Efficacy of Wuling capsules combined with low-dose quetiapine in the treatment of oldest-old patients with insomnia accompanied by anxiety and depression

CAI Chuanyun; HU Xin; ZHU Huajun; LIU Wenzhu; WU Zixing; JIANG Wei

doi:10.6039/j.issn.1001-0408.2024.12.18

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Efficacy of Wuling capsules combined with low-dose quetiapine in the treatment of oldest-old patients with insomnia accompanied by anxiety and depression

更新时间：2024-06-25

- Efficacy of Wuling capsules combined with low-dose quetiapine in the treatment of oldest-old patients with insomnia accompanied by anxiety and depression
- ZHONGGUO YAOFANG Vol. 35, Issue 12, Pages: 1517-1521(2024)
- 作者机构：
  
  中国人民解放军联勤保障部队第九〇一医院全科医学科，合肥　230031
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2024.12.18
  CLC： R749.92;R969
- Published：30 June 2024，
  
  Received：11 November 2023，
  
  Revised：25 April 2024，
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蔡传云,胡欣,朱华军等.乌灵胶囊联合小剂量喹硫平用于失眠伴焦虑抑郁高龄老年患者的疗效分析 ^Δ[J].中国药房,2024,35(12):1517-1521.

CAI Chuanyun,HU Xin,ZHU Huajun,et al.Efficacy of Wuling capsules combined with low-dose quetiapine in the treatment of oldest-old patients with insomnia accompanied by anxiety and depression[J].ZHONGGUO YAOFANG,2024,35(12):1517-1521.
蔡传云,胡欣,朱华军等.乌灵胶囊联合小剂量喹硫平用于失眠伴焦虑抑郁高龄老年患者的疗效分析 ^Δ[J].中国药房,2024,35(12):1517-1521. DOI： 10.6039/j.issn.1001-0408.2024.12.18.

CAI Chuanyun,HU Xin,ZHU Huajun,et al.Efficacy of Wuling capsules combined with low-dose quetiapine in the treatment of oldest-old patients with insomnia accompanied by anxiety and depression[J].ZHONGGUO YAOFANG,2024,35(12):1517-1521. DOI： 10.6039/j.issn.1001-0408.2024.12.18.

摘要

目的

探讨乌灵胶囊联合小剂量喹硫平治疗高龄老年失眠伴焦虑抑郁患者的疗效和安全性。

方法

回顾性分析2020年6月－2022年12月在我院门诊就诊或住院治疗的96例失眠伴焦虑抑郁高龄老年（≥80岁）患者的临床资料。根据治疗方案的不同将患者分为乌灵胶囊组（0.99 g，每天3次，34例）、喹硫平组（25～50 mg，每晚1次，30例）和联合组（同时服用乌灵胶囊和喹硫平，用法用量同单药组，32例）。比较3组患者治疗前和治疗8周后的睡眠监测指标（总睡眠时间、睡眠效率、睡眠潜伏期、觉醒次数）、匹兹堡睡眠质量指数量表（PSQI）评分、14项汉密尔顿焦虑量表（HAMA-14）评分、17项汉密尔顿抑郁量表（HAMD-17）评分、简易智能精神状态量表（MMSE）评分、血清白细胞介素1β（IL-1β）和肿瘤坏死因子α（TNF-α）水平，以及疗效和不良反应发生情况。

结果

与治疗前比较，3组患者治疗后的总睡眠时间、睡眠效率、MMSE评分均显著延长或升高（

＜0.05），睡眠潜伏期、觉醒次数、PSQI评分、HAMA-14评分、HAMD-17评分、血清IL-1β和TNF-α水平均显著缩短或降低（

＜0.05），喹硫平组患者的睡眠潜伏期、觉醒次数、HAMA-14评分、HAMD-17评分、血清TNF-α水平均明显短于或低于乌灵胶囊组，且联合组各定量指标均显著优于喹硫平组和乌灵胶囊组（

＜0.05）。联合组患者的治疗总有效率显著高于喹硫平组和乌灵胶囊组（

＜0.05），3组患者的总不良反应发生率比较差异无统计学意义（

＞0.05）。

结论

乌灵胶囊联合小剂量喹硫平用于高龄老年失眠伴焦虑抑郁患者的疗效优于各药单用，不良反应未见明显增加。

Abstract

OBJECTIVE

To investigate the efficacy and safety of Wuling capsules combined with low-dose quetiapine in the treatment of oldest-old patients with insomnia accompanied by anxiety and depression.

METHODS

The clinical data of 96 oldest-old patients （aged≥80 years） with insomnia accompanied by anxiety and depression who were attending outpatient clinics or hospitalized in our hospital from June 2020 to December 2022 were retrospectively analyzed. According to the different drug treatments， the patients were divided into Wuling capsules group （0.99 g， tid， 34 cases）， quetiapine group （25-50 mg， qn， 30 cases） and combination group （using Wuling capsules and quetiapine simultaneously， same as the single drug groups， 32 cases）. Before and after 8 weeks of treatment， the patients of three groups were compared in terms of photoplethysmography sleep monitoring indexes （total sleep duration， sleep efficiency， sleep latency， and the number of awakening）， Pittsburgh sleep quality index （PSQI） score， 14-item Hamilton anxiety scale （HAMA-14） score， 17-item Hamilton depression scale （HAMD-17） score， mini-mental state examination （MMSE） score， and serum levels of interleukin-1β （IL-1β） and tumor necrosis factor-α （TNF-α）； the therapeutic effects and adverse drug reactions of the three groups were observed and compared.

RESULTS

Compared with before treatment， the total sleep time， sleep efficiency and MMSE scores of the three groups were significantly longer or higher after treatment （

＜0.05）， while the sleep latency， number of awakening， PSQI score， HAMA-14 score， HAMD-17 score， serum IL-1β and TNF-α levels were significantly shorter or lower after treatment （

＜0.05）. Sleep latency， number of awakening， HAMA-14 score， HAMD-17 score and serum TNF-α level in quetiapine group were significantly shorter or lower than Wuling capsules group after treatment （

＜0.05）. Moreover， the above indexes in the combination group were significantly better than quetiapine group and Wuling capsules group （

＜0.05）. The total effective rate of treatment in the combination group was significantly higher than the other two groups （

＜0.05）. There was no significant difference in the incidence of adverse drug reactions among the three groups （

＞0.05）.

CONCLUSIONS

The therapeutic effect of Wuling capsules combined with low-dose quetiapine is better than that of individual drugs for oldest-old patients with insomnia accompanied with anxiety and depression， not increasing the risk of adverse reactions.

关键词

乌灵胶囊小剂量喹硫平失眠焦虑抑郁高龄老年患者

Keywords

low-dose quetiapineinsomniaanxietydepressionoldest-old patients

references

熊风，赖玉清，涂嘉欣，等. 中国老年人群睡眠障碍流行特征的Meta分析[J]. 中国循证医学杂志，2019，19（4）：398-403.

XIONG F，LAI Y Q，TU J X，et al. Epidemiological cha-racteristics of sleep disorders in the Chinese elderly：a meta-analysis[J]. Chin J Evid Based Med，2019，19（4）：398-403.

PANDI-PERUMAL S R，MONTI J M，BURMAN D，et al. Clarifying the role of sleep in depression：a narrative review[J]. Psychiatry Res，2020，291：113239.

蔡传云，江伟，胡欣. 老年慢性失眠的治疗研究进展[J]. 实用临床医药杂志，2023，27（3）：140-143，148.

CAI C Y，JIANG W，HU X. Research progress in treatment of chronic insomnia in the elderly[J]. J Clin Med Pract，2023，27（3）：140-143，148.

ZHOU H F，ZHAO Y，PENG W H，et al. Efficacy and safety of Wuling capsule for insomnia disorder：a syste-matic review and meta-analysis of randomized controlled trials[J]. Sleep Med，2022，93：1-14.

PETERS E M，BOWEN R，BALBUENA L. Low-dose quetiapine for major depressive disorder and sleep impro-vement[J]. J Clin Psychopharmacol，2020，40（5）：500-502.

吴伟，林传行，陈书丽. 慢性失眠伴焦虑抑郁患者血清炎症相关标志物研究进展[J]. 医学与哲学（B），2017，38（5）：18-21.

WU W，LIN C H，CHEN S L. Research progress of serum inflammatory biomarkers in chronic insomnia patients with anxiety or/and depression[J]. Med Philos B，2017，38（5）：18-21.

SATEIA M J. International classification of sleep disorders：third edition：highlights and modifications[J]. Chest，2014，146（5）：1387-1394.

路桃影，李艳，夏萍，等. 匹兹堡睡眠质量指数的信度及效度分析[J]. 重庆医学，2014，43（3）：260-263.

LU T Y，LI Y，XIA P，et al. Analysis on reliability and validity of the Pittsburgh sleep quality index[J]. Chongqing Med，2014，43（3）：260-263.

侍成栋，潘永良. 汉密尔顿抑郁及焦虑量表与正性负性情绪量表的相关性研究[J]. 全科护理，2019，17（2）：140-142.

SHI C D，PAN Y L. Correlation between Hamilton depression and anxiety scale and positive and negative emotion scale[J]. Chin Gen Pract Nurs，2019，17（2）：140-142.

杨晓帆，祁娜，冯媛，等. 基于图像认知的心理测评技术与17项汉密尔顿抑郁量表的相关性研究[J]. 神经疾病与精神卫生，2021，21（4）：249-254.

YANG X F，QI N，FENG Y，et al. Correlation between mental assessment technology based on image cognition and 17-item Hamilton depression scale[J]. J Neurosci Ment Health，2021，21（4）：249-254.

DEVENNEY E，HODGES J R. The Mini-mental state examination：pitfalls and limitations[J]. Pract Neurol，2017，17（1）：79-80.

邹瑛，田道峰，侯亚婷，等. 百乐眠胶囊联合艾司西酞普兰片对失眠伴抑郁焦虑患者睡眠质量、不良情绪以及神经递质水平的影响[J]. 现代生物医学进展，2021，21（8）：1465-1468，1424.

ZOU Y，TIAN D F，HOU Y T，et al. Effect of Bailemian capsule combined with Escitalopram tablet on sleep qua-lity，bad mood and neurotransmitter level of insomnia patients with depression and anxiety[J]. Prog Mod Biomed，2021，21（8）：1465-1468，1424.

吴子幸，胡欣，陶诗萌，等. 老年慢性失眠患者认知功能与失眠严重程度和血清25-羟维生素D3及肿瘤坏死因子α水平的相关性研究[J]. 中国全科医学，2024，27（3）：328-334.

WU Z X，HU X，TAO S M，et al. Correlations of cognitive function with insomnia severity，serum levels of 25-hydroxy vitamin D3 and tumor necrosis factor-α in elderly patients with chronic insomnia[J]. Chin Gen Pract，2024，27（3）：328-334.

马素亚，李婷，魏明清，等. 乌灵胶囊治疗睡眠障碍有效性及安全性Meta分析[J]. 世界中医药，2022，17（5）：715-722.

MA S Y，LI T，WEI M Q，et al. Efficacy and safety of Wuling capsule in treatment of sleep disorder：a meta analysis[J]. World Chin Med，2022，17（5）：715-722.

WANG H P，CHEN H Z，GAO Y，et al. The effect of Wuling capsule on depression in type 2 diabetic patients[J]. Biosci Rep，2020，40（2）：BSR20191260.

MA X Q，JIANG C Q，XU L，et al. Sleep quality and cognitive impairment in older Chinese：Guangzhou biobank cohort study[J]. Age Ageing，2019，49（1）：119-124.

MILLER M A，WRIGHT H，JI C，et al. Cross-sectional study of sleep quantity and quality and amnestic and non-amnestic cognitive function in an ageing population：the English longitudinal study of ageing（ELSA）[J]. PLoS One，2014，9（6）：e100991.

WILCKENS K A，HALL M H，NEBES R D，et al. Changes in cognitive performance are associated with changes in sleep in older adults with insomnia[J]. Behav Sleep Med，2016，14（3）：295-310.

QIN S，LEONG R L F，ONG J L，et al. Associations between objectively measured sleep parameters and cognition in healthy older adults：a meta-analysis[J]. Sleep Med Rev，2023，67：101734.

REN C Y，RAO J X，ZHANG X X，et al. Changed signals of blood adenosine and cytokines are associated with parameters of sleep and/or cognition in the patients with chronic insomnia disorder[J]. Sleep Med，2021，81：42-51.

AGHELAN Z，PASHAEE S，ABTAHI S H，et al. Natural immunosuppressants as a treatment for chronic insomnia targeting the inflammatory response induced by NLRP3/caspase-1/IL-1β axis activation：a scooping review[J]. J Neuroimmune Pharmacol，2023，18（3）：294-309.

KIM J W，KIM Y K，HWANG J A，et al. Plasma levels of IL-23 and IL-17 before and after antidepressant treatment in patients with major depressive disorder[J]. Psychiatry Investig，2013，10（3）：294-299.

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