。1
Vxù??í
、·???y ??
?￥
¤
??
3 8#Sz
¤
?°:[#431 ?yT,5 ?|
?Szx?5 ?、t''p,
P??yT
¨ ? 7Z。
2
¤
?p?t ?í
??5 ?rT
1M
HW,??
lí
>
???1084 è, 7Z ?
¤
?S
?324 èQ、??
3tèOí
11426 èQ、??￥?1?
?T
1235 èQ,? ?&?876 èQ,?bμ1
¤
?、f?
V3422z,
¤
?p??? óq?46Q,
¤
??
3?a1875
èQ,è?í`4361 èQ。í
2T??[9]:í?48%,Ar
32%,μr15%,ír5%,ˉ?
q8.75%,μr
qú?S=?
M1?(7ˉ?
q??S=?M1??B0tí
70.37%、75%D0tí
$
P¨7è_
3èOí
88.87%、90.7%[10-11])。
3)
?
3.1
! ?
>
?t ?í
??￥il
>
?
^B?èn￥%h
?, Vs1e??
>
?????
>
?,|
ì?
>
?aa
^
?¨?B￥?á?
?0t3 %ù5,-
{
??
>
?￥ey#
a?43) ?,èè??0??ì,?á?%?
>
??
n-]
ù
?,
Phf?vˉ,í
M¤
m。á
ì
! ?
>
?t ?
í
??,? ??￥
>
?ù5é? S) ?,úù??s
?
>
?￥ey,3"? ?ù5
>
?￥?Y,g???￥
¤
?
?
3?
M,\é??1 $????
¤
?,é?8??í
,E
?
?¨0? ˉ¨0t{ ?￥?
ù5,3??%?
>
??
n
-]ù
?￥?
3。YV6í`,
P??￥
>
?ù5¤[T
?3 %。
3.2
>
?t ?í
￥T¨D-?"-?
>
?￥í
??
?G L0tí
7???| ?t ?
m
=￥í
ZEX
¤?μ1E￥ s \?,
>
?￥ù
E?,t ?
E
^
?μ-o￥B?[12],í
??1
^YV??y
í?M7
èo?,V7r?í
>
?￥rT。"-è¨￥ ?
N ?
2;v7??N、v7èON、??H?o?N、7è
3tQ
?]?N?。|8
3tò￥??,b
?
?￥
P¨,?1T
Z
E,èOí
?í
m
?
l?
?M￥
r,á
ì?
1181重庆医学2009年5月第38卷第10期
!;v
Eí
>
??[13],X¤?SE1? SDá￥
''ù,M??
^B?
>
??μ úù￥["。á
ìa1
>
?￥t ?í
D0tí
]?×1,
??B? V,á
ì? ?
>
?t ?í
??,
>
???é?
ê5 ?,ü
^??? ?
￥í
Z?,r?#
Hμr??
¤
?、??
¤
??
y、E
???
?×
&?%?￥]
H,D V?￥E
?0t00、QK# ˉ¨、?
??ù5。
3.3?
ky ?
>
???5 ?￥?
T
>
?
^B?èn?
,aa??|
ì￥×
j,tyí
￥?? ''v
?
^h?
?M[
￥
¤?
>
???,4
Uá
ì??
^?
dè?×￥
?? ?yí
,??9F
??￥e m,F×
ü6μ?,9
óí
{ ?B?￥ ?4。á
ìy ?
>
?t ?í
??,??í
'' S
i
>
???,
e Si
>
??￥??, V[
?
H ?á
??é?í
,]
H
ê?^?
>
???i?0tí
￥??9
V ???é?t ?í
,
P
>
??¤[#
H e?。á
ì
?
B? ???￥??¨:,é?"d￥r B?a, 7Z óq?,?
ùè?í`,y ?
>
???5 ?￥?
T,μ ????￥5
?,μ ????￥í
,μ ????W￥?
@,\é
??￥?
? Bˉ,
^′¤w<￥
>
???5 ??
T。
? IóD:
[1]DanielJ,BuysseMD.Sleepdisordersandpsychiatry(Re-
viewofpsychiatry)[M].WashingtonDC:AmericanDsy-
chiatricAssociation,2005:185.
[2]RobinsonDM,KeatingGM.Sodiumoxybate:areview
ofitsuseinthemanagementofnarcolepsy[J].CNS
Drugs,2007,21(4):337.
[3]Anonymous.Insomnia:Howtogetagoodnight′ssleep
[J].AmericanFamilyPhysician,2005,72:1309.
[4]DianeLS.Insomnia:Safeandeffectivetherapyforsleep
problemsintheolderpatient[J].Geriatrics,2002,57
(5):24.
[5]ManjunathNK,TellesS.InfluenceofYogaandAyurveda
onself-ratedsleepinageriatricpopulation[J].IndianJ
MedRes,2005,121
[6]MorinCM,Colecchic,StoneJ,etal. oM
>
?￥?1?0
tí
[J].R?Br.
?SDD?,1999,281:991.
[7]MichaelJS,PeterDN.Insomnia[J].TheLancet,2004,
364:1959.
[8]=?N.
>
?￥?[J].?S
"5? ?D?,2004,12
(2):207.
[9]3S|, ct?,f Vü,?I.
>
?D
¤
?p?%h
[M].?:|
? +D?
,2000:741.
[10]=?6.7è_
3èONí
>
????￥
"543
[J].DD ?
?D
Ll,2008,21(7):790.
[11]ú?.ü?
Eí
>
?32 è[J].
a?D0vDD
,2008,10(4):115.
[12]R ?ü.í
>
?￥+?No
[J].?S?D$D
D?,1997,28(3):130.
[13]CampbellSS,TermannM,LewyAJ,etal.Lighttreat-
mentforsleepdisorders:Consensusreport.V.Age-relat-
eddisturbances[J].JBiol.Rhythm,1995,10:151.
(
là°ù:2009-03-05)
(
¤?1180:)
[5]f
¨S,?
ù
,M.]ù?￥0tí
éZ[J].D
0?,2000,19:311.
[6]VersianiM,MehilaneL,GasznerP,etal.Reboxetine,au-
niqueselectiveNRI,preventsrelapseandrecurrencein
long-termtreatmentofmajordepressivedisorder[J].Clin
Psychiatry,1999,60:400.
[7] ù
?. F]ù0? F]ùí
￥éZ[J].?S
? BD
D?,2003,15:685.
[8]RudolphRL.Achievingremissionfromdepressionwith
venlafaxineandverlafaxineextendedrelease:aliterature
reviewofcomparativestudieswithselectiveserotoninre-
uptakeinhibitors[J].ActaPsvchiatrScand,2002,106
(Suppl415):24.
[9]NuttD.Tolerabilityandsafetyaspectsofmirtazapine[J].
HumPsychophamacol,2002,17(Suppl1):37.
[10]Ró,R X?.]ù?￥ù?éZ[J].?S
"5 Bˉ,
2005,9:131.
[11]|yü.?? F]ù0￥
"5?¨[J].?SDy¨0?
NDs,2004,4:308.
[12]Z/à.DE:[:B?? F]ù0[J].
Zú
DD,
1997,9:51.
[13]?~?,??
?,ò
;\.?1?Rí
]ù?￥
"5
rù?[J].?S
ü S?,2000,33:171.
[14]LeinonenE,SkarsteinJ,BehnkeK,etal.Efficacyandtol-
erabilityofmirtazapineversuscitalopram:adouble-blind,
randomizedsudyinpatientswithmajordepressivedisor-
der[J].IntClinPsychopharmacol,1999,14:329.
[15]ManjIHK,QUirozJA,SpornJ,etal.Enhancingneuronal
plasticityandcellularresiliencetodevelopnovel,im-
provedtherapeuticsfordifficulttotreatdepreesion[J].
BiolPsychiatry,2003,53(8):707.
[16]SantarellIL,SaxeMD.SubstancePantagonists:meetthe
newdrug,sameastheolddrugs?Insightsfromtransgen-
icanimalmodels[J].CNSSpectr,2003,8(8):589.
[17]ButterweckV,HeggerM,WinterhoffH.Flavonoidsof
St.John′sWortreduceHPAaxisfunctionintherat[J].
PlantaMed,2004,70(10):1008.
[18]O′BrienSM,ScottLV,DinanTG.Cytokines:abnormali-
tiesinmajordepressionandimplicationsforpharmaco-
logicaltreatment[J].HumPsychopharmacol,2004,19
(6):397.
(
là°ù:2009-03-05)
1182重庆医学2009年5月第38卷第10期
|
|
