健脾和胃汤联合胃十针治疗脾胃不和型失眠临床研究

Effect of Jianpi Hewei decoction combined with Weishi acupuncture in the treatment of insomnia of spleen-stomach dispiritus

目的:观察健脾和胃汤联合胃十针治疗脾胃不和型失眠效果及对患者中医症候积分、血清因子水平和多导睡眠监测参数的影响。方法:将120例脾胃不和型失眠患者随机均分为对照组(胃十针疗法)和观察组(健脾和胃汤联合胃十针疗法),两组均连续治疗4周。评定两组治疗前后中医症候积分(辗转难眠、多梦易醒、食少纳呆和胃脘嘈杂),检测血清因子水平[去甲肾上腺素(NE)、5-羟色胺(5-HT)和脑源性神经营养因子(BDNF)],评定匹兹堡睡眠质量指数(PSQI)评分,监测多导睡眠监测参数,并统计不良反应发生率和治疗总有效率。结果:两组治疗后的中医症候积分(辗转难眠、多梦易醒、食少纳呆和胃脘嘈杂)、PSQI量表评分、血清因子(NE、5-HT和BDNF)以及多导睡眠监测参数(觉醒时间、觉醒次数、睡眠潜伏期时间和快波睡眠占比)均较治疗前显著改善(P<0.05),且观察组以上指标数值和治疗总有效率均显著优于对照组(P<0.05),而两组的不良反应发生率差异无统计学意义(P>0.05)。结论:健脾和胃汤联合胃十针可有效改善脾胃不和型失眠患者目不瞑中医症候,疗效优于单独使用胃十针,同时可有效调节血清神经递质中促醒因子NE和促眠因子5-HT和BDNF水平,改善睡眠监测指标,安全可靠。

Objective:To observe the effect of Jianpi Hewei decoction combined with Weishi acupuncture in the treatment of insomnia of spleen-stomach dispiritus and its influence on TCM syndrome score,serum factor levels and polysomnography parameters.Methods:120 patients with insomnia of spleen-stomach disharmony were randomly divided into control group(Weishi acupuncture therapy)and observation group(Jianpi Hewei decoction combined with Weishi acupuncture therapy),both groups were treated for 4 weeks.The TCM syndrome scores(tossing and turning,easily waking up,eating less and stomach noise)were evaluated before and after treatment,the serum factor levels[noradrenaline(NE),5-hydroxytryptamine(5-HT)and brain-derived neurotrophic factor(BDNF)]were detected,the Pittsburgh sleep quality index(PSQI)scores were evaluated,the polysomnography parameters were monitored,and the incidence of adverse reactions and total effective rate of treatment were calculated.Results:After treatment,the TCM syndrome scores(tossing and turning,easily waking up,eating less and stomach noise),PSQI scores,serum factors(NE,5-HT and BDNF)and polysomnography parameters(waking time,wakening times,sleep latency time and fast-wave sleep ratio)of the two groups were significantly improved(P<0.05),and the above indexes and total effective rate of treatment in the observation group were significantly better than those in the control group(P<0.05),but there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Jianpi Hewei decoction combined with Weishi acupuncture can effectively improve the TCM symptoms of yawning in patients with insomnia of spleen-stomach disharmony,and the curative effect is better than that of Weishi acupuncture alone.Meanwhile,it can effectively regulate the levels of wake-promoting factor NE,sleep-promoting factor 5-HT and BDNF in serum neurotransmitters,improve sleep monitoring indexes,and it is safe and reliable.