补肾活血汤治疗老年慢性失眠症疗效观察

Observation on curative effect of Bushen Huoxue Decoction on senile chronic insomnia

目的观察中药补肾活血汤治疗老年慢性失眠症的疗效。方法将2018年7月—2019年7月在上海市第七人民医院治疗的92例老年慢性失眠症患者随机分为治疗组和对照组,每组46例。治疗组采用补肾活血汤治疗,对照组采用艾司唑仑治疗,治疗周期均为6周。观察2组治疗前及治疗2周、4周、6周后匹兹堡睡眠量表(PSQI)、SPIEGEL睡眠自评量表、汉密尔顿抑郁量表(HAMD-17)、汉密尔顿焦虑量表(HAMA)评分,根据PSQI减分率评估临床疗效,根据中医症状积分减分率评估中医证候疗效,统计治疗安全性。结果治疗组完成研究42例,对照组完成研究41例。2组治疗后各时间点PSQI、SPIEGEL、HAMD-17、HAMA评分均明显低于治疗前(P均<0.05),且治疗组治疗6周后的各项评分均明显低于对照组(P均<0.05)。治疗组临床疗效总有效率为95.2%(40/42),对照组为92.7%(38/41),2组比较差异无统计学意义(P>0.05)。治疗组中医证候疗效总有效率为90.5%(38/42),对照组为70.7%(29/41),治疗组明显高于对照组(P<0.05)。在整个治疗期间2组均未发现肝、肾功能异常及特殊不适反应。结论补肾活血汤较艾司唑仑治疗可以更有效地改善老年慢性失眠患者的睡眠质量,减轻中医症状及伴有的焦虑、抑郁情绪,且安全性较好。

Objective It is to observe the curative effect of Chinese medicine Bushen Huoxue Decoction in the treatment of chronic insomnia in the elderly.Methods Ninety-two elderly patients with chronic insomnia treated in Shanghai Seventh People’s Hospital from July 2018 to July 2019 were randomly divided into treatment group and control group,with 46 cases in each group.The treatment group was treated with Bushen Huoxue Decoction,and the control group was treated with Estazolam.Both groups were treated for 6 weeks.The scores of the Pittsburgh Sleep Quality Index(PSQI),SPIEGEL Sleep Self-Rating Scale,Hamilton Depression Scale(HAMD-17),Hamilton Anxiety Scale(HAMA)before treatment and 2 weeks,4 weeks,and 6 weeks after treatment were observed in the two groups.The clinical efficacy was evaluated based on the score reduction rate of PSQI,the efficacy of TCM syndromes was evaluated based on the score reduction rate of TCM symptoms,and the safety of treatment was calculated.Results 42 cases completed the study in the treatment group,and 41 cases completed the study in the control group.The scores of PSQI,SPIEGEL,HAMD-17,and HAMA at each time point after treatment were significantly lower than those before treatment in the two groups(all P<0.05),and the scores of the treatment group after 6 weeks of treatment were significantly lower than those of the control group(all P<0.05).The total effective rate of clinical efficacy was 95.2%(40/42)in the treatment group and 92.7%(38/41)in the control group,there was no statistically significant difference between the two groups(P>0.05).The total effective rate of TCM syndromes in the treatment group was 90.5%(38/42),and that in the control group was 70.7%(29/41),the rate in the treatment group was significantly higher than that in the control group(P<0.05).During the whole treatment period,no abnormal liver and kidney function and special discomfort were found in the two groups.Conclusion Compared with estazolam,Bushen Huoxue Decoction can more effectively improve the sleep quality of elderly patients with chronic insomnia,reduce the symptoms of traditional Chinese medicine and the accompanying anxiety and depression,and has better safety.