参附龙骨牡蛎加减方治疗维持性血液透析患者睡眠障碍的效果观察

Observation on the effect of modified Shenfu Longgu Muli Prescription on sleep disorders in maintenance hemodialysis patients

目的分析出现睡眠障碍的维持性血液透析患者采用参附龙骨牡蛎加减方治疗的效果。方法72例出现睡眠障碍的维持性血液透析患者作为研究对象,按照入院时间先后顺序不同分出对照组(2021年6~12月)和试验组(2022年1~6月),每组36例。对照组采用常规药物治疗,试验组在对照组基础上增加参附龙骨牡蛎加减方治疗。比较两组患者治疗前后睡眠质量、中医证候积分、血浆指标[5-羟色胺(5-HT)、褪黑素(MT)]水平、焦虑抑郁心理评分以及治疗效果。结果治疗后,试验组睡眠质量评分(0.68±0.21)分、入睡时间评分(0.79±0.24)分、日间功能评分(0.74±0.25)分、睡眠时间评分(0.83±0.27)分、催眠药物评分(0.63±0.10)分、睡眠效率评分(0.88±0.25)分、睡眠障碍评分(0.77±0.25)分、总分(5.32±1.57)分均低于对照组的(0.91±0.22)、(0.99±0.30)、(1.04±0.22)、(1.35±0.31)、(0.99±0.12)、(1.05±0.30)、(0.95±0.22)、(7.28±1.69)分,差异均具有统计学意义(P<0.05)。治疗后,试验组患者心烦不寐评分(0.54±0.21)分、泛恶嗳气评分(0.50±0.20)分、胸闷评分(0.33±0.02)分、头重目眩评分(0.40±0.03)分均低于对照组的(0.95±0.61)、(0.81±0.23)、(0.99±0.42)、(1.04±0.55)分,差异均具有统计学意义(P<0.05)。治疗后,试验组患者5-HT(94.99±20.24)μg/L、MT(50.24±7.26)pg/L均高于对照组的(80.27±16.54)μg/L、(43.64±6.55)pg/L,差异均具有统计学意义(P<0.05)。试验组治疗总有效率97.22%高于对照组的80.56%,差异具有统计学意义(P<0.05)。治疗后,试验组焦虑抑郁心理因子评分(4.24±1.24)分低于对照组的(7.22±2.24)分,差异具有统计学意义(P<0.05)。结论在维持性血液透析患者治疗中,参附龙骨牡蛎加减方的应用可以减轻患者的睡眠障碍,对提高治疗效果与缓解不良心理具有积极作用,值得推荐。

Objective To analyze the effect of modified Shenfu Longgu Muli Prescription on sleep disorders in maintenance hemodialysis patients.Methods A total of 72 maintenance hemodialysis patients with sleep disorders were selected as the study subjects,and were divided into the control group(June-December 2021)and the experimental group(January-June 2022)according to the different order of admission,with 36 cases in each group.The control group was treated with conventional drugs,and the experimental group was treated with modified Shenfu Longgu Muli Prescription on the basis of the control group.Both groups were compared in terms of sleep quality,traditional Chinese medicine syndrome score,plasma index[5-hydroxytryptamine(5-HT),melatonin(MT)]levels and anxiety and depression scores before and after treatment,and therapeutic effects.Results After treatment,the experimental group had sleep quality score of(0.68±0.21)points,sleep latency score of(0.79±0.24)points,daytime function score of(0.74±0.25)points,sleep time score of(0.83±0.27)points,hypnotic drug score of(0.63±0.10)points,sleep efficiency score of(0.08±0.25)points,sleep disturbance score of(0.07±0.75)points,and total score of(5.32±1.57)points,which were lower than those of(0.91±0.22),(0.99±0.30),(1.04±0.22),(1.35±0.31),(0.99±0.12),(1.05±0.30),(0.95±0.22),and(7.28±1.69)points in the control group,and the differences were statistically significant(P<0.05).After treatment,the scores of vexation and insomnia,nausea and blenching,chest tightness,and heavy head and dizziness were(0.54±0.21),(0.50±0.20),(0.33±0.02),and(0.40±0.03)points in the experimental group,which were all lower than those of(0.95±0.61),(0.81±0.23),(0.99±0.42),and(1.04±0.55)points in the control group,and the differences were statistically significant(P>0.05).After treatment,5-HT of(94.99±20.24)μg/L and MT of(50.24±7.26)pg/L in the experimental group were higher than those of(80.27±16.54)μg/L and(43.64±6.55)pg/L in the control group,and the differences were statistically significant(P<0.05).The total effective rate of the experimental group was 97.22%,which was higher than that of 80.56%of the control group,and the difference was statistically significant(P<0.05).After treatment,the scores of anxiety and depression psychological factors in the experimental group was(4.24±1.24)points in the experimental group,which was lower than that of(7.22±2.24)points in the control group,and the difference was statistically significant(P<0.05).Conclusion In the treatment of maintenance hemodialysis patients,modified Shenfu Longgu Muli Prescription can reduce patients'sleep disorders,improve the therapeutic effect and alleviate adverse psychological effects,which is recommended.