栀子豉汤加味联合盐酸曲唑酮治疗热郁胸膈型焦虑性失眠临床观察  

Clinical Effect of Jiawei Zhizichi Decoction Combined with Trazodone in Treatment of Anxiety Insomnia with the Syndrome of Heat Depression in Chest and Diaphragm

作　　者：耿伟富 苏镇红 司佳佳 曹仕健[2] GENG Weifu;SU Zhenhong;SI Jiajia;CAO Shijian(The First Clinical Medical College of Anhui University of Chinese Medicine,Anhui Hefei 230031,China;The First Affiliated Hospital of Anhui University of Chinese Medicine,Anhui Hefei 230031,China)

机构地区：[1]安徽中医药大学第一临床医学院,安徽合肥230031 [2]安徽中医药大学第一附属医院,安徽合肥230031

出　　处：《安徽中医药大学学报》2025年第1期32-36,共5页Journal of Anhui University of Chinese Medicine

基　　金：安徽省红十字会中医药传承创新发展研究项目(2022ZYYD06)。

摘　　要：目的观察栀子豉汤加味联合盐酸曲唑酮治疗热郁胸膈型焦虑性失眠的临床疗效。方法将60例热郁胸膈型焦虑性失眠患者随机分为对照组与观察组,每组30例。对照组患者接受盐酸曲唑酮治疗,观察组患者在对照组治疗基础上再服用加味栀子豉汤,两组疗程均为4周。采用匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)和中医症状积分评价睡眠质量和热郁胸膈证候,采用汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)评价焦虑程度,采用多导睡眠监测参数客观评价睡眠质量,并综合评价焦虑和失眠的临床疗效,监测两组治疗方法的安全性。结果在降低PSQI、HAMA评分和入睡困难、躁扰不宁、五心烦热、多梦易醒、胸不任物积分和中医症状总积分,减少觉醒次数,减少非快动眼睡眠期N1、N2期比例,缩短睡眠潜伏期,以及增加非快动眼睡眠期N3期比例和快动眼睡眠期比例,延长睡眠总时间,提高睡眠效率方面,观察组均显著优于对照组(P<0.05)。观察组临床疗效显著优于对照组(P<0.05)。两组均未出现明显不良反应。结论栀子豉汤加味联合盐酸曲唑酮治疗热郁胸膈型焦虑性失眠的疗效显著,能有效缓解焦虑情绪,提高睡眠质量,且安全性高。Objective To investigate the clinical effect of Jiawei Zhizichi Decoction combined with trazodone hydrochloride in the treatment of anxiety insomnia with the syndrome of heat depression in chest and diaphragm.Methods A total of 60 patients with anxiety insomnia with the syndrome of heat depression in chest and diaphragm were randomly divided into control group and observation group,with 30 patients in each group.The patients in the control group were given trazodone hydrochloride,while those in the observation group were given Jiawei Zhizichi Decoction in addition to the treatment in the control group;the course of treatment was 4 weeks for both groups.Pittsburgh Sleep Quality Index(PSQI)and traditional Chinese medicine(TCM)symptom score were used to evaluate sleep quality and the syndrome of heat depression in chest and diaphragm;Hamilton Anxiety Scale(HAMA)was used to evaluate the degree of anxiety;polysomnography was used to measure related parameters and assess sleep quality objectively.The treatment outcomes of anxiety and insomnia were evaluated,and the safety of treatment methods was monitored for both groups.Results Compared with the control group,the observation group had significantly better results in reducing PSQI and HAMA scores,total TCM symptom score,and the scores of difficulty falling asleep,restlessness,dysphoria with feverish sensation in chest,palms and soles,dreaminess and easy awakening,and chest discomfort,decreasing the number of awakenings,the percentage of N1 and N2 stages of non-rapid eye movement,and sleep latency,and increasing the percentage of N3 stage of non-rapid eye movement,the percentage of rapid eye movement,total sleep time,and sleep efficiency(P<0.05).The observation group had a significantly better clinical outcome than the control group(P<0.05).No obvious adverse reaction was observed in either group.Conclusion Jiawei Zhizichi Decoction combined with trazodone hydrochloride has a marked clinical effect in the treatment of anxiety insomnia with the syndrome of heat depressi

关 键 词：焦虑性失眠 栀子豉汤 曲唑酮 热郁胸膈 多导睡眠监测 

分 类 号：R256.23[医药卫生—中医内科学]