睡眠训练对帕金森病非运动症状的改善作用

Sleep training in improvement of non-motor symptoms of Parkinson's disease

摘要:

目的了解睡眠训练对帕金森病（PD）患者睡眠质量的改善作用，以及对抑郁和焦虑症状的影响。方法采用回顾性分析与跟踪随访的方法，对2012 年3 月-2014 年9 月在陕西省康复医院确诊的321 例帕金森病（PD）患者进行汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）和老年性痴呆评定量表- 认知分量表（ADAS-cog）测评，筛选符合要求的患者分为3 组：抑郁组（A 组），焦虑组（B 组）和认知障碍组（C 组），进行匹兹堡睡眠质量指数量表（PSQI）调查，分析其与PD非运动症状的相关性。对有睡眠障碍的患者实施睡眠训练方案，训练3～6 个月后再次测评PSQI、HAMD、HAMA 和ADAS-cog。结果调查的PD患者中255 例有非运动症状，各组睡眠质量与非运动症状均呈正相关（p <0.05）。与睡眠训练前比较，睡眠训练后A和B组患者PSQI总得分降低（p <0.05），且HAMD和HAMA 得分也降低（p <0.05）。结论连续睡眠训练能够有效提高PD 患者的睡眠质量，改善抑郁和焦虑症状，对认知障碍无影响。

Abstract:

Objective To investigate the effect of sleep training on sleep quality, the symptoms of depression and anxiety in patients with Parkinson's disease. Methods Using the method of retrospective analysis and follow-up, 321 cases of Parkinson's disease (PD) diagnosed in Shaanxi Kangfu Hospital between March 2012 and September 2014 were evaluated with Hamilton Depression Scale (HAMD scale), Hamilton Anxiety Scale (HAMA scale) and Alzheimer's Disease Assessment Scale (ADAS-cog). The qualified patients were divided into depression group (group A), anxiety group (group B) and cognitive impairment group (group C) (when a patient had more than two kinds of symptoms meantime, grouping according to the highest score),then the sleeping quality was investigated with "Pittsburgh Sleep Quality Index" (PSQI), and the correlations between non motor symptoms and sleeping quality were analyzed. The sleeping training program was performed in the patients with sleeping disorder for 3-6 months, then PSQI, HAMD, HAMA and ADAS-cog scores were evaluated again. Results Of the 321 PD patients, 255 had non-motor symptoms. In all three groups, sleeping quality and non-motor symptoms were positively correlated (p < 0.05). After sleep training, sleeping quality of the groups A and B was significantly improved (p < 0.05), and the HAMD and HAMA scores were significantly reduced (p < 0.05). Conclusions Continuous sleep training can effectively improve the sleeping quality of patients with PD, and improve the symptoms of depression and anxiety. However, it has no effect on cognitive impairment.