调肝安神方对肝郁血瘀证失眠症患者多导睡眠图睡眠结构参数的影响

Effects of Tiaogan Anshen Decoction on sleep structure parameters of polysomnography in insomnia patients with syndrome of liver depression and blood stasis

目的:探讨调肝安神方治疗失眠症肝郁血瘀证患者的临床疗效及对多导睡眠图睡眠结构参数的影响。方法:选取南京中医药大学第二附属医院神经内科失眠专病门诊患者96例,采用随机数字表法随机分为对照组与治疗组,每组48例。对照组给予艾司唑仑1~2mg睡前口服,治疗组在对照组基础上加用调肝安神方治疗,疗程8周。治疗后观察两组中医证候疗效及多导睡眠图睡眠结构参数,比较两组患者总睡眠时间、睡眠潜伏期时间、觉醒时间、REM潜伏期、睡眠效率等睡眠进程参数及REM期和NREM期睡眠阶段N1、N2、N3期各占总睡眠时间的百分比等睡眠结构参数。结果:治疗组总有效率为89.6%(43/48),显著高于对照组的66.7%(32/48)(P<0.05)。睡眠进程参数方面,治疗组较对照组能显著增加睡眠总时间、缩短睡眠潜伏期时间、减少觉醒时间、延长REM潜伏期时间、提高睡眠效率(P<0.05,P<0.01)。睡眠结构参数方面,治疗组较对照组能显著增加N3期睡眠时间及睡眠比例(P<0.01),降低N2期睡眠比例(P<0.05)。结论:调肝安神方治疗肝郁血瘀证失眠症患者能显著提高临床疗效,可通过延长总睡眠时间、改善入睡困难、减少睡眠期清醒时间、增加深睡眠睡眠时间、提高深睡眠比例、延迟浅睡眠进程、提高睡眠效率从而改善失眠患者的睡眠进程及睡眠结构。

Objective:To explore the clinical effect of Tiaogan Anshen Decoction on insomnia patients with the syndrome of liver depression and blood stasis and influence on sleep structure parameters based on polysomnography.Methods:A total of 96 outpatients with insomnia from the insomnia clinic of Neurology Department of the Second Affiliated Hospital of Nanjing University of Chinese Medicine were randomly divided into control group and treatment group,48 cases in each group.The control group was given oral Estazolam 1~2mg before sleep,and the treatment group was given Tiaogan Anshen Decoction based on the control group,and eight weeks as a course of treatment.After treatment,observe the curative effect of TCM syndromes and the structural parameters of polysomnography sleep in 2 groups.Sleep process parameters such as total sleep time,sleep latency time,awakening time,REM latency and sleep efficiency,and sleep structure parameters such as the percentage of N1,N2,and N3 phases of REM and NREM phases in total sleep time were compared between the two groups.Results:After treatment,the total effective rate of the treatment group was 89.6%(43/48),which was significantly higher than 66.7%(32/48)of the control group(P<0.05).In terms of sleep process parameters,the treatment group could significantly increase the total sleep time,shorten the sleep latency time,reduce the awakening time,prolong the REM latency time and improve the sleep efficiency compared with the control group(P<0.05,P<0.01).In terms of sleep structure parameters,the treatment group could significantly increased sleep time and the sleep proportion of stage N3(P<0.01),and decreased the sleep proportion of stage N2 compared with the control group(P<0.05).Conclusion:Tiaogan Anshen Decoction can significantly improve the clinical efficacy of insomnia patients with the syndrome of liver depression and blood stasis.It can help improve the sleep process and sleep structure of insomnia patients by prolonging the total sleep time,improving the difficulty of falling asleep,reducing the waking time during sleep,increasing the time of deep sleep,increasing the proportion of deep sleep,delaying the process of shallow sleep and improving the sleep efficiency.