安神汤加减治疗失眠临床研究

Clinical Study on Modified Anshen Tang for Insomnia

目的:观察安神汤加减治疗肝郁化火型失眠患者的临床疗效及对5-羟色胺(5-HT)、多巴胺(DA)、γ-氨基丁酸(GABA)的影响。方法:将98例失眠患者按随机数字表法分为对照组与观察组各49例。对照组予艾司唑仑片治疗,观察组在对照组基础上加用安神汤加减治疗。比较2组临床疗效及治疗前后中医证候积分、匹兹堡睡眠质量指数(PSQI)评分、多导睡眠监测指标及5-HT、DA、GABA水平。结果:观察组总有效率89.80%,高于对照组77.55%(P<0.05)。与同组治疗前比较,治疗后2组PSQI评分、中医证候积分及DA水平均降低(P<0.05),总睡眠时间延长(P<0.05),睡眠效率及5-HT、GABA水平升高(P<0.05),睡眠潜伏期缩短(P<0.05);与对照组治疗后比较,观察组治疗后PSQI评分、中医证候积分及DA水平较低(P<0.05),总睡眠时间较长(P<0.05),睡眠效率及5-HT、GABA水平较高(P<0.05),睡眠潜伏期较短(P<0.05)。结论:安神汤加减治疗肝郁化火型失眠临床疗效显著,可显著减少患者中医证候积分及PSQI评分,改善多导睡眠监测指标,调节单胺类神经递质水平。

Objective:To observe the clinical effect of modified Anshen tang for patients with insomnia of depressed liver qi transforming into fire type and its effect on 5-hydroxytryptamine(5-HT),dopamine(DA) and γ-aminobutyric acid(GABA).Methods: A total of 98 cases of patients with insomnia were divided into the control group and the observation group according to the random number table method,with 49 cases in each group. The control group was treated with estazolam tablets,and the observation group was additionally treated with modified Anshen tang based on the treatment of the control group. Chinese medicine syndrome scores, Pittsburgh sleep Quality Index(PSQI) scores, polysomnography monitoring indexes and levels of 5-HT, DA and GABA before and after treatment as well as clinical effects in the two groups were compared. Results:The total effective rate was 89.80% in the observation group,higher than that of 77.55% in the control group(P<0.05). After treatment,PSQI scores,Chinese medicine syndrome scores and DA levels in the two groups were decreased when compared with those before treatment(P<0.05), the total sleep time was prolonged(P<0.05), sleep efficiency and levels of 5-HT and GABA were increased(P<0.05),and sleep latency was shortened(P<0.05). After treatment,PSQI score,Chinese medicine syndrome score and DA level in the observation group were lower than those in the control group(P<0.05),the total sleep time was longer(P<0.05),sleep efficiency and levels of 5-HT and GABA were higher(P<0.05),and sleep latency was shorter(P<0.05). Conclusion:Modified Anshen tang has a significant clinical effect in treating insomnia of depressed liver qi transforming into fire type,which can significantly reduce Chinese medicine syndrome scores and PSQI scores,improve polysomnography monitoring indexes and regulate monoamine neurotransmitter levels.