舒眠胶囊联合右佐匹克隆治疗老年人失眠症36例疗效观察

Therapeutic effect of Shumian capsules combined with eszopiclone on insomnia in 36 older adult patients

目的:观察舒眠胶囊联合右佐匹克隆治疗老年失眠症患者的疗效及其对血清神经肽Y(NPY)、5-羟色胺(5-HT)和脑源性神经营养因子(BDNF)水平的影响。方法:选取丽水市第二人民医院2021年1月至2023年3月治疗的老年失眠症患者72例进行随机对照研究,依据随机数字表法分为对照组(n=36)与观察组(n=36)。对照组给予右佐匹克隆治疗,观察组在对照组基础上联合舒眠胶囊治疗,两组疗程4周。比较两组临床疗效及血清NPY、5-HT和BDNF水平变化。结果:观察组总有效率为91.67%(33/36),高于对照组的69.44%(25/36)(χ^(2)=5.67,P<0.05)。治疗后,观察组早醒好转时间、入睡困难好转时间分别为(8.43±2.13)d、(9.19±0.97)d,均短于对照组的(10.98±2.26)d、(11.86±1.73)d(t=4.93、8.08,均P<0.05);观察组匹兹堡睡眠指数(PSQI)评分为(7.36±2.43)分,低于对照组的(10.21±2.17)分(t=5.25,P<0.05);观察组觉醒时间为(87.42±15.56)min,短于对照组的(104.32±17.37)min,睡眠效率[(76.76±3.41)%]和慢波睡眠[(28.98±2.27)min]长于对照组[(72.13±3.26)%和(26.56±2.74)min](t=4.35、-5.89、-4.08,均P<0.001);观察组血清NPY、5-HT、BDNF分别为(9.29±1.52)mg/L、(127.37±18.82)μg/L、(34.51±4.08)μg/L,均高于对照组的(7.21±1.43)mg/L、(98.28±15.54)μg/L、(28.84±3.42)μg/L(t=-5.98、-7.15、-6.39,均P<0.05)。两组不良反应发生率差异无统计学意义(P>0.05)。结论:舒眠胶囊联合右佐匹克隆治疗老年失眠症患者疗效显著,可提高血清NPY、5-HT和BDNF水平。

Objective To investigate the clinical efficacy of Shumian capsules combined with eszopiclone in the treatment of insomnia in patients and its effect on serum levels of neuropeptide Y,5-hydroxytryptamine,and brain-derived neurotrophic factor.Methods A total of 72 older adult patients with insomnia who received treatment at the Second People's Hospital of Lishui from January 2021 to March 2023 were included in this randomized controlled trial.These patients were divided into a control group and an observation group(n=36 per group)using the random digital table method.The control group was treated with eszopiclone,while the observation group was treated with Shumian capsules and eszopiclone.Both groups were treated for 4 weeks.Clinical efficacy and serum levels of neuropeptide Y,5-hydroxytryptamine,and brain-derived neurotrophic factor were compared between the two groups.Results The total response rate in the observation group was significantly higher than that in the control group[91.67%(33/36)vs.69.44%(25/36),χ^(2)=5.67,P<0.05).After treatment,the time to improve in early awakening and the time to recover from insomnia in the observation group were(8.43±2.13)days and(9.19±0.97)days,respectively,which were significantly shorter than those in the control group[(10.98±2.26)days,(11.86±1.73)days,t=4.93,8.08,both P<0.05].The Pittsburgh Sleep Quality Index score in the observation group was(7.36±2.43)points,which was significantly lower than that in the control group[(10.21±2.17)points,t=5.25,P<0.05].The time to improvement in early awakening in the observation group was(87.42±15.56)minutes,which was significantly shorter than that in the control group[(104.32±17.37)minutes,t=4.35,P<0.001].Sleep efficiency and slow-wave sleep duration in the observation group were(76.76±3.41)%and(28.98±2.27)minutes,respectively,which were significantly greater and longer than those in the control group[(72.13±3.26)%,(26.56±2.74)minutes,t=-5.89,-4.08,both P<0.001].The serum levels of neuropeptide Y,5-hydroxytryptamine,and brain-derived neurotrophic factor in the observation group were(9.29±1.52)mg/L,(127.37±18.82)μg/L,and(34.51±4.08)μg/L,respectively,which were significantly higher than those in the control group[(7.21±1.43)mg/L,(98.28±15.54)μg/L,(28.84±3.42)μg/L,t=-5.98,-7.15,-6.39,all P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Shumian capsule combined with eszopiclone is highly effective against insomnia in older adults.The combined therapy can increase serum levels of neuropeptide Y,5-hydroxytryptamine,and brain-derived neurotrophic factor.