疏肝健脾汤联合中药脐贴治疗失眠伴抑郁临床观察

Clinical Observation on Shugan Jianpi Decoction Combined with Umbilicus Sticking in the Treatment of Depression with Insomnia

目的疏肝健脾汤联合中药脐贴对失眠患者疗效及抑郁状态的影响。方法选取2019年2月—2020年4月辽宁健康产业集团阜新矿总医院收治的64例失眠伴抑郁患者,采用随机数字表法分为观察组与对照组,各32例。对照组予西医常规治疗,观察组予以疏肝健脾汤联合中药脐贴治疗,2组均治疗4周。比较2组患者失眠状态及抑郁状态、血清5-羟色胺(5-HT)、去甲肾上腺素(Norepinephrine,NE)及多巴胺(Dopamine,DA)表达水平、中医证候积分及临床疗效。结果经治疗,与对照组相比,观察组患者匹茨堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)、抑郁自评量表(Self-rating depression scale,SDS)、焦虑自评量表(Self-rating anxiety scale,SAS)评分和中医证候积分降低更显著(P<0.05);经治疗,与对照组相比,观察组患者血浆5-HT、NE、DA表达水平升高更显著(P<0.05);临床检测统计,观察组临床总有效率为93.75%(30/32),对照组临床总有效率为71.88%(23/32)(P<0.05)。结论疏肝健脾汤联合中药脐贴可显著改善肝郁脾虚型失眠伴抑郁患者临床症状,起到疏肝解郁、健脾宁心安神的作用,能够缓解患者抑郁情绪,调节血浆5-HT、NE、DA表达水平,值得临床推广。

Objective To observe the effect of Shugan Jianpi decoction combined with umbilicus sticking in the treatment of depression with insomnia.Methods 64 patients with insomnia and depression admitted to Liaoning Health Industry Group Fuxin Mining General Hospital from February 2019 to April 2020 were collected and randomly divided into observation group and control group,with 32 cases in each.The control group was treated with traditional western medicine,and the observation group was treated with Shugan Jianpi decoction combined with umbilical sticking.Both groups were treated for 4 weeks.The insomnia status and depression status,plasma 5-ht,NE,DA expression levels,traditional Chinese medicine syndrome scores and clinical efficacy of the two groups were compared.Results After treatment,compared with the control group,PSQI,SDS and SAS scores in the observation group were significantly reduced(P<0.05).After treatment,compared with the control group,the plasma levels of 5-ht,NE and DA in the observation group were more significantly increased(P<0.05).Clinical test statistics showed that the total clinical effective rate of the observation group was 93.75%(30/32),and that of the control group was 71.88%(23/32),and the curative effect of the observation group was more significant than that of the control group(P<0.05).Conclusion Shugan Jianpi decoction combined with the traditional Chinese medicine umbilical patch can significantly improve the clinical symptoms of insomnia patients with liver depression and spleen deficiency,play the role of soothing the liver and relieving depression,strengthening the spleen,calming the heart and calming the nerves,relieving the depressed mood of patients,and regulating the expression levels of plasma 5-ht,NE and DA,which is worthy of clinical promotion.