解郁清心颗粒联合疏肝调神针刺法治疗卒中后抑郁合并睡眠障碍临床研究

Clinical Study of Jieyu Qingxin Granules Combined with Shugan Tiaoshen Acupuncture in Treating Post-stroke Depression with Sleep Disorder

目的探讨解郁清心颗粒联合疏肝调神针刺法治疗卒中后抑郁(post-stroke depression,PSD)合并睡眠障碍患者的临床疗效。方法选取2021年1月—2022年5月在本院神经内科住院治疗的PSD合并睡眠障碍者60例,随机分为对照组和观察组,每组30例。对照组予以米氮平片口服,观察组接受解郁清心颗粒口服联合疏肝调神针刺法治疗。比较2组患者治疗前后汉密尔顿抑郁量表(Hamilton depression scale,HAMD)评分、匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)、血清白介素-6(interleukin-6,IL-6)及肿瘤坏死因子-α(tumour necrosis factor-α,TNF-α)水平。比较2组患者治疗前后多导睡眠图(polysomnography,PSG)各项指标及治疗期间药物副反应发生情况。结果治疗后,2组患者HAMD及PSQI评分、IL-6及TNF-α水平、入睡后清醒时间、睡眠潜伏期显著低于治疗前(P<0.05),2组患者总睡眠时间、睡眠效率明显高于治疗前(P<0.05)。治疗期间,观察组患者头晕、思睡发生率显著低于对照组(P<0.05)。结论解郁清心颗粒联合疏肝调神针刺法治疗PSD合并睡眠障碍可显著改善患者临床症状,降低炎症因子水平,且副反应较少。

Objective To explore the clinical effect of Jieyu Qingxin granules combined with Shugan Tiaoshen acupuncture in treating patients with post-stroke depression(PSD)and sleep disorder.Methods From January 2021 to May 2022,sixty patients with PSD and sleep disorder hospitalized in the neurology department of our hospital were randomly divided into the control group and the observation group,with 30 patients in each group.The control group was treated with oral mirtazapine tablets,while the observation group received Jieyu Qingxin granules combined with Shugan Tiaoshen acupuncture.Hamilton depression scale(HAMD)score,Pittsburgh sleep quality index(PSQI),levels of serum interleukin-6(IL-6)and tumour necrosis factor-α(TNF-α)before and after treatment were compared between the two groups.Indicators of polysomnography(PSG)before and after treatment and the occurrence of drug side reactions during the treatment period were compared between the two groups.Results After treatment,the HAMD and PSQI scores,levels of IL-6 and TNF-α,waking time and sleep latency period of the two groups were significantly lower than those before treatment(P<0.05).The total sleep time and sleep efficiency of the two groups were significantly higher than those before treatment(P<0.05).During the treatment,the incidence of dizziness and sleepiness in the observation group was significantly lower than that in the control group(P<0.05).Conclusion Jieyu Qingxin granules combined with Shugan Tiaoshen acupuncture in patients with PSD and sleep disorder could significantly improve clinlcal symptom,and reduce the level of inflammatory factors,with few side effects.