交泰丸方剂联合常规治疗对维持性血液透析失眠(心肾不交证)患者疗效及血清TNF⁃α、BDNF的影响  

Effect of Jiaotai Pill Prescription Combined with Routine Treatment on Maintenance Hemodialysis Insomnia(Heart and Kidney Failure Syndrome)in Patients and its Influence on Serum TNF⁃αand BDNF

作　　者：熊玮[1] 高智[1] 王建华[1] 彭斌[1] 李敏[2] Xiong Wei;Gao Zhi;Wang Jianhua;Peng Bin;Li Min(Department of Nephrology,Wuhan Hospital of Traditional Chinese Medicine,Wuhan 430014,China;Department of Cardiology,Wuhan Hospital of Traditional Chinese Medicine,Wuhan 430014,China)

机构地区：[1]武汉市中医医院肾内科,武汉430014 [2]武汉市中医医院心内科,武汉430014

出　　处：《药物流行病学杂志》2022年第12期799-802,共4页Chinese Journal of Pharmacoepidemiology

基　　金：武汉市医学科研项目(编号:WZ20C16)。

摘　　要：目的:观察交泰丸方剂联合西药常规治疗对维持性血液透析失眠(心肾不交证)患者的疗效,及对血清肿瘤坏死因子(TNF⁃α)、脑源性神经营养因子(BDNF)表达的影响。方法:60例维持性血液透析治疗的失眠(心肾不交证)患者随机分为常规组和中药组各30例。常规组患者给予常规血液透析及抗失眠治疗,中药组患者在常规组基础上加用交泰丸方剂治疗。4周后比较两组患者的失眠疗效、药品不良反应,以及治疗前后睡眠质量[匹兹堡睡眠质量指数量表(PSQI)]、血清TNF⁃α、BDNF水平和中医证候积分变化。结果:中药组失眠总有效率为90.00%,明显高于常规组的66.67%(P<0.05)。治疗后,两组PSQI评分、血清TNF⁃α水平及中医证候积分均较前明显降低,而血清BDNF水平则较前明显升高(P<0.05);且中药组各项指标均明显优于常规组(P<0.05)。两组患者均未见明显不良反应发生。结论:交泰丸方剂联合西药常规治疗维持性血液透析失眠(心肾不交证),可有效改善失眠状态及临床症状,降低血清TNF⁃α水平,提高血清、BDNF水平,优于单纯西药治疗,且安全有效。Objective:To observe the curative effect of Jiaotai pill prescription combined with conventional West⁃ern medicine treatment in maintenance hemodialysis insomnia patients(heart and kidney failure),and its influence on the expression of serum tumor necrosis factor(TNF⁃α)and brain⁃derived neurotrophic factor(BDNF).Methods:Totally 60 patients with insomnia(heart⁃kidney disobedience)treated with maintenance hemodialysis were randomly divided into rou⁃tine group and traditional Chinese medicine group with 30 cases in each.The patients in the routine group were given con⁃ventional hemodialysis and anti⁃insomnia treatment,and those in the traditional Chinese medicine group were treated with Jiaotai pill prescription on the basis of the routine group.After four weeks treatment,the efficacy of insomina,adverse reac⁃tions of the two groups,and the sleep quality[Pittsburgh Sleep Quality Index(PSQI)],levels of serum TNF⁃αand BD⁃NF,and TCM syndrome score before and after treatment were compared.Results:The total effective rate of insomnia in the traditional Chinese medicine group was 90.00%,which was obviously higher than that(66.67%)in the routine group(P<0.05).After treatment,the scores of PSQI,PHQ⁃9 and SDS,serum level of TNF⁃α,and TCM syndrome scores in the two groups were obviously reduced than those before treatment(P<0.05),and the serum level of BDNF in the two groups was obviously increased(P<0.05);and all the indicators in the traditional Chinese medicine group were significantly better than those in the routine group(P<0.05).There were no obvious adverse reactions in the two groups during the treatment.Con⁃clusion:Jiaotai pill prescription combined with conventional Western medicine in the treatment of maintenance hemodialy⁃sis insomnia(heart and kidney discord)can effectively improve insomnia state and clinical symptoms,significantly reduce serum levels of TNF⁃αand improve serum levels of BDNF.It is safe and effective in the combination with Western medicine treatment.

关 键 词：交泰丸方剂 维持性血液透析 失眠 心肾不交证 艾司西酞普兰 

分 类 号：R289[医药卫生—方剂学]