睡眠呼吸暂停低通气综合征中医辨治思路

TCM Syndrome Treatment on Sleep Apnea Hypopnea Syndrome

目前中医学对睡眠呼吸暂停低通气综合征(SAHS)尚无统一的治疗标准,临床虽有疗效但依从性欠佳。与西医应用正压通气、手术等手段可立即改善通气、缓解嗜睡相比,中医药治疗SAHS的优势在于改善患者体质、减轻病理损害、纠正合并症以及改善不良生活习惯和职业因素对机体产生的不良影响。基于此,SAHS的中医治疗应以整体观念和辨证论治为基础和主线确定证型,根据多导睡眠图监测结果即呼吸暂停低通气指数进行的病情分级,合理定位中医药的治疗地位,根据SAHS分型即阻塞性和中枢性分别对症加用相关药物,此外尚需结合病因、体质、合并症等诸多因素综合辨治用药。

At present,there is no uniform standard for traditional Chinese medicine（ TCM） treatment on sleep apnea hypopnea syndrome（ SAHS）. In clinical practice,although clinical efficacy can be observed,poor compliance is often a problem. Compared to the fact that western medicine applies positive pressure ventilation or operation that immediately improves breathing and alleviates sleepiness,TCM treatment of SAHS has the advantage of improving the constitution of the patients,alleviating the pathological damage,correcting the complications,and improving bad living habits and adverse effects by occupation factors. Based on this,the TCM treatment of SAHS should be based on the holistic concept and treatment based on syndrome differentiation,and give proper application of TCM treatment according to the classification of polysomnography results,that is,apnea hypopnea index condition,and apply relevant medicine according to the SAHS classification： obstructive or central respectively. In addition,many factors such as the cause of disease,constitution,and complications still need to be comprehensively considered for further differential medication.