枣仁磁石汤加减治疗肝郁脾虚型顽固性失眠48例  

Clinical effect of modified Zaoren Cishi decoction in treatment of refractory insomnia with liver depression and spleen deficiency:An analysis of 48 cases

作　　者：李胜强 刘皇军[1] 李扬声 LI Shengqiang;LIU Huangjun;LI Yangsheng(The First Affiliated Hospital of Yangtze University,Jingzhou 434000,Hubei,China;Nanxian Hospital of Traditional Chinese Medicine,Nanxian 413200,Hunan,China)

机构地区：[1]长江大学第一附属医院,湖北荆州434000 [2]南县中医医院,湖南南县413200

出　　处：《湖南中医杂志》2025年第2期1-5,共5页Hunan Journal of Traditional Chinese Medicine

基　　金：全国基层名老中医药专家传承工作室建设项目(国中医药人教函[2015]174号);湖南省“十四五”第二批中医药领军人才、学科带头人和骨干人才培养项目(湘中医药[2024]3号)。

摘　　要：目的:观察枣仁磁石汤加减治疗肝郁脾虚型顽固性失眠的临床疗效。方法:将94例肝郁脾虚型顽固性失眠患者随机分为2组,治疗组48例予以枣仁磁石汤加减治疗,对照组46例予以西药艾司唑仑片治疗,2组均连续治疗4周。观察2组治疗前后匹兹堡睡眠质量指数(PSQI)积分、睡眠结构相关指标、中医证候积分、血清炎症因子水平、糖化血清白蛋白(GA)水平、5-羟色胺(5-HT)含量以及停药1周后的复发率,并评价其综合疗效。结果:总有效率治疗组为83.33%(40/48),高于对照组的65.22%(30/46),2组比较,差异有统计学意义(P<0.05);治疗后治疗组患者PSQI积分、血清炎症因子水平、睡眠潜伏期及中医证候积分均明显低于对照组(P<0.05),总睡眠时间、睡眠效率、快速动眼期、GA、5-HT等指标均明显高于对照组(P<0.05);停药1周后,治疗组复发率为20.00%(8/40),对照组为60.00%(18/30),2组比较,差异有统计学意义(P<0.01)。结论:枣仁磁石汤加减治疗肝郁脾虚型顽固性失眠疗效较好,且停药后复发率较低,其机制可能是通过调节血清炎症因子与GA水平及5-HT含量等发挥作用。Objective:To investigate the clinical effect of modified Zaoren Cishi decoction in the treatment of refractory insomnia with liver depression and spleen deficiency.Methods:A total of 94 patients with refractory in-somnia with liver depression and spleen deficiency were randomly divided into treatment group with 48 patients and control group with 46 patients.The patients in the treatment group were given modified Zaoren Cishi decoction,while those in the control group were given the Western medicine estazolam tablets;the course of treatment was 4 consecutive weeks for both groups.The two groups were observed in terms of Pittsburgh Sleep Quality Index(PSQI)score,sleep architecture parameters,traditional Chinese medicine(TCM)syndrome score,the serum levels of in-flammatory factors,the level of glycated albumin(GA),and the content of 5-hydroxytryptamine(5-TH),as well as recurrence rate after drug withdrawal for 1 week,and overall response was evaluated.Results:The treatment group had a significantly higher overall response rate than the control group[83.33%(40/48)vs 65.22%(30/46),P<0.05].Compared with the control group after treatment,the treatment group had significantly lower PSQI score,serum levels of inflammatory factors,sleep latency,and TCM syndrome score(P<0.05)and signifi-cantly higher indicators such as total sleep time,sleep efficiency,rapid eye movement,GA,and 5-HT(P<0.05).There was a significant difference in recurrence rate after drug withdrawal for 1 week between the treatment group and the control group[20.00%(8/40)vs 60.00%(18/30),P<0.01].Conclusion:Modified Zaoren Cishi decoc-tion has a good clinical effect in the treatment of refractory insomnia with liver depression and spleen deficiency,with a relatively low recurrence rate after drug withdrawal,possibly by regulating the serum levels of inflammatory factors and GA and the content of 5-HT.

关 键 词：失眠 肝郁脾虚证 枣仁磁石汤 艾司唑仑 

分 类 号：R256.23[医药卫生—中医内科学]