加味连梅汤治疗不寐“热入厥阴证”的临床观察  

Clinical observation of modified Lianmei decoction in treating insomnia with“heat into Jueyin syndrome”

作　　者：郭玉梦 崔杨霖 隋晓琳[2] 刘红豆 孔雨晨 赵志鹏 王安逸 张宪忠[2] GUO Yumeng;CUI Yanglin;SUI Xiaolin;LIU Hongdou;KONG Yuchen;ZHAO Zhipeng;WANG Anyi;ZHANG Xianzhong

机构地区：[1]山东中医药大学,山东济南250355 [2]日照市中医医院,山东日照276800

出　　处：《中医临床研究》2024年第18期36-40,共5页Clinical Journal Of Chinese Medicine

基　　金：第七批全国老中医药专家学术经验继承工作项目:国中医人教函(2022)76号;日照市重点研发计划项目(公益性科技攻关):(2021ZDYF020213)。

摘　　要：目的:观察加味连梅汤治疗不寐“热入厥阴证”的临床疗效。方法:将68例辨证为热入厥阴证的不寐患者,采用随机数字表法分为对照组和观察组,每组34例。对照组每晚睡前口服艾司唑仑,每次1 mg,每日1次;观察组采用中西医结合疗法,在对照组治疗基础上口服加味连梅汤(黄连、生地黄、麦冬、乌梅、阿胶、酸枣仁、生龙骨、生牡蛎、肉桂),每日1剂,水煎至400 mL,早晚饭后温服。疗程均为4周。对观察组与对照组患者治疗前后的临床症状改善情况、中医证候积分、匹兹堡睡眠质量指数量表(Pittsburgh Sleep Quality Index,PSQI)评分等进行比较。结果:观察组治疗总有效率为91.2%(31/34),对照组治疗总有效率为70.6%(24/34),差异具有统计学意义(P<0.05);观察组经过治疗后,中医失眠证候积分较对照组明显降低(P<0.05),且观察组患者所涉及睡眠时间和质量、睡眠障碍情况、入睡时长、日间功能障碍、睡眠效率和促进睡眠药物使用情况的PSQI评分较对照组亦显著降低(P<0.05)。在治疗过程中未发现与加味连梅汤口服有关的不良反应。结论:加味连梅汤治疗不寐热入厥阴证具有确切疗效,可显著改善此类不寐患者的临床症状,如缩短入睡时间,并延长睡眠时间,从而提高患者生活质量。且不良反应发生率低,使用安全,适合临床推广。Objective:To observe the clinical effect of modified Lianmei decoction(加味连梅汤)in treating insomnia with“heat into Jueyin syndrome(热入厥阴证)”.Methods:68 cases of insomnia patients with“heat into Jueyin syndrome”were divided into the control group and the observation group by random number table method,with 34 cases in each group.The control group took estazolam 1mg/time,once/day before going to bed every night;The observation group was treated with integrated Chinese and western medicine,and on the basis of the treatment of the control group,modified Lianmei decoction[Huanglian(Coptis),Dihuang(Rehmannia),Dongmai(Ophiopogon),Wumei(plum),Ejiao,Suanzaoren(jujube kernel),Shenglomnggu(raw keel),Muli(raw oyster),Rougui(cinnamon)]was taken orally once a day,decocted in water to 400 mL,and taken warm in the morning and evening after meals.The course of treatment was 4 weeks.After 4 weeks,the improvement of clinical symptoms,TCM syndrome score,Pittsburgh Sleep Quality Index(PSQI)score before and after treatment were compared between the observation group and the control group.Results:The total effective rate was 91.2%(31/34)in the observation group and 70.6%(24/34)in the control group,the difference was statistically significant(P<0.05).After treatment,the TCM insomnia syndrome score of the observation group was significantly lower than that of the control group(P<0.05).The Pittsburgh Sleep Quality Index(PSQI)scores related to sleep duration and quality,sleep disorder,sleep duration,daytime dysfunction,sleep efficiency and use of sleep-promoting drugs in the observation group were also significantly lower than those in the control group(P<0.05).No adverse reactions related to oral administration of modified Lianmei decoction were found during the treatment.Conclusion:Modified Lianmei decoction has a definite effect on the treatment of insomnia with“heat into Jueyin syndrome”,which can significantly relieve the clinical symptoms of insomnia patients,such as shortening the time to fall asleep and

关 键 词：连梅汤 不寐 热入厥阴证 匹兹堡睡眠质量指数 

分 类 号：R256.23[医药卫生—中医内科学]