于爽　　高麗平　　丁蘭

[摘要] 目的 通過分析中醫(yī)介入的團(tuán)隊(duì)管理模式下對(duì)中青年人群失眠干預(yù)的臨床療效，探討新模式的應(yīng)用價(jià)值。 方法 本研究為前瞻性隨機(jī)對(duì)照研究。選取2018年1—6月就診于我中心的中青年失眠患者178例，隨機(jī)分為對(duì)照組（傳統(tǒng)家庭醫(yī)生服務(wù)模式）與試驗(yàn)組（中醫(yī)介入的團(tuán)隊(duì)管理模式）進(jìn)行管理，每組各89例，采用重復(fù)測(cè)量方差分析評(píng)價(jià)兩組患者的失眠程度（PSQI量表）及焦慮抑郁狀態(tài)（PHQ-9量表）變化，同時(shí)對(duì)比兩組患者的療效。 結(jié)果 兩組的PSQI及PHQ-9量表總分均隨干預(yù)時(shí)間的延長而降低，且呈線性趨勢(shì)（P<0.05）。干預(yù)3個(gè)月時(shí)，試驗(yàn)組的PSQI量表總分為（8.42±3.53）分及PHQ-9量表的總分為（4.96±0.96）分，均低于對(duì)照組[（9.44±3.34）分、（6.03±0.97）分]。6個(gè)月時(shí)，試驗(yàn)組的PSQI量表總分為（6.70±2.86）分、PHQ-9量表的總分為（4.26±0.51）分，均低于對(duì)照組的[（8.43±3.30）分、（5.45±0.67分）]，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。其中，干預(yù)3個(gè)月及6個(gè)月時(shí)，試驗(yàn)組入睡時(shí)間、睡眠效率及睡眠障礙單項(xiàng)得分較治療前的降低程度均大于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療3個(gè)月及6個(gè)月時(shí)，試驗(yàn)組總有效率（73.03%、84.27%）均高于對(duì)照組（53.93%、62.92%），差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）。 結(jié)論 中醫(yī)介入的團(tuán)隊(duì)管理模式下對(duì)中青年患者失眠的干預(yù)療效顯著，焦慮抑郁狀態(tài)改善明顯，值得進(jìn)一步推廣。

[關(guān)鍵詞] 中醫(yī);團(tuán)隊(duì)管理模式;中青年;失眠;干預(yù)

[中圖分類號(hào)] R193.2? ? ? ? ? [文獻(xiàn)標(biāo)識(shí)碼] B? ? ? ? ? [文章編號(hào)] 1673-9701（2021）21-0139-05

Efficacy of traditional Chinese medicine-involved team management mode on insomnia intervention in young and middle-aged patients

YU Shuang? ?GAO Liping? ?DING Lan

Department of Traditional Chinese Medicine， Yuetan Community Health Service Center， Fuxing Hospital， Capital Medical University， Beijing? ?100045，China

[Abstract] Objective To analyze the clinical efficacy of traditional Chinese medicine-involved team management mode on insomnia intervention in young and middle-aged patients， to explore the application value of the new mode. Methods? This study was a prospective randomized controlled study. A total of 178 young and middle-aged patients with insomnia treated in our center from January 2018 to June 2018 were selected and randomly divided into the control group （traditional family doctor service mode） and the experimental group （traditional Chinese medicine-involved team management mode）， with 89 patients in each group. Repeated measure analysis of variance was used to evaluate the changes in degree of insomnia （PSQI scale）， and anxiety and depression status （PHQ-9 scale） in the two groups. The efficacy was also compared between the two groups. Results The total scores of the PSQI and PHQ-9 scales of the two groups were decreased with the extension of the intervention time and showed a linear trend（P<0.05）.At 3 months after intervention， the total scores of the PSQI and PHQ-9 scales in the experimental group were （8.42±3.53）points and （4.96±0.96）points，which were lower than those in the control group as （9.44±3.34）points and （6.03±0.97）points. At 6 months after intervention， the total scores of the PSQI and PHQ-9 scales in the experimental group were （6.70±2.86）points and （4.26±0.51）points， which were lower than those in the control group as（8.43±3.30）points and （5.45±0.67）points， with statistically significant differences（P<0.05）. At 3 and 6 months after intervention， the decreases of individual scores of falling asleep time， sleep efficiency and sleep disturbance in the experimental group were lower than those in the control group， with statistically significant differences（P<0.05）. At 3 and 6 months after treatment， the total effective rates of the experimental group （73.03%，84.27%） were higher than those of the control group （53.93%，62.92%），with statistically significant differences（P<0.05）. Conclusion The traditional Chinese medicine-involved team management mode has significant efficacy on insomnia intervention in young and middle-aged patients， which can significantly improve anxiety and depression status. It is worthy of further promotion.