育阴宁神汤对老年脑卒中后睡眠障碍患者睡眠质量及康复效果的影响  

Efficacy of the Yuyin Ningshen decoction on sleep quality and rehabilitation in elderly patients with post-stroke sleep disorder

作　　者：尤峰[1] You Feng

机构地区：[1]江苏省中医院,江苏南京210029

出　　处：《中医临床研究》2020年第16期87-91,共5页Clinical Journal Of Chinese Medicine

摘　　要：目的:探讨育阴宁神汤对老年脑卒中后睡眠障碍(Post-Stroke Sleep Disorder,PSSD)患者睡眠质量及康复效果的影响。方法:随机将98例老年PSSD患者均分为对照组和观察组,各49例,对照组给予心理疗法干预睡眠,观察组在以上用药基础上给予育阴宁神汤治疗,观察两组治疗前及治疗4周后中医症状积分,评估两组中医证候疗效,对比两组治疗前及治疗4周后的睡眠质量、睡眠进程、睡眠结构、血清相关神经递质指标、神经功能缺损改善情况及日常生活能力。结果:治疗后,两组各中医症状积分及总和显著低于治疗前(P<0.05),且观察组显著低于对照组(P<0.05),观察组中医证候总有效率显著高于对照组(P<0.05)。两组患者的匹兹堡睡眠质量指数评定量表(Pittsburgh Sleep Quality Index,PSQI)中各项及总分评分显著降低(P<0.05),观察组下降幅度显著大于对照组(P<0.05)。两组睡眠进程指标中睡眠潜伏期(Sleep Latency,SL)显著缩短(P<0.05),总睡眠时间(TST)显著延长(P<0.05),觉醒次数(AT)显著减少(P<0.05),观察组的睡眠结构指标中的非快眼动相(nREM)S1期显著缩短(P<0.05),S2、S3及S4期显著延长(P<0.05),快动眼相(REM)睡眠时间占比显著增加(P<0.05),以上指标观察组变化幅度显著大于对照组(P<0.05)。两组中国卒中量表(CSS)评分显著降低(P<0.05),改良Bathel量表(MBI)评分显著增加(P<0.05),两组血清5-羟色胺(5-HT)水平显著升高(P<0.05),P物质(SP)水平显著下降(P<0.05),观察组变化幅度显著大于对照组(P<0.05);结论:育阴宁神汤治疗老年PSSD患者的睡眠障碍效果满意,可有效改善患者的睡眠质量,降低神经系统兴奋性,有助于其神经功能缺损康复和日常生活能力提高。Objective:To explore the effects of Yuyin Ningshen decoction(育阴宁神汤)on sleep quality and rehabilitation effects of elderly patients with PSSD.Methods:98 elderly patients were randomly divided into two groups,with 49 cases in each.The control group was treated with psychotherapy for sleep intervention,and the observation group was given Yuyin Ningshen decotion more.Results:After treatment,the scores of TCM symptoms were significantly lower than before treatment(P<0.05),and the scores in observation group were significantly lower than those in the control group(P<0.05).The total efficiency of TCM syndromes in observation group was significantly higher than the control group(P<0.05).The scores of PSQI were significantly decreased in groups(P<0.05),and the decreases in the observation group were significantly greater than the control group(P<0.05).The sleep process index of SL was significantly shortened(P<0.05),the TST was significantly prolonged(P<0.05),and the AT was significantly decreased(P<0.05),and the nREM of S1 phase was significantly shortened(P<0.05),while the S2,S3 and S4 phases were significantly prolonged(P<0.05),and the REM sleep time was significantly increased(P<0.05),and the changes in observation group were significantly greater than those in the control group(P<0.05).The CSS score in the two groups was significantly decreased(P<0.05),the MBI score was significantly increased(P<0.05),serum 5-HT level in the two groups was significantly increased(P<0.05),SP level was significantly decreased(P<0.05),and the changes in the observation group were significantly larger than those in the control group(P<0.05).Conclusion:The Yuyin Ningshen decoction shows satisfactory effects on sleep disorder in elderly patients with PSSD,and can effectively improve the sleep quality,and reduce the excitability of nervous system,and promote the neurologic impairment rehabilitation and daily living ability.

关 键 词：老年脑卒中后睡眠障碍 育阴宁神汤 睡眠质量 康复效果 

分 类 号：R743.33[医药卫生—神经病学与精神病学]