加味温胆汤治疗痰湿内阻型失眠症疗效观察及对血清5-HT、Glu水平的影响  

Curative Effect of Modified Wendan Decoction for Insomnia of Internal Obstruction of Phlegm-Damp Type and Its Effect on Levels of 5-HT and Glu in Serum

作　　者：沈顶茂 何月敏 SHEN Dingmao;HE Yuemin(Shaoxing 7th People's Hospital,Shaoxing Zhejiang 312000,China)

机构地区：[1]绍兴市第七人民医院,浙江绍兴312000

出　　处：《新中医》2024年第15期13-18,共6页New Chinese Medicine

摘　　要：目的:观察加味温胆汤治疗痰湿内阻型失眠症的疗效及对血清5-羟色胺(5-HT)、谷氨酸(Glu)水平的影响。方法:将100例失眠症患者用随机数字表法分为西药组和中药组各50例。西药组给予艾司唑仑片治疗,中药组给予加味温胆汤治疗。比较2组临床疗效及不良反应,并比较2组治疗前后中医证候积分、匹兹堡睡眠质量指数(PSQI)评分及血清5-HT、多巴胺(DA)、Glu水平。结果:中药组总有效率88.00%,高于西药组72.00%(P<0.05)。治疗后,2组睡眠不安、心烦懊、胸闷、脘痞、痰多、头晕、目眩、口苦等中医证候积分均降低(P<0.05),且中药组均低于西药组(P<0.05)。治疗后,2组睡眠时间、睡眠质量、睡眠障碍、入睡时间、日间功能障碍、睡眠效率、睡眠药物等PSQI评分均降低(P<0.05),且中药组均低于西药组(P<0.05)。治疗后,2组血清5-HT、Glu水平均升高(P<0.05),且中药组高于西药组(P<0.05),2组血清DA水平均降低(P<0.05),且中药组低于西药组(P<0.05)。中药组不良反应发生率6.00%,低于西药组20.00%(P<0.05)。结论:加味温胆汤治疗痰湿内阻型失眠症的效果理想,可有效缓解临床症状,提高睡眠质量,调节血清5-HT、Glu水平,降低不良反应。Objective:To observe the therapeutic effect of modified Wendan Decoction on insomnia of internal obstruction of phlegm-damp type and its effect on the levels of 5-hydroxytryptamine(5-HT)and glutamic acid(Glu)in serum.Methods:A total of 100 cases of patients with insomnia were divided into the western medicine group and the Chinese medicine group according to the random number table method,with 50 cases in each group.The western medicine group was treated with Esazolam Tablets,and the Chinese medicine group was treated with modified Wendan Decoction.The clinical effects and adverse reactions were compared between the two groups;the traditional Chinese medicine(TCM)syndrome scores,Pittsburgh Sleep Quality Index(PSQI)scores and the levels of 5-HT,dopamine(DA)and Glu in serum before and after treatment were compared between the two groups. Results: The total effectiverate was 88.00% in the Chinese medicine group,higher than that of 72.00% in the western medicine group(P<0.05). After treatment, the scores of TCM syndromes such as sleep disturbance, vexation, chestoppression,gastric stuffiness,excessive phlegm,dizziness,vertigo,and bitter taste in the mouth wereall decreased in the two groups (P<0.05),and the above scores in the Chinese medicine group were lowerthan those in the western medicine group (P<0.05). After treatment, the scores of PSQI such as sleeptime,sleep quality,sleep disturbance,time for falling asleep,daytime dysfunction,sleep efficiency andsleep medication were all decreased in the two groups (P<0.05), and the above scores in the Chinesemedicine group were lower than those in the western medicine group (P<0.05). After treatment,the levelsof 5-HT and Glu in serum in the two groups were elevated (P<0.05), and the levels in the Chinesemedicine group were higher than those in the western medicine group (P<0.05);the DA levels in the twogroups were decreased (P<0.05),and the level in the Chinese medicine group was lower than that in thewestern medicine group (P<0.05). The incidence of adverse reactions was

关 键 词：失眠症 痰湿内阻型 温胆汤 5-羟色胺 谷氨酸 中医证候积分 睡眠质量 

分 类 号：R256.23[医药卫生—中医内科学]