【摘要】

目的：评价右佐匹克隆联合舍曲林对脑卒中后抑郁伴睡眠障碍的临床疗效、安全性。
方法：对80例临床诊断脑卒中后抑郁伴睡眠的患者按就诊顺序交叉分为观察组和对照组，治疗6周，停药随访1周；观察组、对照组分别服用右佐匹克隆、劳拉西泮，联用舍曲林，临床使用汉密尔顿抑郁评定量表(HAMD)和睡眠障碍评定量表(SDRS)评价治疗效果；副作用量表（TESS）评定治疗过程中发生的不良反应。
结果：两组患者治疗后1周、6周HAMD、SDRS评分均呈逐渐下降的趋势，治疗前后对比均有统计学差异(P<0．05或P<0．01)，观察组1周末SDRS评分下降更明显，组间比较有显著性差异（P<0．05）；两组6周后总有效率分别80.0％、82％(P<0．05)，患者不良反应发生率观察组低于对照组，比较差异有显著性(P<0．05)，停用镇静催眠药1周时随访，观察组发生失睡反弹率低于对照组（P<0．05）。
结论：右佐匹克隆对脑卒中后抑郁伴睡眠障碍的疗效与劳拉西泮相当，起效更快，不良反应、失睡反弹率更低。

【Abstract】

Objective： To investigate the Clinical efficacy and safety of eszopiclon combined with sertralin on cerebral infarction depressive sleep dysfunction.
Methods：According to the registration order，80 patients with cerebral infarction depressive sleep dysfunction were divided into observation group and control group，treatment of 6 weeks，withdrawal of follow-up for a week；observation group and control group respectively took eszopiclon、lorazepam，combined with sertralin，used the Hamilton depression scale (HAMD) and sleep dysfunction rating scale(SDRS) to evaluate the efficacy of treatment，and side effects were assessed by TESS regularly.
Results：1 week ，6 weeks after treatment in both groups HAMD、SDRS score all showed a trend of gradual decline，compared before and after the treatment are statistically significant(P<0．05或P<0．01)，SDRS score decreased more obvious observation group 1 weekend，comparison between groups have significant difference（P<0．05）；the two groups after 6 weeks total effective rate 80.0％、82％ respectively(P<0．05)， incidence of adverse reactions in patients with observation group is lower than the control group，comparing difference is significant(P<0．05)，stop using sedative hypnotics follow-up at 1 week，observation group insomnia bounce rate was lower than control group（P<0．05）.
Conclusion  ：Eszopiclon on depression associated with sleep disorders after stroke has the curative effect of lorazepam，work faster，adverse reactions，insomnia bounce rate is lower.