血府逐瘀汤治疗早醒型失眠患者的临床效果及其对脑血流动力学的影响  

Clinical effect of Xuefu Zhuyu Decoction in treating patients with early awakening type insomnia and its effect on cerebral haemodynamics

作　　者：郭冬丽 刘霁 温林杰 孙鸿运 周哲屹 GUO Dongli;LIU Ji;WEN Linjie;SUN Hongyun;ZHOU Zheyi(Department of Neurology,Liuzhou Traditional Chinese Medicine Hospital,Guangxi Zhuang Autonomous Region,Liuzhou545001,China;Graduate School,Guangxi University of Chinese Medicine,Guangxi Zhuang Autonomous Region,Nanning530000,China)

机构地区：[1]广西壮族自治区柳州市中医医院神经内科,广西柳州545001 [2]广西中医药大学研究生院,广西南宁530000

出　　处：《中国医药导报》2024年第21期86-90,100,共6页China Medical Herald

基　　金：国家自然科学基金资助项目(82060905);广西壮族自治区柳州市科技计划项目(2021CBC0134)。

摘　　要：目的观察血府逐瘀汤治疗早醒型失眠患者的临床效果及其对脑血流动力学影响。方法选取2021年5月至2023年5月广西壮族自治区柳州市中医医院就诊的失眠患者60例,按照随机数字表法分为治疗组和对照组,每组30例。治疗组口服血府逐瘀汤治疗2周,对照组口服阿普唑仑片治疗2周。比较两组治疗前后匹兹堡睡眠质量指数(PSQI)、失眠严重程度指数(ISI)、睡眠障碍的信念和态度量表(DBAS)评分,采用经颅彩色多普勒超声观察两组治疗前后椎基底动脉血流速度变化,同时比较两组临床疗效。结果治疗后,两组睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、日间功能、总分低于治疗前,且治疗组睡眠质量、睡眠时间、睡眠效率、日间功能、总分低于对照组(P<0.05)。治疗后,两组ISI评分均较治疗前降低,且治疗组低于对照组(P<0.05)。治疗后,两组失眠后果估计、失眠担忧、睡眠期望、药物依赖、总分高于治疗前,且治疗组失眠后果估计、失眠担忧、总分高于对照组(P<0.05)。治疗后,两组椎动脉收缩期峰流速、基底动脉收缩期峰流速、椎动脉平均血流速度、基底动脉平均血流速度均较治疗前升高,且治疗组椎动脉收缩期峰流速、基底动脉收缩期峰流速高于对照组(P<0.05)。两组临床疗效比较,差异无统计学意义(P>0.05)。结论对于早醒型失眠的患者,血府逐瘀汤可有效改善患者睡眠质量、减轻伴随症状、提升日间功能,及减轻失眠恐惧和担心,同时能有效改善患者脑血流动力情况。Objective To observe the clinical effect of Xuefu Zhuyu Decoction in treating patients with early awakening type insomnia and its effect on cerebral haemodynamics. Methods Sixty insomnia patients treated in Liuzhou Traditional Chinese Medicine Hospital, Guangxi Zhuang Autonomous Region from May 2021 to May 2023 were selected and they were divided into treatment group and control group according to random number table method, with 30 cases in each group. The treatment group was treated with Xuefu Zhuyu Decoction for two weeks, and the control group was treated with Alprazolam Tablets for two weeks. Pittsburgh sleep quality index (PSQI), insomnia severity index (ISI), and dysfunctional beliefs and attitudes about sleep (DBAS) scores of the two groups were compared before and after treatment. Transcranial colour Doppler ultrasound was used to observe the changes in the blood flow velocity of vertebrobasilar artery before and after treatment in the two groups, and and the clinical effects of the two groups at the same time were compared. Results After treatment, sleep quality, time to fall asleep, sleep duration, sleep efficiency, sleep disturbance, daytime functioning, and total scores were lower in both groups than before treatment, and sleep quality, sleep duration, sleep efficiency, daytime functioning, and total scores were lower in the treatment group than in the control group (P<0.05). After treatment, the ISI scores of both groups decreased compared with those before treatment, and the scores of the treatment group were lower than those of the control group (P<0.05). After treatment, the estimated consequences of insomnia, insomnia worry, sleep expectancy, drug dependence, and total scores of both groups were higher than those before treatment, and the estimated consequences of insomnia, insomnia worry, and total scores of the treatment group were higher than those of the control group (P<0.05). After treatment, vertebral artery systolic peak flow velocity, basilar artery systolic peak flow velocity, vertebra

关 键 词：失眠 六经病欲解时 血府逐瘀汤 经颅多普勒 阿普唑仑 

分 类 号：R74[医药卫生—神经病学与精神病学]