安尔眠膏汤联合右佐匹克隆片治疗慢性失眠症心肾不交型临床研究  

Clinical study on the treatment of chronic insomnia of heart-kidney disharmony type with An’ ermian cream decoction and dexzopiclone tablet

作　　者：郑艳[1] 崔春丽[1] 顾锡镇[1] ZHENG Yan;CUI Chunli;GU Xizhen(Department of Neurology,Affiliated Hospital of Nanjing University of Traditional Chinese Medicine,Jiangsu,Nanjing 210029)

机构地区：[1]南京中医药大学附属医院神经内科

出　　处：《河北中医》2019年第11期1685-1690,共6页Hebei Journal of Traditional Chinese Medicine

基　　金：第二批江苏省名老中医药专家传承工作室建设项目

摘　　要：目的观察安尔眠膏汤联合右佐匹克隆片治疗慢性失眠症心肾不交型的临床疗效。方法将108例慢性失眠症心肾不交型患者按随机数字表法分为2组。对照组54例予右佐匹克隆片治疗;治疗组54例在对照组基础上加用安尔眠膏汤治疗。2组均治疗30 d后统计疗效,比较2组治疗前后匹兹堡睡眠质量指数量表(PSQI)评分(包括睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍及日间功能障碍)、汉密尔顿焦虑量表(HAMA)评分及汉密尔顿抑郁量表(HAMD)评分变化情况,比较2组治疗前后多导睡眠图(PSG)检测变化情况,包括睡眠进程指标睡眠潜伏期(SL)、觉醒次数(AT)、觉醒时间(AWT)、快速眼球运动睡眠(REM)潜伏期(RL)及睡眠效率(SE)情况,以及睡眠结构指标非快速眼球运动睡眠(NREM)(包括S1、S2及S3+S4期)及REM占整个睡眠时间的百分比。结果治疗组总有效率83.33%,对照组总有效率72.22%,治疗组疗效优于对照组(P<0.05)。2组治疗后PSQI睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、日间功能障碍评分及PSQI总分较本组治疗前均明显降低(P<0.05),且治疗组治疗后PSQI入睡时间、睡眠效率、睡眠障碍评分及PSQI总分均低于对照组(P<0.05)。2组治疗后HAMA评分及HAMD评分与本组治疗前比较均明显降低(P<0.05),且治疗组治疗后HAMA评分及HAMD评分均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后PSG睡眠进程指标SL、AT及AWT均明显降低(P<0.05),SE均明显升高(P<0.05),且治疗组治疗后PSG睡眠进程各指标改善均优于对照组(P<0.05)。与本组治疗前比较,2组治疗后PSG睡眠结构中S1期比例均降低(P<0.05),S2、S3+S4及REM期比例均升高(P<0.05),且治疗组治疗后对PSG睡眠结构中各指标改善均优于对照组(P<0.05)。结论安尔眠膏汤联合右佐匹克隆片治疗慢性失眠症心肾不交型临床疗效确切,可有效缓解患者焦虑、抑郁状态,提高睡眠质Objective To observe the effect of An’ermian cream decoction and dexzopiclone tablet in the treatment of chronic insomnia of heart-kidney disharmony type. Methods 108 cases with chronic insomnia were divided into two groups according to the random number table method. 54 cases in control group were treated by dexzopiclone tablet. 54 cases in treatment group were treated by An’ermian cream decoction on the basis of the control group. the therapeutic effect of the two groups were counted after 30 days of treatment. The changes of Pittsburgh sleep quality index scale(PSQI) scores(including sleep quality, sleep time, sleep latency,sleep efficiency, sleep disorder and daytime dysfunction), Hamilton anxiety acale(HAMA)scores and Hamilton depression scale(HAMD) scores before and after treatment were compared between the two groups. The changes of polysomnography(PSG) before and after treatment were compared between the two groups, including sleep process index sleep latency(SL), arousal times(AT), awakening time(AWT), rapid eye movement sleep(REM),latency(RL) and sleep efficiency(SE), sleep structure index non rapid eye movement sleep(NREM)(including S1, S2 and S3 + S4) and REM as a percentage of total sleep time. Results The total effective rate was 83.33 % in treatment group and 72.22 % in control group. The clinical curative effect of the treatment group was better than that of the control group(P<0.05). The scores of PSQI sleep quality, sleep time, sleep latency, sleep efficiency, sleep disorder, daytime dysfunction and the total score of PSQI in the two groups were significantly lower than those in the group before treatment(P<0.05), and the scores of PSQI sleep time, sleep efficiency, sleep disorder and PSQI in the treatment group were lower than those in the control group(P<0.05). After treatment, HAMA score and HAMD score of the two groups were significantly lower than that of the group before treatment(P<0.05), and the treatment group was lower than the control group(P<0.05). Compared with the group before

关 键 词：失眠症 心肾不交 中西医结合疗法 

分 类 号：R256.23[医药卫生—中医内科学] R338.63[医药卫生—中医学]