加味酸枣仁汤联合佐匹克隆治疗原发性失眠临床研究

Clinical Study on Modified Suanzaoren Decoction Combined with Zopiclone forPrimary Insomnia

目的:观察加味酸枣仁汤联合佐匹克隆治疗原发性失眠肝血亏虚证的临床疗效,以及对血清多巴胺(DA)、5-羟色胺(HT)水平的影响。方法:将108例原发性失眠肝血亏虚证患者以随机数字表法分为联合组与单一组,每组54例。联合组给予加味酸枣仁汤联合佐匹克隆治疗,单一组仅给予佐匹克隆治疗,2组均治疗4周。比较2组临床疗效、中医证候积分、匹兹堡睡眠质量指数(PSQI)评分、多导睡眠图指标及血清DA、5-HT水平。结果:治疗后,联合组总有效率98.15%,高于单一组87.04%,差异有统计学意义(P<0.05)。2组中医证候积分、PSQI评分均较治疗前降低,联合组中医证候积分、PSQI评分均低于单一组,差异均有统计学意义(P<0.05)。2组入睡潜伏期均较治疗前缩短,觉醒次数均较治疗前减少,浅睡眠时间、深睡眠时间、总睡眠时间及快速动眼期均较治疗前增加,差异均有统计学意义(P<0.05);联合组入睡潜伏期短于单一组,觉醒次数少于单一组,浅睡眠时间、深睡眠时间、总睡眠时间及快速动眼期均长于对照组,差异均有统计学意义(P<0.05)。2组血清DA、5-HT水平均较治疗前升高,联合组血清DA、5-HT水平均高于单一组,差异均有统计学意义(P<0.05)。结论:加味酸枣仁汤联合佐匹克隆治疗原发性失眠肝血亏虚证,可改善患者的睡眠质量,调节血清DA、5-HT水平。

Objective:To observe the clinical effect of modified Suanzaoren Decoction combined with Zopiclone on primary insomnia with insufficiency of liver blood syndrome and its effects on the levels of dopamine(DA)and 5-hydroxytryptamine(HT)in serum.Methods:A total of 108 cases of patients with primary insomnia with liver blood deficiency syndrome were divided into the combination group and the single group according to the random number table method,with 54 cases in each group.The combination group was treated with modified Suanzaoren Decoction combined with Zopiclone,and the single group was simply treated with Zopiclone.Both groups were treated for 4 weeks.The clinical effects,traditional Chinese medicine(TCM)syndrome scores,Pittsburgh Sleep Quality Index(PSQI)scores,polysomnography indexes and the levels of DA and 5-HT in serum were compared between the two groups.Results:After treatment,the total effective rate was 98.15%in the combination group,higher than that of 87.04%in the single group,the difference being significant(P<0.05).TCM syndrome scores and PSQI scores in the two groups were decreased when compared with those before treatment,and the above two scores in the combination group were lower than those in the single group,differences being significant(P<0.05).The sleep latency in the two groups were shortened when compared with those before treatment;the awakening times were reduced when compared with those before treatment;the light sleep time,deep sleep time,total sleep time and rapid eye movement period were prolonged when compared with those before treatment,differences being significant(P<0.05).The sleep latency in the combination group was shorter than that in the single group;the awakening time was less than that in the single group;the light sleep time,deep sleep time,total sleep time and rapid eye movement period were longer than those in the control group,differences being significant(P<0.05).The levels of DA and 5-HT in serum in the two groups were increased when compared with those before treatment,and the above two levels in the combination group were higher than those in the single group,differences being significant(P<0.05).Conclusion:Modified Suanzaoren Decoction combined with Zopiclone for primary insomnia with insufficiency of liver blood syndrome can improve the sleep quality and regulate the levels of DA and 5-HT in serum.