柴胡温经汤加减治疗围绝经期肝郁阴虚夹瘀型顽固失眠症临床观察

Clinical observation on modified Chaihu Wenjing Decoction in treatment of refractory insomnia of liver depression,yin deficiency and blood stasis type during perimenopause

目的观察柴胡温经汤加减治疗围绝经期肝郁阴虚夹瘀型顽固失眠症的临床疗效。方法将我院106例围绝经期肝郁阴虚夹瘀型顽固失眠症患者随机分为观察组与对照组各53例。对照组予艾司唑仑片治疗,观察组予加减柴胡温经汤治疗,治疗后,比较两组中医证候评分、睡眠质量匹兹堡睡眠质量指数(PSQI)、情绪状态及炎性细胞因子白介素-6(IL-6)、白介素-1(IL-1)水平。结果治疗后,两组中医证候评分、PSQI每个项目评分及总分、焦虑自评量表(SAS)和抑郁自评量表(SDS)评分、炎性细胞因子IL-6、IL-1水平均显著低于治疗前(均P<0.05),观察组上述指标显著低于对照组(均P<0.05)。结论柴胡温经汤加减治疗围绝经期肝郁阴虚夹瘀型顽固失眠症的临床疗效显著,可有效改善患者中医证候,提升睡眠质量,调节情绪状态,并且下调炎性细胞因子表达。

Objective To observe the clinical efficacy of modified Chaihu Wenjing Decoction in treatment of refractory insomnia with liver depression,yin deficiency,and blood stasis during perimenopause.Methods 106 patients with refractory insomnia of liver depression,yin deficiency,and blood stasis type during the perimenopausal period were randomly divided into control group and observation group,with 53 cases in each group.Control group was treated with eszolam tablets,while observation group was treated with modified Chaihu Wenjing Decoction.The scores of TCM syndromes,Pittsburgh Sleep Quality Index(PSQI),Self-Rating Anxiety Scale(SAS),and Self-rating Depression Scale(SDS),the levels of interleukin-6(IL-6)and IL-1 were compared after treatment.Results After treatment,TCM syndrome scores,PSQI scores for each item and total score,SAS and SDS scores,the levels of IL-6 and IL-1 were significantly lower in both groups than before treatment,and were significantly lower in observation group than control group(P<0.05).Conclusion Modified Chaihu Wenjing Decoction has a significant clinical efficacy in treating refractory insomnia of liver depression,yin deficiency,and blood stasis type during perimenopause.It can effectively improve TCM syndrome,improve sleep quality,regulate emotional state,and downregulate the expression of inflammatory cytokines in patients.