自拟祛痰通络醒神汤治疗阻塞性睡眠呼吸暂停低通气综合征患者合并轻度认知功能障碍的临床效果研究

Clinical effects of self-made Qutan Tongluo Xingshen decoction on patients with obstructive sleep apnea hypopnea syndrome complicated with mild cognitive impairment

目的探讨自拟祛痰通络醒神汤治疗阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患者合并轻度认知功能障碍的临床效果。方法选择2016年10月到2018年10月临床接诊的100例OSAHS患者合并轻度认知功能障碍患者,通过随机数表法分为观察组(n=51)和对照组(n=49),对照组给予生活方式干预常规治疗,观察组在对照组的基础上给予自拟祛痰通络醒神汤进行治疗。比较两组治疗后血氧饱和度、呼吸暂停低通气指数(apnea hypopnea index,AHI)、总睡眠时间及醒觉时间、血液流变学、评估患者认知能力评分、Epworth嗜睡量表(Epworth sleepiness score,ESS)评分、蒙特利尔认知评估(Montreal cognitive assessment,MoCA)评分和临床疗效。结果治疗后,观察组患者夜间最低血氧饱和度、AHI、总睡眠时间、醒觉时间分别为(90.80±5.35)%、(6.23±4.30)次/h、(7.52±3.43)h和(78.52±6.51)min,对照组为(78.46±4.34)%、(10.63±7.01)次/h、(4.38±2.35)h和(68.74±6.11)min。观察组夜间最低血氧饱和度、总睡眠时间及醒觉时间均高于对照组,AHI低于对照组(P<0.05)。治疗后,两组患者ESS评分均下降,MoCA评分均上升,且观察组患者变化更明显(P<0.05)。观察组患者总有效率(96.08%)高于对照组(83.67%,P<0.05)。结论祛痰通络醒神汤可有效改善OSAHS合并轻度认知功能障碍患者的临床症状,改善睡眠障碍和认知功能,调节患者血液循环。

Objective To investigate the clinical effects of self-made Qutan Tongluo Xingshen Decoction on patients with obstructive sleep apnea hypopnea syndrome(OSAHS)complicated with mild cognitive impairment.Methods A total of 100 OSAHS patients with mild cognitive impairment admitted clinically from October 2016 to October 2018 were selected,and divided into observation group(n=51)and control group(n=49)by random number table method.Lifestyle intervention and routine treatment were given to patients of control group while the self-made Qutan Tongluo Xingshen decoction were given to patients of observation group.On the basis of the control treatment,the blood oxygen saturation,apnea hypopnea index(AHI),total sleep time and waking time,hemorheology,cognitive ability score,Epworth sleepiness score(ESS),Montreal cognitive assessment(MoCA)score and clinical efficacy after treatment were recorded and compared between the two groups.Results After treatment,the lowest blood oxygen saturation,AHI,total sleep time and awake time in the observation group were(90.80±5.35)%,(6.23±4.30)times/h,(7.52±3.43)h and(78.52±6.51)min respectively,and those in control group were(78.46±4.34)%,(10.63±7.01)times/h,(4.38±2.35)h and(68.74±6.11)min.The lowest blood oxygen saturation,total sleep time and awake time in the observation group were higher than those in the control group,and AHI was lower than that in the control group(P<0.05).After treatment,ESS scores of patients in both groups decreased and MoCA scores increased,and the changes in patients in the observation group were more obvious(P<0.05).After treatment,the total effective rate of patients in the observation group(96.08%)was higher than that in the control group(83.67%,P<0.05).Conclusion Qutan Tongluo Xingshen decoction can effectively improve the clinical symptoms of OSAHS patients complicated with mild cognitive impairment,improve sleep disorder and cognitive function of patients,and regulate blood circulation of patients.