对于接受血液透析的患者,现有的失眠疗法的有效性:一项随机临床试验
Rajnish Mehrotra1, Daniel Cukor2, Susan M McCurry3
1Kidney Research Institute, Division of Nephrology, Department of Medicine, University of Washington School of Medicine, Seattle, Washington (R.M.).
Annals of internal medicine
|January 15, 2024
概括
对失眠的认知行为疗法 (CBT-I) 和特拉佐在治疗血液透析患者的慢性失眠方面没有比安慰剂更有效. 特拉佐与更高的严重不良事件发生率有关.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 睡眠医学 睡眠医学
- 临床试验 临床试验
背景情况:
- 慢性失眠是接受中心血液透析的患者中普遍存在的问题.
- 在这种特定患者群体中,对失眠的有效治疗选择仍然有限.
研究的目的:
- 评估对治疗失眠的认知行为疗法 (CBT-I),特拉佐和安慰剂在经历长期血液透析的慢性失眠患者的比较有效性.
主要方法:
- 一个随机的,多中心的,双盲的,安慰剂控制的试验在26个透析单位进行.
- 患有慢性失眠的参与者 (失眠严重性指数得分≥10) 被随机分配到6周的CBT-I,特拉佐或安慰剂.
- 主要结局指标是失眠严重性指数分数在7周和25周的变化.
主要成果:
- 无论是CBT-I还是特拉佐都没有显示出在降低失眠严重性指数得分的显著差异,与安慰剂相比,在7周或25周.
- 严重不良事件 (SAE),特别是心血管事件,与CBT-I和安慰剂组相比,在Trazodone组更频繁.
结论:
- 在血液透析患者中,六周的CBT-I或特拉佐治疗没有在治疗轻度至中度慢性失眠方面表现出比安慰剂更好的疗效.
- 特拉佐的使用与严重不良事件的风险增加有关,因此在这个人群中需要谨慎.
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