基于“形神并调”评价归脾汤对胃癌心脾两虚型患者合并睡眠障碍的疗效观察  

Evaluatation of the Therapeutic Effect of Guipi Decoction(归脾汤)on Sleep Disorders in Patients with Heart-Spleen Deficiency Type of Gastric Cancer Based on the Principle of“Regulating Form and Spirit”

作　　者：刘海涛 许雯 张璐 许萍 田建辉[3,4] LIU Haitao;XU Wen;ZHANG Lu;XU Ping;TIAN Jianhui(Jinshan District Integrative Medicine Hospital of Shanghai,Shanghai 201501,China;Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Jinshan Branch,Shanghai 201501,China;Shanghai Municipal Hospital of Traditional Chinese Medicine Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China;Institute of Oncology,Shanghai Municipal Hospital of Traditional Chinese Medicine,Shanghai 200071,China)

机构地区：[1]上海市金山区中西医结合医院,上海201501 [2]上海中医药大学附属龙华医院金山分院,上海201501 [3]上海中医药大学附属市中医医院,上海200071 [4]上海市中医医院肿瘤研究所,上海200071

出　　处：《辽宁中医药大学学报》2025年第4期80-85,共6页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：上海市金山区医药卫生科技创新资金项目(2023-WS-46);上海市中医神志病研究所开放课题(SZB2023102);上海申康医院发展中心第二轮《促进市级医院临床技能与临床创新三年行动计划》研究型医师创新转化能力培训项目(SHD0203CRD010)。

摘　　要：目的观察归脾汤对心脾两虚型胃癌合并睡眠障碍患者疗效及免疫功能的影响。方法60例心脾两虚型胃癌合并睡眠障碍的患者被随机分为治疗组和对照组,每组各30例,对照组口服艾司唑仑片并接受心理指导,治疗组在此基础上联合归脾汤加减,为期8周。观察两组患者治疗前后汉密尔顿焦虑量表(Hamilton Anxiety Scale,HAMA)、汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD)、匹兹堡睡眠质量指数量表(Pittsburgh sleep quality index,PSQI)评分及白细胞介素1β(interleukin-1β,IL-1β)、白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)变化以评价疗效。结果与治疗前相比,两组患者治疗后的HAMA和HAMD量表评分、PSQI评分、中医证候量表积分及IL-1β、IL-6、TNF-α均有显著改变;治疗后,两组之间HAMA和HAMD量表评分无统计学意义,但治疗组PSQI评分及中医证候量表积分明显优于对照组(P<0.01),且IL-6和TNF-α水平显著下降,与对照组相比差异有统计学意义(P<0.01)。结论在常规口服艾司唑仑的基础上联合使用归脾汤不仅显著提高心脾两虚型胃癌患者睡眠障碍的疗效,减轻患者症状的同时,改善免疫功能,达到“形神并调”的目的。Objective To observe the therapeutic effect and immune function of Guipi Decoction(归脾汤)on patients with heart-spleen deficiency type gastric cancer combined with sleep disorders.Methods A total of 60 patients with gastric cancer of the heart-spleen deficiency type in combination with sleep disorders were randomly divided into two groups:a treatment group(n=30)and a control group(n=30).The control group received oral Eszolam tablets,while the treatment group was treated with the addition of Guipi Decoction on this basis for 8 weeks.To observe the HAMA,HAMD,PSQI scale scores,Chinese medicine symptom scale points and changes of IL-1β,IL-6,TNF-α before and after treatment to evaluate the efficacy of the two groups.Results After treatment,there were significant changes in scores for the HAMA,HAMD,PSQI,Chinese medicine symptom scale,and IL-1β,IL-6,and TNF-α in the two groups;there was no statistically significant difference between the two groups in HAMA and HAMD scale scores,but the treatment group had better PSQI and Chinese medicine scores than the control group(P<0.01),and the levels of IL-6 and TNF-α decreased significantly,which were significantly different from the control group(P<0.01).Conclusion Combining the use of Guipi Decoction with oral Eszolam not only improved the therapeutic effect of sleep disorders in gastric cancer patients with deficiency of heart and spleen,but also alleviated the symptoms of the patients,improved the immune function,and achieved the purpose of“regulating form and spirit”at the same time.

关 键 词：归脾汤 胃癌 心脾两虚型 睡眠障碍 形神并调 

分 类 号：R273[医药卫生—中西医结合]