摘要
目的探讨丹栀逍遥散治疗肝郁化火型失眠症的最佳辨治要点,为临床医者运用该方治疗肝郁化火型失眠症的辨识运用上提供科学的依据。方法收集2018年6月—2019年6月国医大师伍炳彩教授门诊运用丹栀逍遥散方治疗的80例肝郁化火型失眠症患者的社会人口学、四诊信息、病史特征等,评估治疗前后睡眠(匹兹堡睡眠质量指数量表,PSQI)和心理情绪[焦虑抑郁量表(SAS)和抑郁自评量表(SDS)]改善情况。通过单因素卡方检验及二分类logistic回归分析,得出有效、无效患者之间具有统计学差异的最佳辨识要素。结果治疗后PSQI、SAS、SDS评分均有降低(P<0.01)。治疗后总有效率为80%,有效组病例64例,无效组病例16例,通过单因素探索性分析,得出有效组与无效组患者就诊时病例资料间有统计学差异的变量有13个。其中烦(急)躁、女性、工作生活压力大、小便黄赤、病程短、入睡困难、胸肋不舒、舌红、脉弦、脉细等变量与疗效成正相关,而惊悸、重度焦虑(SAS≥70)、中重度抑郁(SDS≥60)变量与疗效呈负相关。最后将上述13个变量再次行二分类logistic回归分析,最后得出变量为烦(急)躁、工作生活压力大、舌红和脉弦。(P<0.05)。结论丹栀逍遥散治疗肝郁化火型失眠疗效确切,但具有其临床适用范围,本方治疗失眠的核心辨识依据可能为烦(急)躁、工作生活压力大、舌红和脉弦。
Objective To explore the best differentiation and treatment points of Danzhi Xiaoyao powder in treating insomnia of stagnation of liver and fire type,and to provide scientific basis for the identification and application of this prescription in treating insomnia of stagnation of liver and fire type.Methods 80 patients with insomnia of liver depression and fire type treated by Danzhi Xiaoyao powder from June 2018 to June 2019 were collected and their social demography,four diagnostic information and medical history were analyzed.Sleep quality index(PSQI)and psychological mood(anxiety and depression scale,SAS and SAS)were evaluated before and after treatment.Self-rating Depression Scale(SDS)improved.Through single factor chi-square test and binary logistic regression analysis,the best identification factors with statistical differences between effective and ineffective patients were obtained.Results After treatment,the scores of PSQI,SAS and SDS were all decreased(P<0.01).After treatment,the total effective rate was 80%,64 cases in the effective group and 16 cases in the ineffective group.Through single factor exploratory analysis,13 variables were found to be statistically different between the effective group and the ineffective group.Among them,dysphoria,female,work-life stress,yellow urine,short course of disease,difficulty in falling asleep,chest-rib discomfort,red tongue,pulse string and fine pulse were positively correlated with curative effect,while palpitation,severe anxiety(SAS≥70)and moderate or severe depression(SDS≥60)were negatively correlated with curative effect.Finally,the above 13 variables were analyzed by binary logistic regression.Finally,the results showed that the variables were irritability,work-life stress,red tongue and pulse chord(P<0.05).Conclusion Danzhi Xiaoyao powder is effective in treating insomnia of liver depression and fire type,but it has its clinical application scope.The core identification basis of Danzhi Xiaoyao powder in treating insomnia may be irritability,high pressure of work and life,red tongue and pulse chord.
作者
黄春华
钟良
韦玲芝
伍建光
HUANG Chunhua;ZHONG Liang;WEI Lingzhi;WU Jianguang(Encephalopathy Department,the Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine,Jiangxi Province,Nanchang 330006,China;Grade 2017 Graduate,Jiangxi University of Traditional Chinese Medicine,Jiangxi Province,Nanchang 330004,China)
出处
《光明中医》
2020年第7期996-998,1027,共4页
GUANGMING JOURNAL OF CHINESE MEDICINE
基金
江西省社发领域重点研发计划项目(No.20161BBG70105)
