柴胡加龙骨牡蛎汤治疗失眠伴抑郁焦虑患者的疗效观察  

Observation on the Efficacy of Chaihu Longgu Muli Decoction in Treating Patients with Insomnia Accompanied by Depression and Anxiety

作　　者：焦秀清 代升平 孟焱 段红艳[3] JIAO Xiu-qing;DAI Sheng-ping;MENG Yan;DUAN Hong-yan(International Medical Center,Henan Provincial People's Hospital,Zhengzhou 450003,China;Second Department of Cardiovascular Medicine,Henan Integrated Traditional Chinese and Western Medicine Hospital,Zhengzhou 450003,China;Department of Geriatrics,Henan Provincial People's Hospital,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院国际医疗中心,郑州450003 [2]河南省中西医结合医院心血管内二科,郑州450003 [3]河南省人民医院老年病科,郑州450003

出　　处：《中国合理用药探索》2025年第2期99-104,共6页Chinese Journal of Rational Drug Use

摘　　要：目的:探讨柴胡加龙骨牡蛎汤治疗失眠伴抑郁焦虑患者的临床疗效。方法:选取2023年11月1日~2024年3月31日期间于我院和河南省中西医结合医院诊治的75例失眠伴焦虑抑郁患者作为研究对象,采用随机数字表法分为对照组(脱落2例,n=36)和观察组(脱落2例,n=35)。对照组患者给予右佐匹克隆片联合盐酸曲唑酮片治疗,观察组患者在对照组治疗基础上给予柴胡加龙骨牡蛎汤治疗,两组均治疗4周。比较两组匹兹堡睡眠质量指数(PSQI)量表、失眠严重指数(ISI)量表、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评分、临床疗效及不良反应发生情况。结果:治疗2周、4周时,两组患者PSQI和ISI评分均降低(P<0.05),且观察组治疗4周时PSQI和ISI评分均低于对照组(P<0.05)。两组患者治疗4周时HAMD和HAMA评分均降低(P<0.05);观察组治疗2周、4周时HAMD和HAMA评分均低于对照组(P<0.05)。观察组患者治疗总有效率(91.43%)高于对照组(77.78%,P<0.05)。两组患者不良反应总发生率比较无统计学差异(χ^(2)=2.129,P=0.145>0.05)。结论:在西药治疗基础上联用柴胡加龙骨牡蛎汤治疗失眠伴抑郁焦虑患者临床疗效较佳,可显著改善患者失眠程度、睡眠质量、抑郁焦虑症状,且不会增加不良反应的发生风险。Objective:To investigate the clinical efficacy of Chaihu Longgu Muli decoction in treating patients with insomnia accompanied by depression and anxiety.Methods:A total of 75 patients with insomnia accompanied by depression and anxiety treated in our hospital and Henan Integrative Medicine Hospital from November 1,2023 to March 31,2024 were selected and assigned to the control group(2 dropouts,n=36)and observation group(2 dropouts,n=35)by random number table method.The control group was treated with dexzopiclone tablets combined with trazodone hydrochloride tablets,and the observation group was treated with Chaihu Longgu Muli decoction in addition to the treatment given in the control group.Both groups were treated for 4 weeks.The scores of Pittsburgh sleep quality index(PSQI)scale,insomnia severity index(ISI)scale,Hamilton depression scale(HAMD)and Hamilton anxiety scale(HAMA),clinical efficacy and adverse reactions were compared between the two groups.Results:After 2 and 4 weeks of treatment,the scores of PSQI and ISI were decreased in both groups(P<0.05).The scores of PSQI and ISI in the observation group were lower than those in the control group after 4 weeks of treatment(P<0.05).The scores of HAMD and HAMA were decreased in both groups after 4 weeks of treatment(P<0.05),and the scores of HAMD and HAMA in the observation group were lower than those in the control group after 2 and 4 weeks of treatment(P<0.05).The total effective rate in the observation group(91.43%)was higher than that in the control group(77.78%,P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups(χ^(2)=2.129,P=0.145>0.05).Conclusion:Chaihu Longgu Muli decoction combined with conventional western medicine shows better clinical efficacy in treating patients with insomnia accompanied by depression and anxiety,significantly improving the severity of insomnia,sleep quality and symptoms of depression and anxiety,without increasing the risk of adverse reactions.

关 键 词：柴胡加龙骨牡蛎汤 失眠伴抑郁焦虑 临床疗效 睡眠障碍量表 焦虑抑郁量表 

分 类 号：R256.23[医药卫生—中医内科学]