加减柴胡温经汤治疗对围绝经期失眠(肝郁阴虚夹瘀型)患者中医症候积分、神经递质及炎症因子的影响

Effects of modified Chaihu Wenjing Decoction on scores of TCM symptoms,neurotransmitters and inflammatory factors in patients with perimenopausal insomnia(liver-depression yin-deficiency and blood stasis type)

目的:探究加减柴胡温经汤治疗对围绝经期失眠(肝郁阴虚夹瘀型)患者中医症候积分、神经递质及炎症因子的影响。方法:于2021年12月~2022年12月本院收治的围绝经期失眠患者中选取102例作为研究对象,并按随机数字表法分成对照组(51例)和研究组(51例)。对照组给予舒乐安定治疗,研究组给予加减柴胡温经汤治疗,时长均为8周。比较两组疗效、中医症候(长期失眠、健忘、心烦易怒、肌肤甲错瘙痒、疲乏酸痛)积分、神经递质因子[β-内啡肽(β-EP)、神经肽Y(NPY)、5-羟色胺(5-HT)]水平、炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、白介素-6(IL-6)]水平、睡眠结构[总睡眠时间(TST)、睡眠潜伏期(SL)、睡眠效率(SE)、觉醒时间(AT)]和不良反应发生率的变化。结果:治疗8周后,研究组的总有效率为92.16%高于对照组的76.47%(P<0.05);两组的各项症候积分低于治疗前(P<0.05),且研究组低于对照组(P<0.05);两组NPY、β-EP、5-HT水平高于治疗前,IL-6、TNF-α、IL-1β水平低于治疗前,且研究组变化的幅度高于对照组(P<0.05);两组TST、SE高于治疗前,SL、AT均低于治疗前,且研究组变化的幅度高于对照组(P<0.05);两组不良反应发生率对比,差异无统计学意义(P>0.05)。结论:加减柴胡温经汤治疗肝郁阴虚夹瘀型围绝经期失眠患者的效果显著,能有效改善中医症候,提高神经递质含量,降低炎症因子水平,优化睡眠结构。

Objective To explore the effects of modified Chaihu Wenjing Decoction on scores of TCM symptoms,neurotransmitters and inflammatory factors in patients with perimenopausal insomnia(liver-depression yin-deficiency and blood stasis type).Methods A total of 102patients with perimenopausal insomnia of liver-depression yin-deficiency and blood stasis type admitted to the hospital were enrolled as the research objects between December 2021and December 2022.According to random number table method,they were divided into control group(51cases)and study group(51cases).The control group was treated with routine western medicines,while study group was treated with modified Chaihu Wenjing Decoction for 8weeks.The curative effect,changes in scores of TCM symptoms(chronic insomnia,forgetfulness,irritability,skin itching,fatigue and ache),levels of neurotransmitters[β-endorphin(β-EP),neuropeptide Y(NPY),5-hydroxytryptamine(5-HT)]and inflammatory factors[interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)],sleep structure[total sleep time(TST),sleep latency(SL),sleep efficiency(SE),awakening time(AT)]and incidence of adverse reactions were compared between the two groups.Results After 8weeks of treatment,total response rate of study group was higher than that of control group(P<0.05).After treatment,scores of TCM symptoms in both groups were decreased(P<0.05),which were lower in study group than control group(P<0.05).After treatment,levels of NPY,β-EP and 5-HT were increased,while levels of TNF-α,IL-1βand IL-6were decreased in both groups(P<0.05),and the change amplitude was greater in study group than control group(P<0.05).After treatment,TST and SE were increased,while SL and AT were decreased in both groups(P<0.05),and the change amplitude was greater in study group than control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The curative effect of modified Chaihu Wenjing Decoction is significant in patients with perimenopausal insomnia(liver-depression yin-deficiency and blood stasis type),which can effectively improve TCM symptoms,increase levels of neurotransmitters,reduce levels of inflammatory factors and optimize sleep structure.