【摘要】 目的比较网络化认知行为治疗(ICBT)、传统面对面认知行为治疗(CBT)及药物治疗对失眠症患者睡眠参数及焦虑和抑郁水平的影响,了解ICBT对失眠症的治疗效果。方法选取符合DSM-5诊断标准的失眠症患者79例,随机分为ICBT组(n=27)、CBT组(n=26)、药物治疗组(n=26),各组均进行连续8周的治疗。比较3组治疗前、治疗第4周、治疗结束时睡眠参数、焦虑及抑郁水平的差异。结果与治疗前相比,治疗第4周、治疗结束时3组睡眠参数明显改善,焦虑及抑郁水平明显下降,差异均有统计学意义(P<0.05)。治疗第4周,药物治疗组入睡潜伏期、总睡眠时间、入睡后觉醒时间等与ICBT、CBT组比较差异有统计学意义(P<0.05)。治疗结束时,ICBT组、CBT组的入睡潜伏期、焦虑及抑郁水平均低于药物治疗组,差异有统计学意义(P<0.05),而ICBT组与CBT组比较,除抑郁水平外,焦虑水平及睡眠参数两组比较差异均无统计学意义(P>0.05)。结论 ICBT对失眠症的改善速度较药物治疗慢,但是治疗结束时,其疗效优于药物治疗且与传统的面对面CBT效果差异不大。更多还原

【Abstract】 Objective To evaluate the effectiveness of internet-based cognitive behav ioral therapy(ICBT) for the treatment of insomnia by comparison of sleep parameters, degrees of anxiety and depression of the ICBT, with traditional faceto-face cognitive behavioral therapy(CBT) and pharmacotherapy for insomnia. Methods Seventy-nine cases meeting proposed DSM-5 criteria for insomnia disorder were randomly assigned to ICBT(n=27), CBT(n=26), and pharmacotherapy(n=26) group, and treated accordingly for 8 consecutive weeks. The sleep parameters, the levels of anxiety and depression in the 3 groups were compared and analyzed before, 4 weeks after and the termination of treatment. Results Comparing to that of pre-treatment, the sleep parameters were significantly improved, anxiety and depression levels obviously decreased after treatment for 4 and 8 consecutive weeks, the differences were statistically significant(P<0.05). After treatment for 4 consecutive weeks, the sleep latency, total asleep time and wake time after sleep were significantly different(P<0.05) when compared with pharmacotherapy group with ICBT and CBT groups. After the treatment, the sleep latency, anxiety and depression levels were lower in ICBT and CBT groups than those in pharmacotherapy group, and the difference was statistically significant(P<0.05). In addition, no significant difference(P>0.05) was found in sleep parameters and anxiety level between ICBT group and CBT group. Conclusion ICBT may display a slower effect on improving speed in falling asleep than the pharmacotherapy does, but the efficacy of ICBT is better than that of pharmacotherapy after treatment, and there is no significant difference compared to traditional face-to-face CBT.更多还原