新疆医科大学学报

目的 观察失眠认知行为治疗(CBT-I)结合中医治疗在老年冠心病合并睡眠障碍患者中的应用效果。方法 选择2021年6月至2023年9月在新疆医科大学第一附属医院收治的400例老年冠心病合并睡眠障碍患者，随机分成研究组和对照组各200例，对照组采取常规治疗，研究组以CBT-I疗法结合中医治疗进行治疗。以匹兹堡睡眠质量指数量表(PSQI)、生活质量量表(SF-36)、抑郁自评量表(SDS)、焦虑自评量表(SAS)以及西雅图心绞痛量表(SAQ)评价两组患者的治疗效果。结果 治疗后，两组患者的入睡时间、睡眠时间、睡眠效率、睡眠质量、催眠药物、日间功能、睡眠障碍评分均较治疗前降低，且研究组低于对照组(P<0.05);两组患者在生理机能、生理职能、躯体疼痛、一般健康状况、精力、社会功能、情感职能、精神健康、健康变化评分均较治疗前升高，且研究组高于对照组(P<0.05);两组患者SAS、SDS评分均较治疗前降低，且研究组低于对照组(P<0.05);两组患者的身体活动受限程度、心绞痛稳定状态、心绞痛发作情况、治疗满意程度、疾病认知程度评分均较治疗前上升(P<0.05),且研究组高于对照组(P<0.05)。结论 失眠认知行为治疗结合中医治疗可有效提高老年冠心病睡眠障碍患者睡眠质量，改善生活质量，促进冠心病功能状态稳定并降低其焦虑抑郁程度。

Objective To observe of the application effect of cognitive behavioral therapy for insomnia(CBT-I) combined with traditional Chinese medicine(TCM)in elderly patients with coronary heart disease and sleep disorders. Methods 400 elderly patients with coronary heart disease and sleep disorders admitted to the First Affiliated Hospital of Xinjiang Medical University from June 2021 to September 2023 were randomly divided into study group and control group, with 200 patients in each group. The control group received conventional treatment, while the study group received CBT-I therapy combined with TCM treatment. The treatment efficacy of the 2 groups of the patients was evaluated using Pittsburgh Sleep Quality Index(PSQI), Quality of Life Scale(SF-36), Self Rating Depression Scale(SDS), Self Rating Anxiety Scale(SAS) and Seattle Angina Questionnaire(SAQ). Results The sleep onset time, sleep duration, sleep efficiency, sleep quality, hypnotic drugs, daytime function and sleep disorder scores of both groups of the patients were decreased compared to before the treatment, and the study group was lower than the control group(P<0.05). Both groups of the patients showed an increase in physiological muscle function, physiological function, physical pain, general health status, energy, social function, emotional function, mental health and health change scores compared to before the treatment, and the study group was higher than control group(P<0.05). The SAS and SDS scores of both groups of the patients were decreased compared to before the treatment, and the study group was lower than control group(P<0.05). The degree of physical activity restriction, stable state of angina pectoris, incidence of angina pectoris, treatment satisfaction and disease cognition scores of both groups of the patients was increased compared with before the treatment(P<0.05), and the study group was higher than control group(P<0.05). Conclusion The combination of cognitive-behavioral therapy and TCM treatment can effectively improve the sleep quality and quality of life of the elderly patients with coronary heart disease sleep disorders, promote the stability of coronary heart disease functional status, and reduce their anxiety and depression levels.