酸枣仁汤联合通焦利眠贴治疗脑梗死后失眠

Study on the therapeutic effect of Suanzaoren decoction combined with Tongjiao Limian plaster on patients with insomnia after cerebral infarction

目的探讨酸枣仁汤联合通焦利眠贴治疗脑梗死后失眠患者疗效及对血清5-羟色胺(5-HT)、脑源性神经营养因子(BDNF)和神经肽Y(NPY)水平的影响。方法回顾性选取2021年1月-2023年5月本院收治的86例脑梗死后失眠患者,根据其治疗方案分为中医联合治疗组(n=40,采用酸枣仁汤联合通焦利眠贴治疗)和常规西医治疗组(n=46,采用艾司唑仑片口服治疗)。比较2组临床疗效,治疗前后睡眠质量[匹兹堡睡眠质量指数量表(PSQI)、睡眠状况自评量表(SRSS)]、血清神经递质(5-HT、BDNF、NPY)水平变化及治疗期间不良反应发生情况。结果治疗后,中医联合治疗组PSQI、SRSS评分均低于常规西医治疗组(P<0.05)。中医联合治疗组患者临床疗效总有效率为85.00%,常规西医治疗组的总有效率为63.04%,中医联合治疗组优于西医治疗组(P<0.05)。治疗后,中医联合治疗组血清5-HT、BDNF、NPY水平均高于常规西医治疗组(P<0.05)。2组治疗期间总不良反应发生率比较均无统计学意义(P>0.05)。结论酸枣仁汤联合通焦利眠贴可有效改善脑梗死后失眠患者的睡眠质量,上调5-HT、BDNF、NPY水平,提高临床疗效。

Objective To explore the curative effect of Suanzaoren decoction combined with Tongjiao Limian plaster on patients with insomnia after cerebral infarction and its influences on levels of serum 5-hydroxytryptamine(5-HT),brain-derived neurotrophic factor(BDNF)and neuropeptide Y(NPY).Methods A total of 86 patients with insomnia after cerebral infarction admitted to the Second Affiliated Hospital of Anhui University of Traditional Chinese Medicine from January 2021 to May 2023 were selected and their data were retrospectively analyzed.According to the different treatment methods,the patients were divided into the traditional Chinese medicine(TCM)combined treatment group(n=40)and the routine Western medicine treatment group(n=46).The TCM combined treatment group was treated with Suanzaoren decoction combined with Tongjiao Limian plaster,while the routine Western medicine treatment group was treated with Eszolam tablets orally.The clinical curative effect,and the changes of sleep quality[Pittsburgh Sleep Quality Index(PSQI),Self-Rating Scale of Sleep(SRSS)]and serum neurotransmitter levels(5-HT,BDNF,NPY)before and after treatment in the two groups were compared.The occurrence of adverse reactions during treatment was compared between the two groups.Results After treatment,scores of PSQI and SRSS in the TCM combined treatment group were lower than those in the routine Western medicine treatment group(P<0.05).The total clinical response rate in the TCM combined treatment group(85.00%)was higher than that in the routine Western medicine treatment group(63.04%)(P<0.05),and the TCM combined treatment group was better than the routine Western medicine treatment group.After treatment,the levels of serum 5-HT,BDNF and NPY in the TCM combined treatment group were higher than those in routine Western medicine treatment group(P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups during treatment(P>0.05).Conclusion Suanzaoren decoction combined with Tongjiao Limian plaster can effectively improve sleep quality,and upregulate the levels of 5-HT,BDNF and NPY,and improve clinical curative effect in patients with insomnia after cerebral infarction.