《中国康复理论与实践》

《中国康复理论与实践》 ›› 2017, Vol. 23 ›› Issue (6): 720-724.doi: 10.3969/j.issn.1006-9771.2017.06.021

• 临床研究 • 上一篇    下一篇

心率变异性生物反馈干预不同类型失眠障碍的比较

陆红宇, 宋鲁平, 李泓钰, 徐舒, 王曼   

  1. 1.首都医科大学康复医学院,北京市 100068;
    2.中国康复研究中心北京博爱医院,北京市 100068。
  • 收稿日期:2017-04-25 修回日期:2017-05-26 出版日期:2017-06-25 发布日期:2017-06-27
  • 通讯作者: 宋鲁平(1964-),女,汉族,山东人,主任医师,教授,博士研究生导师,主要研究方向：神经康复、认知神经科学。E-mail: songluping882002@aliyun.com。
  • 作者简介:陆红宇(1991-),女,汉族,四川成都市人,硕士研究生,主要研究方向：神经康复、认知神经科学。
  • 基金资助:
    1.国家自然科学基金项目(No.81341044); 2.中央级公益性科研院所基本科研业务费专项资金项目(No.2015CZ-49); 3.中国康复研究中心项目(No.2016ZX-14)

Comparison of Heart Rate Variability Biofeedback Intervention for Different Types of Insomnia Disorder

LU Hong-yu, SONG Lu-ping, LI Hong-yu, XU Shu, WANG Man   

  1. 1. Capital Medical University School of Rehabilitation Medicine, Beijing 100068, China;
    2. China Rehabilitation Research Center, Beijing 100068, China
  • Received:2017-04-25 Revised:2017-05-26 Published:2017-06-25 Online:2017-06-27
  • Contact: Correspondence to SONG Lu-ping. E-mail: songluping882002@aliyun.com

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摘要： 目的 探究心率变异性(HRV)生物反馈训练对不同类型失眠障碍患者的影响。方法 2016年6月至2017年3月,对17例单纯性失眠患者、19例失眠伴焦虑患者及19例失眠伴抑郁患者均进行HRV生物反馈训练及相同的药物治疗(酒石酸唑吡坦,每晚服用10 mg),训练前后采用匹兹堡睡眠质量指数(PSQI)、症状自评量表(SCL-90)、汉密尔顿焦虑量表(HAMA)及汉密尔顿抑郁量表(HAMD)进行评估并进行HRV数据采集。结果 HRV生物反馈训练后,三类失眠患者PSQI、SCL-90、HAMA、HAMD评分及低频段功率/高频段功率(LF/HF)均降低(t>1.446, P<0.05)。训练后,三组PSQI评分有显著性差异(F=3.537, P=0.038)。失眠伴焦虑、失眠伴抑郁组训练前后PSQI评分差值、LF/HF差值大于单纯性失眠组(P<0.05),失眠伴焦虑与失眠伴抑郁组间差值无显著性差异(P>0.05)。结论 HRV生物反馈训练对三种类型失眠患者均有改善作用,其中,对失眠伴焦虑及失眠伴抑郁组患者睡眠质量改善程度优于单纯性失眠患者。

关键词: 心率变异性, 生物反馈, 失眠, 焦虑, 抑郁

Abstract: Objective To investigate the effect of heart rate variability (HRV) biofeedback training on patients with three types of insomnia disorder. Methods From June, 2016 to March, 2017, 17 patients in simple insomnia group, 19 patients in insomnia with anxiety group, and 19 patients in insomnia with depression group were included. All the patients received HRV biofeedback training and same medication (zolpidem tartrate, 10 mg every night). They were assessed with Pittsburgh Sleep Quality Index (PSQI), Symptom Checklist 90 (SCL-90), Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD), and HRV parameters were tracked before and after training. Results After training, the scores of PSQI, SCL-90, HAMA , HAMD and the ratio of low frequency (LF) and high frequency (HF) (LF/HF) decreased in all groups (t>1.446, P<0.05). There was significant difference in PSQI among three groups (F=3.537, P=0.038). The D-values of the PSQI score and LF/HF before and after training were more in the insomnia with anxiety group and the insomnia with depression group than in the simple insomnia group (P<0.05), however, no significant difference was observed between the insomnia with anxiety group and the insomnia with depression group (P>0.05). Conclusion HRV biofeedback training could improve the symptoms of patients with three types of insomnia disorder, especially for those with anxiety or depression.

Key words: heart rate variability, biofeedback, insomnia, anxiety, depression

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