加味半夏厚朴汤治疗阻塞性睡眠呼吸暂停综合征的疗效观察

Effective observation on treating obstructive sleep apnea syndrome with the Jiawei Banxia Houpo decoction

目的:观察加味半夏厚朴汤治疗阻塞性睡眠呼吸暂停综合征的疗效。方法:选取60例中重度阻塞性睡眠呼吸暂停综合征患者,随机分为对照组、治疗组各30例,对照组给予调节生活方式,合理饮食、控制体质量处理,另给予单水平无创呼吸机(飞利浦REMstar Auto567)连续气道正压通气模式,每晚1次,每次7 h,压力根据患者情况而定,疗程12周。治疗组在对照组的基础上每天服用加味半夏厚朴汤,疗程12周。观察两组的总有效率,治疗前后中医证候积分、Epworth嗜睡量表(Epworth Sleepiness Scale,ESS)、韦克斯勒记忆量表(Wechsler Memory Scale,WMS)、多导联睡眠呼吸监测的呼吸紊乱指数(Apnea–Hypopnea Index,AHI)、最低血氧饱和度(Lowest Oxygen Saturation,LSaO_(2))、代谢指标血清空腹血糖(Glucose,GLU)、糖化血红蛋白(Glycosylated hemoglobin,GHb)、总胆固醇(Total Cholesterol,TC)、三酰甘油(Triglyceride,TG)的变化。结果:治疗组总有效率显著高于对照组(P<0.05),两组治疗后中医证候积分较前显著性改善(P<0.05),且治疗组的改善更为显著(P<0.05);治疗后治疗组ESS、WMS、AHI、LSaO_(2)较治疗前改善(P<0.05),且优于对照组(P<0.05),而对照组治疗后ESS、WMS较治疗前改善(P<0.05),但AHI、LSaO_(2)较治疗前无显著性差异(P>0.05)。两组治疗后代谢指标GLU、GHb、TC、TG较前显著改善(P<0.05),且治疗组的改善更为显著(P<0.05)。结论:加味半夏厚朴汤治疗阻塞性睡眠呼吸暂停综合征的疗效良好,能改善患者嗜睡及记忆力下降,改善患者的代谢水平。

Objective:To observe efficacy of the Jiawei Banxia Houpo decoction(加味半夏厚朴汤)on OSAS.Methods:60 cases with OSAS were divided into 2 groups,30 cases in each.The control group was given lifestyle adjustments,reasonable diet,and weight control,and single-level noninvasive ventilator(Philips REMstar Auto567)CAPA mode,once a night,7 hours as one time;and the pressure was determined according to the patient’s condition,and the course of treatment was 12 weeks.On the basis of the control group,the treatment group took Jiawei Banxia Houpo decoction every day for 12 weeks.Results:The total efficiency in the treatment group was significantly higher than the control group(P<0.05).After treatment,the scores of TCM syndromes in the two groups were significantly improved(P<0.05),and the improvement in the treatment group was significant(P<0.05);after treatment,ESS,WMS,AHI,and LSaO_(2) in the treatment group were improved(P<0.05),and better than the control group(P<0.05).In the control group,ESS and WMS were improved after treatment compared with before treatment(P<0.05).However,AHI and LSaO_(2) were not significantly different from before treatment(P>0.05).After treatment,the metabolic indexes GLU,GHb,TC,and TG were significantly improved in the two groups(P<0.05),and the improvement in the treatment group was more significant(P<0.05).Conclusion:The Jiawei Banxia Houpo decoction has a good effect on OSAS,which can improve the patients’sleepiness and memory decline,and improve metabolic level.