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目的:分析失眠认知行为疗法（cognitive behavioral therapy on insomnia，CBT-i）对失眠伴抑郁患者以及单纯失眠患者的疗效。方法:71例符合失眠症诊断的患者，根据贝克抑郁量表（Beck Depression Inventory，BDI）得分分为单纯失眠组（<14分，33例）和失眠伴抑郁组（≥14分，38例）。2组患者每天填写睡眠日记，并给予8周标准的CBT-i治疗，在治疗前（基线）、治疗第4周、治疗第8周、治疗结束后4周（第3个月）、治疗结束后16周（第6个月）采用匹兹堡睡眠质量指数（Pittsburgh Sleep Quality Index，PSQI）、失眠严重程度指数（Insomnia Severity Index，ISI）、BDI、贝克焦虑量表（Beck Anxiety Inventory，BAI）、SF-36健康调查简表对2组患者睡眠质量、抑郁焦虑程度、个人健康状况等进行评估，采用独立样本n t检验进行组间比较，采用重复测量方差分析进行各时间点组内比较。n 结果:与基线时比较，单纯失眠组和失眠伴抑郁组第8周、第3个月和6个月随访时入睡潜伏期、睡眠效率、PSQI、ISI、BDI、BAI、SF-36组内比较差异均有统计学意义。失眠伴抑郁组较单纯失眠组在基线、第8周、第3个月和6个月随访时BAI（n t=-6.340、-3.301、-3.511、-2.982）、SF-36（n t=4.162、3.195、2.022、3.629）评分差异有统计学意义（n P<0.01或0.05），2组ISI评分在第6个月随访时差异有统计学意义[（7.3±4.6）分与（4.7±3.4）分，n t=-2.044，n P=0.048]。2组入睡潜伏期和睡眠效率以及PSQI的评分在第8周、第3个月和6个月随访时与基线的变化量差异均无统计学意义；而2组BAI、BDI评分在第8周与第3个月和6个月随访时与基线的变化量差异有统计学意义。n 结论:CBT-i对失眠伴抑郁患者和单纯失眠患者均有效，且可以缓解失眠伴抑郁患者的抑郁症状以及改善患者生活质量。“,”Objective:To study the effect of cognitive behavioral therapy on insomnia (CBT-i) for patients with insomnia and patients with comorbid depressive disorder.Methods:According to the score of Beck Depression Inventory (BDI), 71 patients who met the diagnosis of insomnia were divided into the insomnia group (<14 points, 33 cases) and the insomnia with depression group (≥14 points, 38 cases). Patients in both groups filled in sleep diaries every day and were given standard CBT-i treatment for 8 weeks. Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), BDI, Beck Anxiety Inventory (BAI), and the SF-36 Health Survey were evaluated before treatment (baseline), at 4 weeks, 8 weeks, 4 weeks after treatment (3 months), and 16 weeks after treatment (6 months). Independent samplen t test was utilized to compare difference between two groups, while repeated measures ANOVA was adopted to analyze data at different timepoints.n Results:Compared with baseline assessment, both insomnia group and insomnia with depression group showed significant differences in Sleep Onset Latency (SOL), Sleep Efficiency (SE), PSQI, ISI, BDI, BAI, and SF-36. There were no significant difference between the two groups, at baseline, 8 weeks, 3 months and 6 months in SOL, and SE, however, significant difference was found in the scores of BAI (n t=-6.340,-3.301,-3.511,-2.982), and SF-36 (n t=4.162,3.195,2.022,3.629; n P<0.01 or 0.05). In the meantime, there was a significant difference on PSQI and ISI at 8 weeks and 3 months, while there was no significant difference of them at month 6 (7.3±4.6 n vs. 4.7±3.4, n t=-2.044, n P=0.048) . There were no statistically significant differences in sleep latency, sleep efficiency and PSQI scores between the insomnia group and the insomnia with depression group at 8 weeks, 3 months and 6 months. However, compared with baseline measurement, the two groups showed statistically significant differences on BAI and BDI scores at week 8, month 3 and month 6 (all n P<0.01).n Conclusions:CBT-i is effective for patients with insomnia as well as those with comorbid depression, it could be helpful to alleviate the depressive symptoms and improve patient′s quality of life.