养血疏肝汤治疗肝郁化火型失眠临床研究

Clinical Research on Insomnia Due to Liver Depression Transforming into Fire Treated with Blood-Nourishing and Liver-Dispersing Decoction

目的:观察养血疏肝汤治疗肝郁化火型失眠的临床疗效。方法:将147例肝郁化火型失眠患者随机分为观察组75例和对照组71例。对照组在常规生活心理干预的基础上给予艾司唑仑,观察组在常规生活心理干预的基础上给予养血疏肝汤。观察两组患者的临床疗效,比较两组患者治疗前后血清相关激素[皮质醇(cortisol,COR)、生长激素(growth hormone,GH)、三碘甲状腺激素(three iodine thyroid hormone,T3)、四碘甲状腺激素(four iodine thyroid hormone,T4)]及生活质量评分变化情况。结果:观察组有效率为90.67%,对照组有效率为70.42%,两组患者临床疗效比较,差异具有统计学意义(P<0.05)。两组患者治疗后COR、GH、T3、T4、TRH、TSH较治疗前明显下降,且观察组优于对照组,差异均有统计学意义(P<0.05)。两组患者治疗后心理领域、生理领域、社会关系领域、环境领域4个维度得分均明显上升,且观察组上升幅度均大于对照组,差异均有统计学意义(P<0.05)。结论:养血疏肝汤治疗肝郁化火型失眠疗效显著,可显著提高患者生活质量,其作用机制可能与调节丘脑-垂体-肾上腺轴/甲状腺轴有关。

Objective： To observe the clinical effects of Blood-Nourishing and Liver-Dispersing Decoction on insomnia due to l iver depression transforming into fire. Methods： Totally 147 insomnia patients due to l iver depression transforming into fire were randomized into observation group（ 75 cases） and control group（ 71 cases）. Control group were given conventional mental intervention and Estazolam while observation group were additionally given Blood-Nourishing and Liver-Dispersing Decoction. The clinical effects of both groups were observed. The levels of COR,GH,T3 and T4 and life quality in both groups before and after treatment were compared. Results： The effective rate was 90. 67% in observation group and 70. 42% in control group; the difference had statistical significance（ P〈0. 05）. After treatment,the levels of COR,GH,T3,T4,TRH and TSH declined significantly,and observation group were superior to control group,with statistical difference（ P〈0. 05）. The scores of mental,physical,social relationship and environmental fields increased obviously,and the rise in observation group was bigger than that in control group,with statistical difference（ P〈0. 05）. Conclusion： Blood-Nourishing and Liver-Dispersing Decoction has significant therapeutic effects on insomnia due to liver depression transforming into fire and can enhance the life quality of patients,whose mechanism may be related to the regulation of thalamus-pituitary gland-adrenal gland/thyroid axle.