从肝论治失眠症224例疗效分析

Treatment of insomnia according to the liver in TCM：a study of 224 patients

目的：探讨从肝论治失眠症的临床疗效。方法收集2012年7月－2013年12月安徽省阜阳市人民医院中西医结合科失眠症患者224例，以平肝潜阳、活血安神为治疗原则，以柴胡龙骨牡蛎汤为基本方，从辨证分型、是否合并躯体性疾病、就诊前是否服用安眠药、病程评分变化等方面采用Spiegel睡眠问卷调查量表评分进行疗效评价。结果224例中，总有效率为89.73%（201/224）。各证型间疗效比较，差异无统计学意义（χ2＝11.293，P＝0.721）；单纯性与非单纯性失眠疗效比较，差异无统计学意义（χ2＝1.216，P＝0.704）；就诊前服用安眠药者与未服用安眠药者总有效率比较，差异有统计学意义（χ2＝6.510，P＝0.011）；不同病程间疗效比较，差异有统计学意义（χ2＝9.278，P＝0.001）。结论从肝论治可减轻失眠症患者对镇静安眠药的依赖，有一定的临床疗效。

Objective To evaluate the efficacy in patients with insomnia treated according to the liver in TCM. Methods A total of 224 patients with insomnia were enrolled and treated according to the liver in TCM. The principle of suppressing hyperactive liver and subsiding yang and promoting blood circulation for tranquillization was adopted, and Longgu Muli decoction was used as basic therapeutic formula. The therapeutic effects were evaluated using Spiegel Sleep Questionnaire according to the syndrome differentiation type, whether the body disease appeared, whether taking hypnotics before the treatment, and the variation of disease course. Results The total effective rate was 89.73%（201/224） in 224 patients with insomnia. There were no significant difference in effective rate among different syndrome differentiation types （χ2=11.293, P=0.721）, between simple and non-simple insomnia （χ2=1.216, P=0.704）. There were significant difference in effective rate between taking and not taking hypnotics before the treatment （χ2=6.510, P=0.011）, and among different disease course （χ2=9.278, P=0.001）. Conclusion Treatment according to the liver in TCM can reduce the dependence on hypnotics and has certain efficacy in patients with insomnia.