黄连温胆汤加减联合耳穴放血治疗痰热内扰型失眠患者的临床效果

Clinical effects of Huanglian Wendan decoction combined with ear acupoint bloodletting in treatment of patients with insomnia of phlegm-heat internal disturbance type

目的:观察黄连温胆汤加减联合耳穴放血治疗痰热内扰型失眠患者的临床效果。方法:选取240例痰热内扰型失眠患者为研究对象,按照随机数字表法分为研究组与对照组各120例。两组均服用艾司唑仑片,在此基础上对照组采用耳穴放血治疗,研究组在对照组基础上加用黄连温胆汤加减治疗,比较两组临床疗效、中医证候积分、匹兹堡睡眠质量指数(PSQI)评分和不良反应发生率。结果:研究组治疗总有效率为90.83%,明显高于对照组的70.83%,差异有统计学意义(P<0.05);治疗后,两组心烦懊恼、睡眠不安、胸闷脘痞、头晕目眩、神疲乏力、大便秘结和痰多口苦等中医证候积分均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);治疗后,两组PSQI评分均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);两组均未发生明显不良反应。结论:在艾司唑仑片治疗基础上采用黄连温胆汤加减联合耳穴放血治疗痰热内扰型失眠患者可提高治疗总有效率,降低中医证候积分和PSQI评分,效果优于艾司唑仑片联合耳穴放血治疗。

Objective:To observe clinical effects of Huanglian Wendan decoction combined with ear acupoint bloodletting in treatment of patients with insomnia of phlegm-heat internal disturbance type.Methods:240 patients with insomnia of phlegm-heat internal disturbance type were selected as the research objects,and were divided into study group and control group according to the random number table method,120 cases in each group.Both groups took Estazolam tablets.On this basis,the control group was treated with ear acupoint bloodletting,while the study group was treated with Huanglian Wendan decoction on the basis of that of the control group.The clinical efficacy,the TCM syndrome score,the Pittsburgh sleep quality index(PSQI)score and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of treatment in the study group was 90.83%,which was significantly higher than 70.83%in the control group,and the difference was statistically significant(P<0.05).After the treatment,the scores of TCM syndromes such as dysphoria,sleep disturbance,chest tightness,epigastric distention,dizziness,fatigue,constipation,extensive phlegm and bitter taste of the two groups were lower than those before the treatment;those of the study group were lower than those of the control group;and the differences were statistically significant(P<0.05).After the treatment,the PSQI scores of the two groups were lower than those before the treatment;that of the study group was lower than that of the control group;and the differences were statistically significant(P<0.05).However,no obvious adverse reactions occurred in the two groups.Conclusions:Based on the treatment of Estazolam tablets,Huanglian Wendan decoction combined with ear acupoint bloodletting for the patients with insomnia of phlegm-heat internal disturbance type can improve the total effective rate of treatment,and reduce the TCM syndrome score and the PSQI score.Moreover,it is superior to Estazolam tablets combined with ear acupoint bloodletting treatment.