礞石滚痰汤加味联合唑吡坦治疗痰热内扰型失眠症临床研究  

Clinical Study on Modified Mengshi Guntan Tang Combined with Zolpidem for Insomnia of Phlegm-Heat Harassing the Interior Type

作　　者：应婉榕 YING Wanrong

机构地区：[1]浙江中医药大学,浙江杭州310053 [2]杭州市下城区中医院,浙江杭州310004

出　　处：《新中医》2022年第18期11-14,共4页New Chinese Medicine

摘　　要：目的:观察礞石滚痰汤加味联合唑吡坦治疗痰热内扰型失眠症的临床疗效及对患者认知功能的影响。方法:以随机数字表法将102例痰热内扰型失眠症患者分为对照组和观察组,每组51例。对照组予以唑吡坦治疗,观察组予以礞石滚痰汤加味联合唑吡坦治疗,2组均治疗4周。比较2组临床疗效、不良反应发生率,比较2组治疗前后多导睡眠监测指标、认知功能。结果:观察组总有效率92.16%,高于对照组76.47%(P<0.05)。治疗后,2组睡眠效率(SE)均较治疗前升高,睡眠总时间(TST)均较治疗前延长,睡眠潜伏期(SOL)均较治疗前缩短,觉醒次数(AT)均较治疗前减少,差异均有统计学意义(P<0.05);观察组SE高于对照组,TST长于对照组,SOL短对照组,AT少于对照组,差异均有统计学意义(P<0.05)。治疗后,2组简易智力状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)评分均较治疗前升高(P<0.05),观察组MMSE、MoCA评分均高于对照组(P<0.05)。观察组不良反应发生率5.88%,低于对照组19.61%(P<0.05)。结论:礞石滚痰汤加味联合唑吡坦治疗痰热内扰型失眠症效果确切,可明显改善患者的睡眠质量及认知功能,且安全性高。Objective:To observe the clinical effect of modified Mengshi Guntan tang combined with zolpidem for insomnia of phlegm-heat harassing the interior type and its effects on cognitive function.Methods:A total of 102 cases of patients with insomnia of phlegm-heat harassing the interior type were divided into the control group and the observation group according to the random number table method,with 51 cases in each group. The control group was treated with zolpidem,and the observation group was treated with modified Mengshi Guntan tang combined with zolpidem. Both groups were treated for four weeks. Clinical effects and the incidence of adverse reactions were compared between the two groups. The polysomnography monitoring indexes and cognitive function were compared between the two groups before and after treatment. Results:The total effective rate was 92.16% in the observation group,higher than that of 76.47% in the control group(P<0.05). After treatment,sleep efficiency(SE) in the two groups were increased when compared with those before treatment,total sleep time(TST) was prolonged,sleep onset latency(SOL) was shortened,and awakening times(AT) was decreased,differences being significant(P<0.05). SE in the observation group was higher than that in the control group,TST was longer,SOL was shorter, and AT was fewer, differences being significant(P<0.05). After treatment, scores of MiniMental State Exam(MMSE) and Montreal Cognitive Assessment(MoCA) in the two groups were increased when compared with those before treatment(P<0.05),and the two scores in the observation group were higher than those in the control group(P<0.05). The incidence of adverse reactions was 5.88% in the observation group, lower than that of 19.61% in the control group(P<0.05). Conclusion: Modified Mengshi Guntan tang combined with zolpidem has a defined effect in the treatment of insomnia of phlegmheat harassing the interior type,which can effectively improve sleep quality and cognitive function,with high safety.

关 键 词：失眠症 痰热内扰证 礞石滚痰汤 唑吡坦 多导睡眠监测 认知功能 不良反应 

分 类 号：R256.23[医药卫生—中医内科学]