枣仁归脾二花汤联合失眠三针治疗脑梗死后痰热内扰型失眠症效果观察  

Clinical effects of the Zaoren Guipi Erhua decoction plus acupuncture on insomnia of the internal phlegm-heat disturbance type after cerebral infarction

作　　者：韦文婕 吴迪 WEI Wenjie

机构地区：[1]武汉市武东医院,湖北武汉430084

出　　处：《中医临床研究》2022年第1期75-79,共5页Clinical Journal Of Chinese Medicine

摘　　要：目的:观察枣仁归脾二花汤联合失眠三针治疗脑梗死后痰热内扰型失眠症的临床效果。方法:以武汉市武东医院2018年1月-2019年12月收治的80例脑梗死后痰热内扰型失眠症患者为研究对象,采用随机数字表法均分为两组,各40例。对照组采用常规西医治疗,观察组联用枣仁归脾二花汤合失眠三针治疗,比较两组治疗效果。结果:观察组治疗有效率显著高于对照组(P <0.05);两组治疗后各中医证候积分均较治疗前降低(P <0.05),观察组治疗后痰多胸闷、嗳气、目眩恶心、心烦口苦、舌苔黄腻以及不寐头重等证候积分均低于对照组(P <0.05);两组治疗后匹兹堡睡眠质量指数量表(Pittsburgh Sleep Quality Index,PSQI)评分均显著降低,且观察组治疗后PSQI总分及各因子评分与对照组比较,P <0.05;观察组治疗后多巴胺及5-羟色胺水平均高于对照组,P <0.05;经治疗两组椎动脉血流速度及基底动脉血流速度均有所改善,但观察组脑血流速度增快显著优于对照组,P <0.05;观察组不良反应发生率明显低于对照组,且3个月复发率明显少于对照组,P <0.05。结论:枣仁归脾二花汤与失眠三针联合应用,可显著改善脑梗死后痰热内扰型失眠症患者的多巴胺、5-羟色胺水平,增强脑血流速度,提升患者的睡眠质量,临床疗效显著。Objective:To observe clinical effects of the Zaoren Guipi Erhua decoction(枣仁归脾二花汤)plus acupuncture on insomnia of the internal phlegm-heat disturbance type after cerebral infarction.Methods:80 cases from January 2018 to December 2019 were selected as the research objects,and were divided into two groups according to the random number table method,40 cases in each.The control group was treated with conventional Western medicine,and the observation group was treated with the Zaoren Guipi Erhua decoction plus acupuncture for insomnia more.Results:The total efficiency in the observation group was significantly higher than that in the control group(P<0.05).The total TCM syndrome scores in the two groups after treatment were lower than before treatment(P<0.05).The scores of syndromes such as excessive phlegm and chest tightness,belching,dizziness and nausea,upset and bitter mouth,yellow and greasy tongue coating,and insomnia in the observation group were lower than the control group(P<0.05).PSQI scores in the two groups after treatment were significantly lower than before treatment.The total PSQI scores and the score of each factor were compared with those in the control group,P<0.05.Dopamine and 5-HT levels in the observation group after treatment were higher than the control group,P<0.05.After treatment,the vertebral artery blood flow velocity and basilar artery blood flow velocity were improved in the two groups,but the increase of cerebral blood flow velocity in the observation group was significantly better than the control group,P<0.05.The adverse reaction in the observation group was significantly lower than the control group,and the 3-month recurrence in the observation group was significantly lower than the control group,P<0.05.Conclusion:The Zaoren Guipi Erhua decoction plus acupuncture can significantly improve the levels of dopamine and 5-HT in patients with insomnia of the internal phlegm-heat disturbance type after cerebral infarction,enhance cerebral blood flow,and improve the quality of sl

关 键 词：脑梗死 枣仁归脾二花汤 失眠三针 痰热内扰型 失眠症 

分 类 号：R256.23[医药卫生—中医内科学]