安宫牛黄丸对阻塞性睡眠呼吸暂停低通气综合征患者血中食欲素A、瘦素及神经肽Y的影响

The impact of Angong Niuhuang Wan(安宫牛黄丸) on orexin-A,Leptin and neuropeptide Y in patients with obstructive sleep apnea-hypopnea syndrome

目的观察安宫牛黄丸对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血中食欲素A(Orex-in-A)、神经肽Y(NPY)和瘦素(Leptin)的影响。方法选择经多导睡眠图仪行多导睡眠监测(PSG)确诊的轻、中度OSAHS患者50例,随机分为两组。治疗组25例给予安宫牛黄丸1丸,睡前服,每日1次,治疗30 d;对照组25例不给予任何治疗。治疗前后用放射免疫法和酶联免疫吸附法分别检测血浆食欲素A、NPY和血清瘦素水平,并进行夜间睡眠监测。结果与对照组比较,治疗组治疗后患者睡眠呼吸暂停低通气指数(AHI)、觉醒指数明显减少〔(16.33±3.57)次/h比(22.23±9.98)次/h,(103.58±32.90)次/s比(127.89±42.78)次/s,P<0.01和P<0.05〕,平均经皮血氧饱和度(MSpO2)和最低经皮血氧饱和度(LSpO2)明显增加(0.950±0.032比0.934±0.048,0.830±0.041比0.826±0.127,P<0.01和P<0.05),+期睡眠百分比、鼾声指数和最长呼吸暂停时间均无差异。激素水平测定结果显示,治疗组治疗后食欲素A、瘦素水平较对照组明显降低(P<0.01和<0.05),而NPY无明显差异(P>0.05)。相关性分析表明,OSAHS患者食欲素A、瘦素和NPY与AHI(r1=0.445,r2=0.480,r3=0.454)、觉醒指数(r1=0.613,r2=0.510,r3=0.479)均呈正相关(P<0.05或P<0.01),食欲素A与MSpO2和LSpO2呈负相关(r1=-0.666,P1<0.01;r2=-0.513,P2<0.05)。结论安宫牛黄丸能够降低轻、中度OSAHS患者血食欲素A、瘦素的水平,从而改善OSAHS患者的预后。

Objective To observe the impact of Angong Niuhuang Wan(安宫牛黄丸) on orexin-A,neuropeptide Y(NPY) and Leptin in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods Total 50 mild and moderate cases of OSAHS which were definitely diagnosed by the results of polysomnogram′s monitoring were selected and randomly divided into treatment group and control group(each n=25).The treatment group took one pill of Angong Niuhuang Wan everyday before sleep for 30 days,while the control group received no tr...