炙甘草汤合归脾汤加减联合劳拉西泮治疗老年顽固性失眠临床研究

Clinical Study on Modified Zhigancao Decoction Complicated with Guipi Decoction Combined with Lorazepan for the Senile with Intractable Insomnia

目的:观察炙甘草汤合归脾汤加减联合劳拉西泮治疗老年顽固性失眠心脾两虚证的临床疗效。方法:选取60例老年顽固性失眠心脾两虚证患者,依照区组随机化分组法分为对照组和观察组各30例。对照组给予劳拉西泮片治疗,观察组在对照组基础上给予炙甘草汤合归脾汤加减治疗,2组均治疗1个月。比较2组临床疗效,治疗前后中医证候积分、汉密尔顿焦虑量表(HAMA)评分、汉密尔顿抑郁量表(HAMD)评分,记录不良反应发生率。结果:治疗后,观察组临床疗效总有效率96.67%,高于对照组73.33%(P<0.05)。2组多梦易醒、神疲乏力、心悸健忘、头晕目眩积分及总分均较治疗前降低,观察组上述4项中医证候积分及总分均低于对照组,差异均有统计学意义(P<0.05)。2组HAMA、HAMD评分均较治疗前降低,观察组HAMA、HAMD评分均低于对照组,差异均有统计学意义(P<0.05)。治疗期间,观察组不良反应发生率6.67%,与对照组16.67%比较,差异无统计学意义(P>0.05)。结论:炙甘草汤合归脾汤加减联合劳拉西泮治疗老年顽固性失眠心脾两虚证可提高临床疗效,改善患者的临床症状,缓解其焦虑、抑郁情绪,安全性好。

Objective:To observe the clinical effect of modified Zhigancao Decoction complicated with Guipi Decoction combined with Lorazepan for the senile with intractable insomnia with deficiency of both the heart and spleen syndrome.Methods:A total of 60 cases of senile patients with intractable insomnia with deficiency of both the heart and spleen syndrome were selected and divided into the control group and the observation group based on block randomization grouping method,with 30 cases in each group.The control group was treated with Lorazepam Tablets,and the observation group was additionally treated with modified Zhigancao Decoction complicated with Guipi Decoction based on the treatment of the control group.Both groups were treated for 1 month.The scores of traditional Chinese medicine(TCM)syndrome,Hamilton Anxiety Scale(HAMA),and Hamilton Depression Scale(HAMD)before and after treatment,as well as the clinical effects were compared between the two groups.The incidence of adverse reactions was recorded.Results:After treatment,the total effective rate of clinical effect was 96.67%in the observation group and 73.33%in the control group,the difference being significant(P<0.05).The scores of deaminess and festless sleep,mental fatigue and lack of strength,palpitation and forgetfulness,and dizziness and dizzy vision as well as the total TCM syndrome scores in the two groups were decreased when compared with those before treatment,and the above four TCM syndrome scores and total score in the observation group were lower than those in the control group,differences being significant(P<0.05).The scores of HAMA and HAMD in the two groups were decreased when compared with those before treatment,and the scores of HAMA and HAMD in the observation group were lower than those in the control group,differences being significant(P<0.05).During treatment,the incidence of adverse reactions was 6.67%in the observation group and 16.67%in the control group,there being no significance in the difference(P>0.05).Conclusion:Based on Lorazepam Tablets,the additional treatment of modified Zhigancao Decoction complicated with Guipi Decoction combined with Lorazepan for the senile with intractable insomnia with deficiency of both the heart and spleen syndrome can improve clinical effects and clinical symptoms,and relieve their anxiety and depression,with good safety.