加味温胆汤对围绝经期失眠痰热型患者血清5-HT、MT、TNF-α及性激素水平的影响  

Effect of Modified Wendantang on Serum 5-HT,MT,TNF-α,and Sex Hormone Levels in Patients with Perimenopausal Insomnia of Phlegm Heat Type

作　　者：王艳[1] 徐月霞 丁炜[1] WANG Yan;XU Yuexia;DING Wei(The First Affiliated Hospital of Nanjing Medical University,Nanjing 210000,China;Nanjing Changjiang Hospital,Nanjing 210000,China)

机构地区：[1]南京医科大学第一附属医院,南京210000 [2]南京长江医院,南京210000

出　　处：《中国实验方剂学杂志》2025年第9期12-18,共7页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：张家港市中医医院青年自然科学基金项目(zzyq1907);江苏省省中医药科技发展计划重点项目(ZD202327)。

摘　　要：目的:探讨加味温胆汤在围绝经期失眠痰热型患者治疗中的应用价值,观察其对神经递质及体脂肪的影响。方法:162例围绝经期失眠痰热型患者均于2021年5月至2023年11月在南京医科大学第一附属医院中医科就诊,纳入研究前均随机分组。对照组81例用西医常规治疗,观察组81例联合加味温胆汤治疗,治疗4周。结果:与本组治疗前比较,治疗后两组血清白细胞介素-β(IL-1β)、肿瘤坏死因子-α(TNF-α)降低,多巴胺(DA)、褪黑素(MT)、5-羟色胺(5-HT)升高(P<0.05);治疗后与对照组比较,观察组上述指标改善更优(P<0.05);与本组治疗前比较,治疗后两组卵泡刺激素(FSH)、黄体生成素(LH)水平降低,雌二醇(E_(2))水平升高(P<0.05);治疗后与对照组比较,观察组上述性激素指标改善更优(P<0.05);与本组治疗前比较,治疗后两组快速眼动睡眠期(REM)时间、总睡眠时间(TST)延长,睡眠潜伏期(SL)缩短(P<0.05);治疗后与对照组比较,观察组睡眠情况改善更优(P<0.05);与本组治疗前比较,治疗后两组匹兹堡睡眠质量指数(PSQI)、中医总症状积分降低(P<0.05);治疗后与对照组比较,观察组PSQI、中医总症状积分改善更优(P<0.05);观察组总有效率93.83%(76/81),对照组总有效率82.72%(67/81)(χ^(2)=9.135,P<0.05)。结论:对于围绝经期失眠痰热型患者而言应用加味温胆汤有助于调控神经递质,调控炎性因子水平,改善性激素水平,提高睡眠质量,提高疗效。Objective:To explore the application value of modified Wendantang in the treatment of perimenopausal insomnia of phlegm heat type and observe its effects on neurotransmitters and body fat.Methods:A total of 162 patients with perimenopausal insomnia of phlegm heat type who were treated in the Traditional Chinese Medicine Department of The First Affiliated Hospital with Nanjing Medical University from May 2021 to November 2023 were randomly divided into two groups before inclusion in the study.The control group of 81 cases received conventional Western medicine treatment,while the observation group of 81 cases received combined treatment with modified Wendantang,and the treatment lasted for 4 weeks.Results:Interleukin-β(IL-1β),and tumor necrosis factor alpha(TNF-α)decreased,while serum dopamine(DA),melatonin(MT)and serotonin(5-HT)increased in both groups after treatment compared with before treatment(P<0.05).After treatment,compared with the control group,the observation group showed better improvement in the above indicators(P<0.05).The levels of follicle stimulating hormone(FSH)and luteinizing hormone(LH)decreased,while the level of estradiol(E_(2))increased in both groups after treatment compared with before treatment(P<0.05).Compared with the control group,the observation group showed better improvement in the above sex hormone indicators after treatment(P<0.05).The rapid eye movement sleep period(REM)and total sleep time(TST)were prolonged,and the sleep latency(SL)was shortened in the two groups after treatment compared with before treatment(P<0.05).Compared with the control group,the observation group showed better improvement in sleep conditions after treatment(P<0.05).The Pittsburgh sleep quality index(PSQI)and Traditional Chinese Medicine(TCM)total symptom score decreased significantly in both groups after treatment compared with before treatment(P<0.05).Compared with the control group,the observation group showed better improvement in PSQI and TCM total symptom score after treatment(P<0.05).The total e

关 键 词：加味温胆汤 围绝经期失眠 痰热型 神经递质 褪黑素(MT) 肿瘤坏死因子-α(TNF-α) 性激素 睡眠质量 

分 类 号：R256[医药卫生—中医内科学] R287[医药卫生—中医学] R256.23