阿普唑仑联合五音疗法治疗冠心病伴失眠的效果及对患者睡眠状态、心率变异性的影响

The Effect of the Combination of Alprazolam and Five Tone Therapy in the Treatment of Coronary Heart Disease with Insomnia and its Impact on Sleep Status and Heart Rate Variability in Patients

【目的】探讨阿普唑仑联合五音疗法治疗冠心病伴失眠的效果及对患者睡眠状态、心率变异性的影响。【方法】选择2021年4月至2022年12月本院收治的98例冠心病伴失眠患者,采用随机数字表法将其分为对照组和观察组,每组49例。两组均予以基础冠心病治疗,对照组同时予以阿普唑仑治疗,观察组同时予以阿普唑仑联合五音疗法治疗。比较两组疗效、心血管不良事件、治疗前后病情相关评分[中医证候总积分、匹兹堡睡眠质量指数量表(PSQI)、失眠严重指数(ISI)、汉密尔顿焦虑量表(HANA)]、心率变异性指标[相邻正常RR间期差值均方(RMSSD)、24 h窦性心博RR间期标准差(SDNN)、RR间期平均标准差(SDANN)]、实验室指标[瘦素、褪黑素(MT)、血管紧张素Ⅱ(AngⅡ)]。【结果】观察组总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,观察组中医证候总积分及ISI评分、PSQI评分、HANA评分均低于对照组,差异有统计学意义(P<0.05)。治疗后,两组RMSSD、SDNN、SDANN高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。治疗后,两组MT高于治疗前,瘦素、AngⅡ低于治疗前,且观察组与对照组比较,差异有统计学意义(P<0.05)。观察组心血管不良事件总发生率低于对照组,差异有统计学意义(P<0.05)。【结论】阿普唑仑联合五音疗法治疗冠心病伴失眠患者疗效较好,可有效改善睡眠状态,提高心率变异性,促进疾病康复,降低心脑血管不良事件发生率。

【Objective】To explore the effect of alprazolam combined with five tone therapy in the treatment of coronary heart disease with insomnia and its impact on sleep status and heart rate variability in patients.【Methods】A total of 98 patients with coronary heart disease and insomnia admitted to our hospital from April 2021 to December 2022 were selected.They were randomly divided into a control group and an observation group using a random number table method,with 49 cases in each group.Both groups were treated with basic coronary heart disease,the control group was treated with aprazolam,and the observation group was treated with aprazolam combined with five tone therapy.Two groups were compared in terms of efficacy,cardiovascular adverse events,disease-related scores before and after treatment[total score of traditional Chinese medicine syndrome,Pittsburgh Sleep Quality Index(PSQI),Insomnia Severity Index(ISI),Hamilton Anxiety Scale(HANA)],heart rate variability indicators[mean square difference between adjacent normal RR intervals(RMSSD),24-hour sinus rhythm RR interval standard deviation(SDNN),mean standard deviation between RR intervals(SDANN)],and laboratory indicators[leptin,melatonin(MT),angiotensinⅡ(AngⅡ)].【Results】The total effective rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).After treatment,the total score of traditional Chinese medicine syndromes,ISI score,PSQI score,and HANA score in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).After treatment,the RMSSD,SDNN,and SDANN of the two groups were higher than before treatment,while the observation group was higher than the control group,with statistical significance(P<0.05).After treatment,the MT levels in both groups were higher than before treatment,while the levels of leptin and AngⅡwere lower than before treatment.The difference between the observation group and the control group was statistically significant(P<0.05).The total incidence of cardiovascular adverse events in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).【Conclusion】The combination of alprazolam and five tone therapy has a good therapeutic effect on patients with coronary heart disease and insomnia.It can effectively improve sleep status,increase heart rate variability,promote disease recovery,and reduce the incidence of cardiovascular and cerebrovascular adverse events.