加味酸枣仁汤对阴虚火旺型慢性失眠患者主客观睡眠的影响

Study on Effect of Modified Suanzaoren Tang on Subjective and Objective Sleep Quality in Chronic Insomniacs of Yin Deficiency with Effulgent Fire Type

目的:观察加味酸枣仁汤治疗阴虚火旺型慢性失眠患者的临床疗效,分析比较其对主客观睡眠的影响。方法:共纳入符合标准的病例70例,随机分为2组,最终纳入统计学的患者共67例。西药组33例予艾司唑仑片,建议患者根据自身情况,非连续性服药,每次服1片,睡前服用,每周服用3~5天。中药组34例予加味酸枣仁汤水煎剂,每天1剂,分2次服用。疗程为8周。结果:①治疗后,西药组和中药组匹兹堡睡眠质量指数(PSQI)评分均有显著改善(P<0.01);但2组间评分比较,差异无统计学意义(P>0.05)。②治疗后,西药组睡眠总时间、浅睡时间较前增加,快速动眼(REM)睡眠时间、觉醒时间、初入睡时间较前缩短,差异均有统计学意义(P<0.05),熟睡时间治疗前后比较,差异无统计学意义(P>0.05)。中药组熟睡时间较前增加,初入睡时间较前缩短(P<0.05),睡眠总时间、浅睡时间、REM睡眠时间、觉醒时间治疗前后比较,差异均无统计学意义(P>0.05);2组治疗后各项数据指标比较,差异无统计学意义(P>0.05)。③中药组安全性良好,不良反应出现例数较西药组少。结论:加味酸枣仁汤在主观睡眠的改善方面,疗效与艾司唑仑相当。在客观睡眠指标的改善方面,两者亦无明显差异;加味酸枣仁汤可能通过改善睡眠结构,增加熟睡时间来起到改善睡眠的作用;而且临床使用安全,不良反应小于艾司唑仑。

Objective:To observe the clinical effect of modified Suanzaoren tang for chronic insomniacs of yin deficiency with effulgent fire type,and to analyze and compare its effect on subjective and objective sleep quality.Methods:In accordance with the inclusion criteria,a total of 70 cases were included and randomly divided into two groups,and 67 cases were included finally.The western medicine group(33 cases)was given estazolam tablets;according to their own conditions,they were recommended to take one tablet at a time before going to bed,and for three to five days a week.The Chinese medicine group(34 cases)was given decoction of modified Suanzaoren tang for one dose per day and each dose was taken twice.Both groups were treated for eight weeks.Results:①After treatment,the scores of PSQI in the two groups were significantly improved(P<0.01),but there was no significance being found in the comparison of the scores in the two groups(P>0.05).②After treatment,in the western medicine group,the total sleep time and the time of light sleep were increased when compared with those before treatment;the time of rapid eye movement(REM)sleep,the awakening time and the time of first falling asleep were shortened when compared with those before treatment,differences being significant(P<0.05);there was no significance being found in the comparison of the deep sleep time before and after treatment in the western medicine group(P>0.05).After treatment,in the Chinese medicine group,the deep sleep time was prolonged when compared with that before treatment,and the time of first falling asleep was shortened when compared with that before treatment(P<0.05);compared with the total sleep time,the time of light sleep,the REM sleep time and the awakening time before and after treatment,there was no significance in the difference(P>0.05).After treatment,no significant difference was found in the comparison of each index in the two groups(P>0.05).③The treatment for the Chinese medicine group had good safety and fewer cases of adverse reactions than that for the western medicine group.Conclusion:The effect of modified Suanzaoren tang on the improvement of subjective sleep is similar to that of estazolam.As for the improvement of the objective sleep,the difference between the two treatments is not obvious.The mechanism of modified Suanzaoren tang improving sleep may be the adjustment of sleep structure and the increase of deep sleep time.Moreover,compared with estazolam,it is safe in clinical use with fewer adverse reactions.