柴桂温胆汤加减治疗肝郁痰阻型失眠的临床疗效研究

Clinical Effect Study on Modified Chai Gui Wendan Decoction in the Treatment of Insomnia with Liver Stagnation and Phlegm Obstruction Type

【目的】探讨柴桂温胆汤加减治疗肝郁痰阻型失眠患者的临床疗效。【方法】将80例肝郁痰阻型失眠患者随机分为观察组43例和对照组37例。观察组给予柴桂温胆汤加减治疗,对照组给予艾司唑仑片治疗,疗程为8周。观察2组患者治疗前后简易智力状态检查量表(MMSE)评分、匹兹堡睡眠质量指数(PSQI)评分、汉密尔顿焦虑量表(HAMA)评分和中医证候积分的变化情况,并评价2组患者的临床疗效及安全性。【结果】(1)治疗8周后,观察组的总有效率为86.05%(37/43),对照组为67.57%(25/37);组间比较,观察组的总体疗效和总有效率均明显优于对照组(P<0.05)。(2)治疗后,2组患者的MMSE各项评分均较治疗前明显提高,PSQI各项评分均较治疗前明显降低(P<0.05);组间比较,观察组的MMSE各项评分均明显高于对照组,PSQI各项评分均明显低于对照组(P<0.01)。(3)治疗后,2组患者的HAMA评分和中医证候积分均较治疗前明显降低(P<0.05),且观察组的HAMA评分和中医证候积分均明显低于对照组(P<0.01)。(4)观察组的不良反应率为0.00%(0/43),明显低于对照组的24.32%(9/37),差异有统计学意义(P<0.05)。【结论】柴桂温胆汤加减治疗肝郁瘀阻型失眠症患者疗效显著,不仅可改善睡眠质量,延长睡眠时间,提高患者认知功能,还可改善失眠患者伴随的焦虑状态及中医证候,且无明显不良反应,安全性高。

Objective To investigate the clinical efficacy of modified Chai Gui Wendan Decoction in the treatment of insomnia with liver stagnation and phlegm obstruction type.Methods Eighty insomnia patients with liver stagnation and phlegm obstruction type were randomly divided into observation group(43 cases)and control group(37 cases).The observation group was treated with Chai Gui Wendan Decoction and the control group was treated with estazolam tablets,and the course for treatment lasted for 8 weeks.The changes of mini-mental state examination(MMSE)scores,Pittsburgh Sleep Quality Index(PSQI)scores,Hamilton Anxiety Scale(HAMA)scores and traditional Chinese medicine(TCM)syndrome scores in the two groups were observed before and after treatment,and the clinical efficacy and safety of the two groups were evaluated after treatment.Results(1)After8 weeks of treatment,the total effective rate was 86.05%(37/43)in the observation group and was 67.57%(25/37)in the control group.The intergroup comparison showed that the overall efficacy and total effective rate of observation group were significantly superior to those of the control group(P<0.05).(2)After treatment,MMSE scores and PSQI scores in the two groups were significantly increased compared with those before treatment(P<0.05),and the scores in the observation group were significantly higher than those in the control group(P<0.01).(3)After treatment,HAMA scores and TCM syndrome score in the two groups were significantly decreased compared with those before treatment(P<0.05),and the scores in the observation group were significantly lower than those in the control group(P<0.01).(4)The incidence of adverse reaction in the observation group was0.00%(0/43),which was significantly lower than that in the control group[24.32%(9/37)],and the difference was statistically significant(P<0.05).Conclusion Chai Gui Wendan Decoction has significant therapeutic effect in treating patients with liver stagnation and phlegm obstruction type of insomnia.The decoction is effective not only in improving sleep quality,length of sleep and cognitive function of patients,but also in relieving the accompanied anxiety state and TCM syndromes of insomnia patients,with high safety while without obvious adverse reactions.