血府逐瘀汤用治顽固性失眠的研究进展  

Investigation of progress research on the Xuefu Zhuyu Decoction in treatment of intractable insomnia

作　　者：杜何樊 黄金元[2] DU Hefan;HUANG Jinyuan(Clinical College of Traditional Chinese Medicine,Hubei University of Traditional Chinese Medicine,Hubei Province,Wuhan 430071,China;Department of Treating Preventing Disease,Wuhan Hospital of Traditional Chinese Medicine,Hubei Province,Wuhan 430071,China)

机构地区：[1]湖北中医药大学中医临床学院,湖北武汉430071 [2]武汉市中医医院治未病科,湖北武汉430071

出　　处：《中国当代医药》2023年第15期28-33,共6页China Modern Medicine

摘　　要：顽固性失眠对人体和社会的危害深远,且发病率逐年升高,是当今社会亟待解决的重要问题。目前临床上多单独使用西药对其进行治疗,但会带来头昏、日间困倦、认知功能减退、肌张力降低、跌倒、反跳性失眠、戒断反应等副作用。近些年我国中医学界进一步论证了瘀血所致气血运行失常、脏腑功能错乱失用是顽固性失眠的主要病因,而血府逐瘀汤正可凭借行气活血化瘀功效,祛除瘀血之患,使人气血流畅、神有所养、寤寐正常。大量临床研究表明,顽固性失眠患者使用本方后匹兹堡睡眠质量指数(PSQI)明显降低,且不良反应罕见;患者应用本方联合中医外治疗法后PSQI各项得分及总分均优于单独应用本方;联合西药治疗可在中医证候积分及PSQI均明显下降的基础上提高西药减服率并降低成瘾性风险。相关实验显示,血府逐瘀汤治疗顽固性失眠的机制可能为上调神经递质γ-氨基丁酸(GABA)水平、抑制炎症细胞因子、提高机体一氧化氮(NO)表达水平等。针对血府逐瘀汤治疗顽固性失眠的应用现状,本文对近年来相关临床证据和理论、实验研究成果做一综述,旨在归纳、探讨本方在临床上取得疗效的理论依据,后续进一步深入探索其应用价值。Persistent insomnia has a far-reaching danger to the human body and society,and its incidence is increasing year by year,which becomes an important problem that needs to be solved in today's society.Currently,insomnia has mostly be treated with western medicine alone,but that bring many side effects such as dizziness,daytime sleepiness,cognitive impairment,muscle tone reduced,falls,rebound insomnia,and withdrawal reactions.In recent years,it has been further proven in Chinese medicine that the malfunction of qi and blood due to blood stasis and the malfunction of internal organs are the main causes of intractable insomnia.Just in time,Xuefu Zhuyu Decoction can eliminate the problem of blood stasis by promoting the flow of qi,activating blood circulation and eliminating blood stasis,so that people can have a smooth flow of qi and blood,the mind can be nourished,wake up and sleep normally.Numerous clinical studies have shown that the Pittsburgh sleep quality index(PSQI)of patients with persistent insomnia was significantly reduced after using this formula,and adverse reactions were rare,the PSQI scores and total scores of patients who applied this formula in combination with external Chinese medicine treatment were better than those of patients who applied this formula alone,the combination of western medicine treatment can improve the reduction rate of western medicine and reduce the PSQI on the basis of the significant reduction of both the Chinese medicine symptoms and the PSQI.The combination of western medicine treatment can improve the reduction rate of western medicine and reduce the risk of addiction.Related experiments have shown that the mechanism of Xuefu Zhuyu Decoction in the treatment of intractable insomnia may be the upregulation of the neurotransmitter gamma-aminobutyric acid(GABA)level,inhibition of inflammatory cytokines,and increase of nitric oxidation(NO)expression level in the body.This paper reviews the clinical evidence,theoretical and experimental research results in recent years,with the a

关 键 词：顽固性失眠 血瘀 血府逐瘀汤 药理作用 研究进展 

分 类 号：R256.23[医药卫生—中医内科学]