加减柴胡温经汤辅助治疗肝郁阴虚夹瘀型失眠的疗效及对神经递质、情绪的影响

Effect of adding and reducing Chaihu Wenjing Decoction in the treatment of insomnia with liver-stagnation Yin deficiency and its influence on neurotransmitter and emotion

目的探讨加减柴胡温经汤辅助治疗肝郁阴虚夹瘀型失眠患者的疗效及对神经递质、情绪的影响。方法选取2021年5月至2022年5月该院收治的94例肝郁阴虚夹瘀型失眠患者作为研究对象,采用随机数字表法分为常规组和试验组,每组各47例。常规组采用百乐眠胶囊治疗,试验组采用百乐眠胶囊联合加减柴胡温经汤治疗。比较两组临床疗效、治疗前后相关评分[汉密尔顿抑郁量表(HAMD)、匹兹堡睡眠质量指数(PSQI)、汉密尔顿焦虑量表(HAMA)]、中医证候积分、血清神经递质[5-羟色胺(5-HT)、神经肽(NPY)、去甲肾上腺素(NE)、P物质(SP)]水平、性激素[雌二醇(E 2)、黄体生成素(LH)、卵泡刺激素(FSH)]水平。结果试验组治疗后临床总有效率为97.87%,高于常规组的82.98%,差异有统计学意义(P<0.05);两组治疗后PSQI、HAMD及HAMA评分均明显低于治疗前,且试验组均明显低于常规组,差异均有统计学意义(P<0.05);试验组治疗后烦躁易怒、入睡困难、多梦易醒及情志抑郁积分均明显低于常规组,差异均有统计学意义(P<0.05);试验组治疗后NPY、5-HT水平均高于常规组,NE、SP水平均低于常规组,差异均有统计学意义(P<0.05);试验组治疗后FSH、LH水平均明显低于常规组,E 2水平明显高于常规组,差异均有统计学意义(P<0.05)。结论加减柴胡温经汤辅助治疗肝郁阴虚夹瘀型失眠可提高疗效,改善患者临床症状、神经递质及性激素水平,减轻其负面情绪,有助于患者恢复。

Objective To investigate the effect of adding and reducing Chaihu Wenjing decoction in the treatment of insomnia patients with liver-stagnation Yin deficiency and its influence on neurotransmitter and emotion.Methods A total of 94 cases of insomnia with liver-stagnation and Yin deficiency treated in our hospital from May 2021 to May 2022 were selected as research objects,and were divided into conventional group and experimental group by random number table method,with 47 cases in each group.The conventional group was treated with Bailemian capsule,and the experimental group was treated with Bailemian capsule combined with Chaihu Wenjing decoction.The clinical efficacy,related scores before and after treatment[Hamilton Depression Scale(HAMD),Pittsburgh Sleep Quality Index(PSQI),Hamilton Anxiety Scale(HAMA)],TCM syndrome score,serum neurotransmitters[5-hydroxytryptamine(5-HT),neuropeptide(NPY),norepinephrine(NE),substance P(SP)]levels,sex hormones[estradiol(E 2),luteinizing hormone(LH),follicle stimulating hormone(FSH)]levels.Results The total effective rate of the experimental group was 97.87%,which was higher than 82.98%of the conventional group,and the difference was statistically significant(P<0.05).After treatment,the PSQI,HAMD and HAMA scores of the two groups were significantly lower than those before treatment,and the experimental group was significantly lower than the conventional group,the differences were statistically significant(P<0.05).After treatment,the scores of irritability,difficulty falling asleep,easy to wake up from multiple dreams and emotional depression in the experimental group were significantly lower than those in the conventional group,and the differences were statistically significant(P<0.05).After treatment,the levels of NPY and 5-HT in the experimental group were higher than those in the conventional group,and the levels of NE and SP were lower than those in the conventional group,with statistically significant differences(P<0.05).After treatment,the levels of FSH and LH in the experimental group were significantly lower than those in the conventional group,and the level of E 2 was significantly higher than that in the conventional group,and the differences were statistically significant(P<0.05).Conclusion Adding and reducing Chaih u Wenjing decoction can improve the curative effect in the treatment of insomnia with liver depression and Yin deficiency and blood stasis,improve the clinical symptoms,neurotransmitter and sex hormone levels,reduce their negative emotions and help patients recover.