基于“肝藏魂”理论观察疏肝活血方对慢性乙型肝炎患者失眠及肝功能的影响  

Effects of “Shugan Huoxue Recipe”on Insomnia and Liver Function in Patients with Chronic Hepatitis B Based on Theory of “Liver Storing Soul”

作　　者：张鑫[1] 黄凌鹰[1] 周振华[1] 李曼[1] 高亚婷[1] 孙学华[1] 高月求[1] 

机构地区：[1]上海中医药大学附属曙光医院肝病科,上海201203

出　　处：《上海中医药大学学报》2017年第1期9-12,共4页Academic Journal of Shanghai University of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(81473477;81403354;81473629;81403351;81503545);国家"艾滋病和病毒性肝炎等重大传染病防治"科技重大专项项目(2012ZX10005004-002);上海市进一步加快中医药事业发展三年行动计划项目(ZY3-LCPT-1-1001;ZY3-CCCX-3-3027;ZY3-CCCX-3-3029;CY3-CCCX-3-2006);上海市自然科学基金资助项目(14ZR1441900);上海市科委科研计划资助项目(14YF1411600;15YF1412300;16401931300;16401970600);上海申康市级医院新兴前沿技术联合攻关项目(SHDC12016121);上海中医药大学预算内项目(2014YSN39)

摘　　要：目的:观察疏肝活血方联合恩替卡韦治疗慢性乙型肝炎(CHB)伴失眠患者的临床疗效。方法:纳入100例具有失眠症状的CHB患者,随机分为治疗组和对照组,每组50例。两组患者均给予恩替卡韦抗病毒治疗,治疗组加用疏肝活血方治疗,疗程为3个月。评价两组患者的中医证候积分及匹兹堡睡眠质量指数量表(PSQI)评分,检测并比较两组患者治疗前后的谷丙转氨酶(ALT)、总胆红素(TBIL)及乙肝病毒核酸(HBV DNA)水平。结果:治疗后,两组患者的中医证候积分均显著下降(P<0.01,P<0.05),且治疗组患者的积分低于对照组(P<0.01)。治疗后,治疗组患者的PSQI睡眠质量、入睡时间和睡眠时间评分均显著下降(P<0.01),且治疗组患者的各项评分均低于对照组(P<0.01)。治疗后,两组患者的ALT、TBIL、HBV DNA水平均明显降低(P<0.01,P<0.05),但两组患者的ALT、TBIL、HBV DNA水平组间比较,其差异无统计学意义(P>0.05)。结论:基于"肝藏魂"理论的疏肝活血方可改善CHB伴失眠患者的失眠状态和中医证候,提高患者的睡眠质量。Objective： To observe the clinical effects of ＂Shugan Huoxue Recipe＂ combined with entecavir in treating patients of chronic hepatitis B （CHB） with insomnia. Methods ： One hundred patients of CHB with insomnia were selected and randomly divided into the treatment group and control group, 50 cases in each group. All the patients were treated with entecavir for antivirus treatment and the patients in the treatment group were treated with ＂ Shugan Huoxue Recipe＂ additionally, with a course of 3 months. The scores of Chinese medical syndrome and Pittsburgh Sleep Quality Index （PSQI） were evaluated and the levels of alanine aminotransferase （ALT）, total bilirubin （TBIL） and HBV DNA were detected and compared. Results ： After treatment, the scores of Chinese medical syndrome in both groups were significantly decreased （ P 〈 0.01 ,P 〈 0.05 ）, and the scores of the treatment group were lower than those of the control group （P 〈 0.01 ）. After treatment, the scores of sleep quality, falling asleep time and sleep time in PSQI in the treatment group were markedly decreased （P 〈0.01 ）, and all the scores of the treatment group were lower than those of the control group （P 〈0.01 ）. After treatment, the levels of ALT, TBIL and HBV DNA in both groups were obviously decreased （ P 〈 0.01, P 〈 0.05 ）, while there were no statistical differences between the two groups on the levels of ALT, TBIL and HBV DNA （ P 〉 0. 05 ）. Conclusion： ＂Shugan Huoxue Recipe＂ which bases on the theory of ＂liver storing soul＂ can improve the insomnia and the Chinese medical syndrome and enhance the sleep quality in patients of CHB with insomnia.

关 键 词：慢性乙型肝炎 失眠 肝藏魂 疏肝活血方 肝功能 

分 类 号：R259[医药卫生—中西医结合]