桂枝甘草龙骨牡蛎汤加减治疗阴虚火旺型更年期失眠疗效及对患者睡眠质量、神经递质的影响  

Clinical Efficacy of Modified Guizhi Gancao Longgu Muli Tang in Treating Menopausal Insomnia and Its Effect on Sleep Quality and Neurotransmitter

作　　者：蔡艳[1] 叶玉妹[1] 张涛[1] 杨慰[1] 王归雁 石伟[1] CAI Yan;YE Yu-mei;ZHANG Tao;YANG Wei;WANG Gui-yan;SHI Wei(Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai 200137,China)

机构地区：[1]上海中医药大学附属第七人民医院,上海200137

出　　处：《中国实验方剂学杂志》2019年第9期38-42,共5页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：上海市浦东新区卫生系统重点专科项目(PWZzk2017-01)

摘　　要：目的:探讨更年期失眠患者应用桂枝甘草龙骨牡蛎汤加减治疗的临床效果。方法:选取2016年1月至2018年6月本院收治的134例女性更年期失眠患者,使用随机数字表法将其随机分成观察组与对照组,各67例。对照组口服右佐匹克隆,观察组在此基础上联合桂枝甘草龙骨牡蛎汤加减治疗。所有患者均治疗4周。对比两组临床效果,治疗前后睡眠质量[匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)]评分,神经递质[谷氨酸(glutamic acid,Glu),γ-氨基丁酸(γ-aminobutyric acid,GABA),5-羟色胺(5-hydroxytryptamine,5-HT),多巴胺(dopamine,DA)]水平变化,不良反应发生情况。结果:观察组总有效率为92.5%(62/67),明显高于对照组的80.6%(54/67)(P<0.05)。两组治疗后PSQI中入睡时间、睡眠效率、睡眠质量等6个维度评分(除催眠药物维度外)及总分较本组治疗前均明显下降(P<0.05),且观察组治疗后PSQI中各维度(入睡时间、睡眠效率、催眠药物等)评分及总分较对照组同期均明显降低(P<0.05)。与本组治疗前对比,两组治疗后血清Glu,DA浓度均明显减少(P<0.05),血清GABA,5-HT含量均明显升高(P<0.05);且观察组改善更明显(P<0.05)。观察组不良反应率与对照组比较差异无统计学意义。结论:阴虚火旺型更年期失眠应用桂枝甘草龙骨牡蛎汤加减治疗能明显提高患者睡眠质量,改善失眠症状,纠正神经递质代谢紊乱,疗效确切,患者耐受性较好。Objective: To explore the clinical efficiency of modified Guizhi Gancao Longgu Muli Tang in treating menopausal insomnia. Method: A total of 134 female cases with menopausal insomnia in our hospital from January 2016 to June 2018 were selected as research objectives and randomly divided into observation group( 67 cases) and control group( 67 cases). Oral zopiclone was provided to control group,and modified Guizhi Gancao Longgu Muli Tang combined with oral zopiclone was provided to observation group. All cases were treated for 4 weeks. The two groups’ clinical effects, sleep quality [pittsburgh sleep quality index( PSQI) score ],neurotransmitter [glutamate( Glu),γ-aminobutyric acid( GABA),5-hydroxytryptamine( 5-HT),dopamine( DA)]levels before and after treatment,as well as adverse reactions were compared. Result: Observation group’s overall effective rate was 92. 5%( 62/67),which was significantly higher than 80. 6%( 54/67) of control group( P<0. 05). Both groups’ scores and total scores of the six dimensions including sleep time,sleep efficiency and sleep quality in PSQI( except for the hypnotic drug dimension) after treatment were significantly lower than those before treatment( P <0. 05),and observation group’s scores and total scores of each dimension( like sleeping time,sleep efficiency,hypnotic drugs) in PSQI after treatment were significantly lower than those in control group( P< 0. 05). Compared with those before treatment,both groups’ serum Glu,DA levels decreases significantly( P< 0. 05),while serum GABA,5-HT levels increased significantly( P <0. 05),and observation group showed more significant improvement( P <0. 05). Observation group’s adverse reaction rate was lower than that of control group,with no statistically significant difference. Conclusion: Modified Guizhi Gancao Longgu Muli Tang can improve sleep quality,alleviate symptoms of insomnia,and correct neurotransmitter metabolic disorder for patients with menopausal insomnia,with an exact curative effect and a higher tolerance of pat

关 键 词：更年期失眠 桂枝甘草龙骨牡蛎汤加减 睡眠质量 神经递质 安全性 阴虚火旺型 

分 类 号：R22[医药卫生—中医基础理论] R242[医药卫生—中医学]