朱砂安神汤加减联合艾司唑仑片治疗原发性失眠的临床疗效及对相关实验室指标的影响

Efficacy of modified Zhusha Anshen Decoction combined with estazolam tablets and its relation with related laboratory indexes for primary insomnia

目的观察朱砂安神汤加减联合艾司唑仑片治疗原发性失眠的临床疗效及对相关实验室指标的影响。方法将158例原发性失眠患者按照随机数字表法分为2组,对照组79例予艾司唑仑片治疗,治疗组79例在对照组治疗基础上加用朱砂安神汤加减治疗,2组均治疗4周。比较2组疗效;比较2组治疗前后血清脑源性神经营养因子(BDNF)、γ-氨基丁酸(GABA)、5-羟色胺(5-HT)、多巴胺(DA)水平变化;比较2组治疗前后匹兹堡睡眠质量指数量表(PSQI)评分及中医证候评分变化。结果治疗组总有效率94.94%(75/79),对照组总有效率82.28%(65/79),治疗组疗效优于对照组(P<0.05)。2组治疗后BDNF、GABA及5-HT水平均较本组治疗前升高(P<0.05),DA水平较本组治疗前降低(P<0.05),且治疗组治疗后BDNF、GABA及5-HT水平均高于对照组(P<0.05),DA水平低于对照组(P<0.05)。2组治疗后PSQI各项评分及总评分均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后中医证候各项评分及总评分均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。结论朱砂安神汤加减联合艾司唑仑片治疗原发性失眠,可提高临床效果,其作用机制可能与改善BDNF、GABA、5-HT、DA水平有关。

Objective To observe the efficacy of modified Zhusha Anshen Decoction combined with estazolam tablets and its relation with related laboratory indexes for primary insomnia(PI)and.Methods Totally 158 PI patients were randomly divided into equal group,in addition to estazolam tablets,and treatment group additionally received modified Zhusha Anshen Decoction.A 4-week treatment were performed,serum brain-derived neurotrophic factor(BDNF),Gamma-aminobutyric acid(GABA),5-hydroxytryptamine(5-HT),dopamine(DA),Pittsburgh Sleep Quality Index Scale(PSQI),traditional Chinese medicine(TCM)syndrome score were included as comparators;the curative effect was counted.Results The overall effective rate was 94.94%(75/79)in treatment group,better than that of 82.28%(65/79)in control group(P<0.05).After treatment,elevated BDNF,GABA and 5-HT in groups were found(P<0.05),and which in treatment group was higher than control group(P<0.05);reduced DA in groups was recorded(P<0.05),which in treatment group was lower(P<0.05);PSQI scores and TCM symptom scores in groups were decreased(all P<0.05),improvement of which in treatment group were significantly better(all P<0.05).Conclusion For PI patients,modified Zhusha Anshen Decoction combined with estazolam tablets can improve the clinical effect,the improvement of the expression of BDNF,GABA,5-HT and DA may be an important mechanism of its action.