温胆汤对急性冠状动脉综合征患者术后焦虑症状和睡眠障碍的影响

Effects of Wendan Decoction on Postoperative Anxiety and Sleep Disorder in Patients with Acute Coronary Syndrome

目的:探讨温胆汤对急性冠状动脉综合征(acute coronary syndrome,ACS)患者术后焦虑症状和睡眠障碍的影响。方法:选择经皮冠状动脉介入(percutaneous coronary intervention,PCI)术后伴焦虑症状的患者94例为研究对象,采用随机数字表法将患者分为对照组和观察组各47例。对照组予氟哌噻吨美利曲辛治疗,观察组予温胆汤加减治疗,两组均治疗4周。观察两组治疗前后医院焦虑和抑郁量表(hospital anxiety and depression scale,HADS)、匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)、感知压力量表(perceived stress scale-14,PSS-14)评分及血清5-羟色胺(5-hydroxytryptamine,5-HT)、去甲肾上腺素(norepinephrine,NE)、多巴胺(dopamine,DA)、谷氨酸(glutamate,GLU)、γ-氨基丁酸(γ-aminobutyric acid,GABA)和微小核糖核酸17-92(micro RNA-17-92,miR-17-92)mRNA表达水平。结果:治疗后两组HADS-A、HADS-D、PSQI、PSS-14评分和血清GLU表达水平均较治疗前降低(P<0.05),且观察组上述指标表达水平均低于对照组(P<0.05);治疗后两组血清5-HT、NE、DA、GABA和miR-17-92 mRNA表达水平均高于治疗前(P<0.05),且观察组上述指标水平均高于对照组(P<0.05)。结论:温胆汤可减轻ACS患者PCI术后焦虑症患者的不良情绪,改善患者睡眠质量,降低患者压力感知,其作用机制可能与温胆汤调控5-HT、NE和DA能系统功能,调节miR-17-92 mRNA表达水平有关。

Objective:To discuss the influence of Wendan decoction on postoperative anxiety and sleep disorder in patients with acute coronary syndrome(ACS).Methods:All 94 patients suffering anxiety after PCI were chosen as the research subjects,and they were divided into the control group and the observation group using random number table method with 47 cases in each group.The control group was treated with Deanxit,and the observation group took Wendan decoction orally,both groups were treated for four weeks.To observe hospital anxiety and depression scale(HADS),PSQI,PSS-14 scores and the levels of 5-hydroxytryptamine(5-HT),norepinephrine(NE),dopamine(DA),glutamate(GLU),γ-aminobutyric acid(GABA)and micro RNA-17-92(miR-17-92)mRNA before and after the treatment in the two groups.Results:After the treatment,the scores of HADS-A,HADS-D,PSQI and PSS-14,and the levels of serum GLU were lower than these before the treatment in the two groups(P<0.05),and the expressions of these indexes in the observation group were lower than these of the control group(P<0.05);after the treatment,the expressions of 5-HT,NE,DA,GABA and miR-17-92mRNA of both groups were higher than these before the treatment(P<0.05),and the levels of the indicators of the observation group were higher than these of the control group(P<0.05).Conclusion:Wendan decoction could alleviate the negative moods in ACS patients suffering anxiety after PCI,improve the quality of sleep,and relieve the patients'perceived stress,and its mechanism of action might be related to the modulation of 5-HT,NE and DA,the regulation of miR-17-92 mRNA expressions by Wendan decoction.