解郁清心颗粒联合超低频重复经颅磁刺激治疗慢性失眠的临床研究

Clinical Study on Jieyu Qingxin Granule(解郁清心颗粒) Combined with Ultra-Low Frequency Repetitive Transcranial Magnetic Stimulation in Treatment of Chronic Insomnia Disorder

目的研究解郁清心颗粒联合超低频重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)治疗对慢性失眠障碍(chronic insomnia disorder,CID)患者的影响。方法选取该院2021年7月—2022年7月收治的80例CID患者,随机数字表法分为40例观察组和40例对照组。对照组采用右佐匹克隆片+超低频rTMS治疗,观察组采用右佐匹克隆片+超低频rTMS治疗+解郁清心颗粒治疗,均治疗4周。比较两组间治疗后临床疗效,比较两组间治疗前后中医证候积分、睡眠质量、认知功能,焦虑抑郁情绪水平变化及治疗期间不良反应发生情况差异。结果治疗后,观察组总有效率为95.00%(38/40)显著高于对照组80.00%(32/40)(P<0.05);治疗后,观察组中主症和次症证候积分均显著低于对照组(P<0.05);治疗后,观察组匹兹堡睡眠质量指数和多导睡眠图变化幅度均显著高于对照组(P<0.05);治疗后,观察组认知水平显著高于对照组;治疗后,观察组汉密尔顿焦虑量表和抑郁量表水平均显著低于对照组(P<0.05);治疗期间,所有患者均未出现明显不良反应。结论解郁清心颗粒联合超低频rTMS治疗CID患者临床疗效更佳,改善患者睡眠治疗,提高认知功能,减轻焦虑抑郁情绪,值得应用。

Objective To study the effects of Jieyu Qingxin Granule(解郁清心颗粒)combined with ultra-low frequency repetitive transcranial magnetic stimulation(rTMS)in treating chronic insomnia disorder(CID).Methods Eighty patients with CID who were treated in the hospital from July 2021 to July 2022 were selected and randomly divided into observation group(40 cases)and control group(40 cases).The control group was treated with eszopiclone tablets+ultra-low frequency rTMS while the observation group was given eszopiclone tablets+ultra-low frequency rTMS+Jieyu Qingxin Granule,and both groups were treated for 4 weeks.The clinical efficacy after treatment,TCM syndromes scores,sleep quality,cognitive function and anxiety and depression before and after treatment and occurrence of adverse reactions during treatment were compared between the two groups.Results After treatment,the total effective rate in the observation group(95.00%,38/40)was significantly higher than that in the control group(80.00%,32/40)(P<0.05).The scores of primary and secondary symptoms after treatment in the observation group were significantly lower compared with those in the control group(P<0.05).After treatment,the changes of Pittsburgh Sleep Quality Index and polysomnography were significantly higher in the observation group compared to those of the control group(P<0.05).The cognitive level in the observation group after treatment was significantly higher than that in the control group(P<0.05).After treatment,the scores of Hamilton Anxiety Scale and Hamilton Depression Scale in the observation group were significantly lower compared to those of the control group(P<0.05).During treatment,no obvious adverse reactions occurred in all patients.Conclusion Jieyu Qingxin Granule combined with ultra-low frequency rTMS has good clinical efficacy in the treatment of patients with CID,and it can improve the sleep treatment,enhance the cognitive function and relieve the anxiety and depression.