昼夜分治法治疗中风后失眠的随机对照研究

A Randomized Controlled Trial of Diurnal and Diurnal Treatment for Insomnia after Stroke

目的:观察昼夜分治法治疗中风后失眠(昼不精、夜不瞑)的疗效。方法:选取2019年1月至2020年1月福建中医药大学附属第三人民医院收治的住院患者80例作为研究对象,按照随机数字表法随机分为观察组和对照组,每组40例。对照组给予艾司唑仑睡前口服,观察组昼精方(早餐后0.5 h服用):桂枝10 g、葛根10 g、猪苓15 g、泽泻15 g、法半夏10 g、丹参15 g、党参15 g。夜瞑方(晚餐后30 min服用):珍珠母30 g、磁石10 g、龙骨20 g、酸枣仁15 g、茯神15 g、柏子仁15 g、郁金15 g、百合20 g。连续治疗2周为1个疗程。观测临床表现匹兹堡睡眠质量指数(Pittsburgh Sleep Quality Index,PSQI)、失眠严重程度指数(Insomnia Severity Index,ISI)、不良反应。结果:观察组痊愈18例,显效9例,有效8例,无效5例,总有效率87.5%;对照组痊愈14例,显效5例,有效11例,无效10例,总有效率75.0%;观察组疗效优于对照组,PSQI、ISI 2组均有改善,观察组改善优于对照组,差异有统计学意义(P<0.01)。结论:昼夜分治法治疗中风后失眠(昼不精、夜不瞑),疗效确切,值得推广使用。

Objective:To observe the therapeutic effect of diurnal and diurnal treatment on post-apoplexy insomnia.Methods:A total of 80 inpatients from January 2019 to January 2020 in the Third People′s Hospital Affiliated to Fujian University of Traditional Chinese Medicine were selected as the research objects,and randomly divided into observation group and control group according to the random number table method,with 40 patients in each group.The control group was given estazolam orally before going to bed.In the observation group,diurnal prescription(taken 0.5 h after breakfast)was as follows:cassia twig 10 g,pueraria 10 g,poring coboling 15 g,Alisma cathayensis 15 g,Pinellia ternata 10 g,Salvia miltiorrhiza 15 g,codonopsis pilosula 15 g.Night prescription(to be taken 30 minutes after dinner):30 g of mother of pearl,10 g of lodestone,20 g of keel,15 g of jujube kernel,15 g of porium,15 g of cypress seed,15 g of turmeric,20 g of lily bulb.Continuous treatment for 2 weeks is 1 course of treatment.The clinical manifestations,Pittsburgh sleep quality index(PSQI),insomnia severity index(ISI)and adverse reactions were observed.Results:In the observation group,18 cases were cured,9 cases were obvious,8 cases were effective,5 cases were ineffective,and the total effective rate was 87.5%.In the control group,14 cases were cured,5 cases were obvious,11 cases were effective,and 10 cases were ineffective,with a total effective rate of 75.0%.The curative effect of the observation group was better than that of the control group.Both PSQI and ISI were improved in the two groups,and the improvement of the observation group was better than that of the control group,with statistically significant difference(P<0.01).Conclusion:Diurnal and diurnal treatment for postapoplectic insomnia is effective and worth popularizing.