基于“阴阳交通”睡眠理论应用柴夏十味汤治疗痰热内扰型失眠临床研究

Clinical Study on the Treatment of Phlegm-Heat Insomnia by Chaixiashiwei Decoction Based on the Sleep Theory of“Inter Action of Yin And Yang”

目的:观察基于“阴阳交通”睡眠理论应用柴夏十味汤治疗痰热内扰型失眠的临床疗效。方法:选取2020年7月至2022年6月北京市鼓楼中医医院内科门诊收治的失眠患者70例作为研究对象,按照随机数字表法分为观察组和对照组,每组35例。观察组给予柴夏十味汤口服,对照组给予艾司唑仑口服,连续用药4周。观察2组疗效,以匹兹堡睡眠质量指数量表(PSQI)评价睡眠质量,以Epworth嗜睡量表评价日间嗜睡程度,以中医证候积分评价症状改善情况。结果:观察组总有效率97.14%,对照组总有效率85.71%,观察组疗效优于对照组(P<0.05);观察组PSQI总分及睡眠质量、入睡时间、睡眠时间、催眠药物4项因子分、Epworth嗜睡量表评分、中医证候积分均低于对照组,2组差异均有统计学意义(均P<0.05);2组不良事件发生率差异无统计学意义(P>0.05)。停药4周后随访,观察组复发率5.71%,对照组复发率31.43%,2组差异有统计学意义(P<0.05)。结论:基于“阴阳交通”睡眠理论应用柴夏十味汤治疗痰热内扰型失眠,在改善患者睡眠质量、缩短入睡时间、延长睡眠时间、减少催眠药物、改善日间嗜睡及减轻痰热内扰相关症状方面具有优势,且具备较好的安全性和长期疗效。

Objective:To observe the effect of ChaixiaShiwei Decoction on phlegm-heat insomnia.Methods:A total of 70 insomnia patients in the internal medicine outpatient department of Gulou Hospital of Traditional Chinese Medicine of Beijing from July 2020 to June 2022 were selected as the research objects,and were divided into observation group and control group by random number table method,35 cases in each group.The control group was given Esazolam,and the observation group was given ChaixiaShiwei Decoction Formula granules.The course of treatment was 4 weeks.The effects of the two groups were observed.Sleep quality was evaluated by Pittsburgh Sleep Quality Index Scale(PSQI),daytime sleepiness was evaluated by Epworth sleepiness scale,and symptom improvement was evaluated by TCM syndrome score.Results:After treatment,the total effective rate of the observation group was 97.14%,while that of the control group was 85.71%.The therapeutic effect of the observation group was better than that of the control group(P<0.05).The total score of PSQI,the score of subjective sleep quality,sleep latency,sleep duration,used sleep medication,Epworth score and TCM syndrome score of the observation group were lower than those of the control group,and the differences between the two groups were statistically significant(all P<0.05).There was no significant difference in the incidence of adverse events between the two groups(P>0.05).Follow up after 4 weeks of discontinuation,the recurrence rate was 5.71%in the observation group and 31.43%in the control group,the difference between the two groups was statistically significant(P<0.05).Conclusion:The application of ChaixiaShiwei Decoction in the treatment of phlegm-heat insomnia based on the sleep theory of“Yin and Yang communication”has advantages in improving patients′sleep quality,shortening sleeping latency,extending sleeping duration,reducing hypnotic drugs,improving daytime sleepiness and alleviating phlegm-heat related symptoms,and has good safety and long-term efficacy.