归脾汤加味联合小剂量曲唑酮治疗脑卒中后失眠及对血脂及血流动力学的影响

Effect observation of Guipi Decoction combined with low dose trazodone hydrochloride tablets on insomnia and blood lipid and hemodynamics after stroke

目的:观察归脾汤加味联合小剂量盐酸曲唑酮片对脑卒中后失眠(心脾两虚证)的疗效.方法:采用随机数字表法抽取治疗组及对照组患者各60例,均给予脑卒中的基础治疗,对照组予右佐匹克隆片口服,治疗组予盐酸曲唑酮片及归脾汤加味口服,观察两组治疗前后匹兹堡睡眠质量指数(Pittsburgh Sleep Quality Index,PSQI)、改良Rankin评分(Modified Rankin Scale,mRS)及血脂、脑部血流动力学指标变化,评估临床疗效并随访6个月复发率.结果:临床疗效:治疗组总有效率93.33%(56/60)高于对照组80.0%(48/60)(P<0.05);两组治疗后PSQI、mRS评分均较治疗前有改善(P<0.05),治疗组改善程度均优于对照组(P<0.05);两组患者三酰甘油(Triglyceride,TG)、血清总胆固醇(Serum Total Cholesterol,TC)及低密度脂蛋白胆固醇(Low-Density Lipoprotein Cholesterol,LDL-C)均有所下降,高密度脂蛋白胆固醇(High-Density Lipoprotein Cholesterol,HDL-C)有所升高,治疗组优于对照组(P<0.05);脑部血流动力学指标改善情况治疗组优于对照组(P<0.05);治疗组复发率低于对照组(P<0.05);两组均无明显不良反应.结论:归脾汤加味口服联合小剂量盐酸曲唑酮片对脑卒中后失眠(心脾两虚证)疗效确切,且能有效改善患者的脂质代谢及血液循环情况.

Objective:To observe the effect of Guipi Decoction(归脾汤)combined with low dose trazodone hydrochloride tablets on insomnia after stroke(heart-spleen deficiency syndrome).Methods:60 cases in the treatment group and 60 cases in the control group were selected by random number table method,all patients were given basic treatment for stroke.The control group took Eszopiclone tablets,the treatment group was given low dose trazodone hydrochloride tablets and Guipi Decoction orally.The changes of Pittsburgh sleep quality index(PSQI),modified Rankin score(mRS),blood lipid and cerebral hemodynamics were observed before and after treatment.The clinical efficacy was evaluated and the recurrence rate was followed up for 6 months.Results:The clinical efficacy:The effective rate of the treatment group 93.33%(56/60)was higher than that of the control group 80.0%(48/60)(P<0.05);the PSQI and mRS scores of the two groups were improved after treatment(P<0.05),and the improvement degree of the treatment group was better than that of the control group(P<0.05);the triglyceride(TG),total cholesterol(TC)and low density lipoprotein(LDL-C)of the two groups were all decreased,and the high density lipoprotein(HDL-C)was increased,the treatment group was better than the control group(P<0.05);the improvement of cerebral hemodynamics index in the treatment group was better than that in the control group(P<0.05);the recurrence rate in the treatment group was lower than that in the control group(P<0.05);there were no obvious adverse reactions in both groups.Conclusion:The curative effect of Guipi Decoction combined with low dose trazodone hydrochloride tablets is definite and lasting on post-stroke insomnia(heartspleen deficiency syndrome),and there is effective improvement of lipid metabolism and blood circulation in patients.