黄连温胆汤治疗睡眠低通气的临床研究

Clinical Study on the Decoction for Clearing away Gallbladder-Heat with Coptidis for the Treatment of Obstructive Sleep Apnea Hypopnea Syndrome

目的 观察黄连温胆汤治疗睡眠呼吸暂停低通气的临床效果,并分析其疗效机理。方法 将采用多导睡眠图技术(PSG)诊断为阻塞性睡眠呼吸暂停低通气综合征(Obstructive Sleep Apnea Hypopnea Syndrome, OSAHS)并以低通气为主的54名患者随机分组,分别予中药黄连温胆汤和都可喜治疗。治疗2周后,从减轻临床症状、缩短低通气持续时间、提高血氧饱和度等方面进行对照分析。结果 黄连温胆汤能明显改善OSAHS患者的睡眠紊乱、胸闷、舌象等临床表现。复查PSG结果,黄连温胆汤治疗后,平均睡眠时间延长47 min、低通气总时间缩短10 min,90%以下血氧饱和度总时间减少15 min,疗效明显优于都可喜治疗组。但两种治疗方法对阻塞睡眠呼吸暂停的治疗效果欠佳。结论 黄连温胆汤对睡眠呼吸暂停低通气综合征,特别是以低通气和低氧为主的患者有一定的效果,值得进一步研究。

Objective To appraise the effect of Decoction for Clearing away Gallbladder-Heat with Coptidis for the treatment of Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS), especially hypoventilation. Methods 27 patients with OSAHS was treated with Decoction for Clearing away Gallbladder-Heat with Coptidis for 2 weeks. 27 patients with OSAHS was treated with Duxil served as controls. Polysomnography was performed and questionnaires recorded prior to and immediately after treatment both group. Results The efficiency of Decoction for Clearing away Gallbladder-Heat with Coptidis was 77%. The medial sleep-time increased 47 minutes, the medial hypopnoea time decreased 10 minutes, and the medial time for SaO2 less than 90% decreased 15 minutes. Comparing with the Duxil group, the difference was significant (P<0.01). Conclusion The Decoction for Clearing away Gallbladder-Heat with Coptidis improved OSAHS, especially those with hypoventilation and hypo-oxygen.