归脾汤加减联合穴位贴敷治疗心脾两虚型老年失眠的疗效及对血清25-羟维生素D_(3)水平的影响  

Clinical efficacy of modified Guipi Decoction with point application for senile insomnia of heart-spleen deficiency and its relationship between serum 25-hydroxyvitamin D_(3)

作　　者：董燕萍[1] 李欣[1] 鲍晓敏[1] DONG Yanping;LI Xin;BAO Xiaomin(Department of Geriatrics,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院老年病科,上海200437

出　　处：《河北中医》2021年第12期1965-1968,共4页Hebei Journal of Traditional Chinese Medicine

基　　金：上海市卫生和计划生育委员会中医药科研课题(编号:2018LP028)。

摘　　要：目的观察归脾汤加减联合穴位贴敷治疗心脾两虚型老年失眠的临床疗效及对血清25-羟维生素D_(3)水平的影响。方法将63例心脾两虚型老年失眠患者按照随机数字表法分为2组,对照组31例予归脾汤加减治疗,治疗组32例予归脾汤加减联合穴位贴敷治疗。2组均治疗4周后统计疗效,比较2组治疗前后匹兹堡睡眠质量指数(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、日间功能障碍)、血清25-羟维生素D_(3)水平变化情况。结果治疗组总有效率87.50%(28/32),对照组总有效率61.29%(19/31),治疗组疗效优于对照组(P<0.05)。治疗组治疗后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总分较本组治疗前均下降(P<0.05),对照组治疗后除睡眠障碍评分外,其余各项评分及总分较本组治疗前均下降(P<0.05),且治疗组治疗后PSQI入睡时间、睡眠时间、睡眠效率、日间功能障碍评分及总分均低于对照组(P<0.05)。2组治疗后血清25-羟维生素D_(3)水平与本组治疗前比较均升高(P<0.05),但2组治疗后组间比较差异无统计学意义(P>0.05)。结论归脾汤加减联合穴位敷贴治疗心脾两虚型老年失眠疗效确切,可明显减少患者入睡时间,延长睡眠时间,提高睡眠效率,改善日间功能障碍,增加血清25-羟维生素D_(3)水平。Objective To observe the clinical efficacy of modified Guipi Decoction combined with point application for senile insomnia(heart-spleen deficiency)and its relationship between serum 25-hydroxyvitamin D_(3)[25(OH)D_(3)].Methods Totally 63 patients with senile insomnia(heart-spleen deficiency)were randomly assigned into treatment group(n=32)and control group(n=31),patients in treatment group were treated with modified Guipi Decoction with point application,and patients in control group only with modified Guipi Decoction.A 4-week treatment was performed,pittsburgh sleep quality index(PSQI)(sleep quality,fall asleep time,sleep time,sleep efficiency,sleep disorders,daytime dysfunction),25(OH)D_(3) were included as comparators;the curative effect was counted.Results The overall effective rate in treatment group was better than that in control group[87.50%(28/32)vs 61.29%(19/31),(P<0.05),respectively].After treatment,reduced PSQI scores in treatment group were found(P<0.05),decreased PSQI scores except for sleep disorders score in control group were recorded(P<0.05),PSQI scores(fall asleep time,sleep time,sleep efficiency,daytime dysfunction)were lower in treatment group in comparison with control group(P<0.05).25(OH)D_(3) in groups was higher after treatment than that before treatment(P<0.05),but no statistically significant differences were found between groups(P>0.05).Conclusion For patients with senile insomnia(heart-spleen deficiency),modified Guipi Decoction combined with point application has a definite curative effect,which is significantly capable of reducing fall asleep time,prolonging sleep time,improving sleep efficiency and daytime dysfunction,and increasing 25(OH)D_(3).

关 键 词：入睡和睡眠障碍 穴位贴敷法 归脾汤 老年失眠 维生素D 

分 类 号：R256.23[医药卫生—中医内科学]