平胃散加减联合持续气道正压通气治疗阻塞性睡眠呼吸暂停低通气综合征疗效观察

Observation on curative effect of modified Pingwei powder combined with continuous positive airway pressure on obstructive sleep apnea hypopnea syndrome

目的观察平胃散加减联合持续气道正压通气治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的临床疗效。方法选择2019年2月—2020年2月石家庄市中医院收治的OSAHS患者100例,随机分为2组。对照组给予持续气道正压通气治疗,观察组在对照组基础上联合平胃散加减治疗,2组疗程均为8周。比较2组治疗前后中医症状积分、体质指数(BMI)、血清超敏C反应蛋白(hs-CRP)、呼吸暂停低通气指数(AHI)、夜间最低S a(O_(2))、Epworth嗜睡量表(ESS)评分、蒙特利尔认知评估量表(MoCA)评分,统计2组中医症状疗效和西医疗效。结果2组治疗后中医症状单项(打鼾、嗜睡、神疲肢重、乏力懒言、头重如裹、头晕、肥胖浮肿、寐不安、多涎、脘腹痞满、口舌生疮)积分和总积分均较治疗前明显降低(P均<0.05),且观察组治疗后上述积分均明显低于对照组(P均<0.05)。2组治疗后BMI、血清hs-CRP、AHI、ESS评分均较治疗前明显降低(P均<0.05),夜间最低S a(O_(2))均较治疗前明显增高(P均<0.05),观察组治疗后上述指标改善情况均优于对照组(P均<0.05)。2组治疗后MoCA量表中视空间执行功能、注意力与计算、延迟回忆、抽象力评分与总分均较治疗前明显增高(P均<0.05),且观察组治疗后上述评分均明显高于对照组(P均<0.05)。观察组中医症状疗效总有效率为92%(46/50),明显高于对照组的70%(35/50),差异有统计学意义(P<0.05);观察组西医治疗总有效率为88%(44/50),明显高于对照组的68%(34/50),差异有统计学意义(P<0.05)。结论平胃散加减联合持续气道正压通气治疗OSAHS不仅可改善患者症状,降低BMI及炎症反应,还能改善呼吸及睡眠结构,提高认知功能。

Objective It is to observe the clinical efficacy of modified Pingwei powder combined with continuous positive airway pressure on obstructive sleep apnea hypopnea syndrome(OSAHS). Methods A total of 100 OSAHS patients admitted to Shijiazhuang Hospital of Traditional Chinese Medicine from February 2019 to February 2020 were selected and randomly divided into two groups. The control group was treated with continuous positive airway pressure, and the observation group was treated with modified Pingwei powder on the basis of the control group. Both groups were treated for 8 weeks. The traditional Chinese medicine(TCM) symptom scores, body mass index(BMI), serum high-sensitivity C-reactive protein(hs-CRP), apnea-hypopnea index(AHI), nighttime lowest Sa(O), Epworth sleepiness scale(ESS) scores, Montreal Cognitive Assessment(MoCA) scores before and after treatment were compared between the two groups, and the efficacy of TCM symptom and western medicine in the two groups were calculated. Results After treatment, the scores of each item(snoring, drowsiness, mental fatigue and heavy limbs, weakness and lazy speech, heavy head, dizziness, obesity and edema, restless sleep, excessive salivation, abdomen fullness, mouth and tongue sores) and total scores of TCM symptoms were significantly lower than those before treatment(all P<0.05), and the above scores of the observation group were significantly lower than those of the control group after treatment(all P<0.05). After treatment, BMI, serum hs-CRP, AHI, and ESS scores in both groups were significantly lower than those before treatment(all P<0.05), and the lowest Sa(O) at night was significantly higher than that before treatment(P<0.05), the improvement of the above indexes after treatment was better than that of the control group(P<0.05). The scores of visuospatial executive function, attention and calculation, delayed recall, abstraction and total score of MoCA after treatment were significantly higher than those before treatment in both groups(all P<0.05), and the above scores of the observation group were significantly higher than those of the control group after treatment(all P<0.05). The total effective rate of TCM symptoms in the observation group was 92%(46/50), which was significantly higher than 70%(35/50) in the control group, and the difference was statistically significant(P<0.05). The total effective rate of western medicine treatment in the observation group was 88%(44/50), which was significantly higher than 68%(34/50) in the control group, and the difference was statistically significant(P<0.05). Conclusion Modified Pingwei powder combined with continuous positive airway pressure can not only improve the symptoms of patients, reduce BMI and inflammatory response, but also improve the structure of breathing and sleep, and improve cognitive function in the treatment of OSAHS.