肝硬化患者睡眠障碍的研究进展与中医治疗

Research Progress on Sleep Disorders in Patients with Liver Cirrhosis and TCM Treatment

睡眠障碍在肝硬化中很常见,并影响着生命质量。最常见的睡眠障碍有失眠、白天过度嗜睡以及睡眠-觉醒倒置。肝硬化睡眠障碍的生理病理机制很复杂,包括心理因素、环境因素、褪黑色素的代谢、血糖的波动、氨毒性、体温变化、生长激素释放肽、炎性反应递质,其中存在5种特殊病因引起的睡眠障碍,如酗酒、丙肝病毒、原发性胆汁性肝硬化、Wilson病、阻塞性睡眠呼吸暂停综合征。肝硬化睡眠障碍的治疗从中、西医2个方面入手,各自存在着非药物及药物2种不同治疗手段。目前肝硬化睡眠障碍的机制仍存在众多争议,故暂无系统的治疗方案,中医方面也欠缺对证型及治法、处方用药的总结。

Sleep disorders are common in cirrhosis and affect quality of life.The most common abnormalities are insomnia,excessive daytime sleepiness,and sleep-wake inversion.The pathophysiological mechanism for sleep disturbances in cirrhosis are complex and include psychological factors,environmental factors,melatonin metabolism,fluctuations in blood glucose,ammonia toxicity,alterations in thermoregulation,altered ghrelin secretion profiles,and inflammatory mediators.And there are five special causes of sleep disorders,such as alcoholism,hepatitis C virus,primary biliary cirrhosis,Wilson disease,and Obstructive Sleep Apnoea.There are different treatment methods for cirrhosis and sleep disorders.At this stage,there are no systematic treatment plan for cirrhotic sleep disorders.At present,the mechanism of cirrhosis and sleep disorders still has many controversies,so there is no systematic treatment plan,and the TCM treatment lacks a summary of syndrome types,treatment methods,and prescription medication.