摘要
目的探讨老年心脾两虚证慢性失眠患者经甘麦芪仙磁石汤治疗的效果。方法选择在郑州市中医院于2021年1月至2023年2月接受治疗的98例老年心脾两虚证慢性失眠患者,使用随机数字表法分为A组和B组,各49例。A组给予艾司唑仑片,B组在A组基础上给予甘麦芪仙磁石汤。两组均持续治疗4周。比较两组治疗1、2、4周后的治疗有效率,治疗前、治疗4周后的多导睡眠监测指标、睡眠质量、过度觉醒状态、心理状态及细胞因子水平,以及治疗期间的安全性。结果治疗4周后,B组治疗有效率为85.71%,高于A组的53.06%(P<0.05)。与治疗前比较,治疗4周后,两组睡眠潜伏期(SL)均缩短,且B组短于A组;两组睡眠效率(SE)、非快速眼动3期(N3)睡眠时间比例、快速眼动睡眠期(REM)占TST比例(REM/TST)均升高,且B组高于A组;睡眠总时间(TST)均延长,且B组长于A组;觉醒次数(NWAK)均降低,且B组低于A组(P<0.05)。与治疗前比较,治疗4周后,两组阿森斯失眠量表(AIS)、过度觉醒量表(HAS)、抑郁症筛查量表(PHQ-9)、广泛性焦虑量表-7(GAD-7)评分均降低,且B组低于A组(P<0.05)。两组治疗4周后的血清5-羟色胺(5-HT)、γ-氨基丁酸(GABA)水平均比治疗前高,且与A组比较,B组更高;两组血清皮质醇(CORT)、脑源性神经营养因子(BDNF)、胶质纤维酸性蛋白(GFAP)、鸢尾素(Irisin)水平均降低,且B组低于A组(P<0.05)。A组和B组不良反应发生率分别为14.29%、6.12%,差异无统计学意义(P>0.05)。结论甘麦芪仙磁石汤有助于调节老年心脾两虚证慢性失眠患者5-HT、GABA、CORT、BDNF、GFAP、Irisin等因子水平,有效改善老年心脾两虚证慢性失眠患者睡眠质量及心理状态,进而提高治疗效果,且安全性良好。
Objective To investigate the therapeutic effect of Ganmai Qixian Cishi Decoction in elderly patients with chronic insomnia of heart-spleen deficiency syndrome.Methods A total of 98 elderly patients with chronic insomnia of heart-spleen deficiency syndrome treated at Zhengzhou Hospital of Traditional Chinese Medicine from January 2021 to February 2023 were divided into Group A and Group B,with 49 cases each,using a random number table method.Group A was administered estazolam tablets,while Group B received Ganmai Qixian Cishi Decoction in addition to the treatment given to Group A.Both groups were treated for 4 weeks.The therapeutic efficacy rates after 1,2,and 4 weeks of treatment,polysomnography parameters,sleep quality,hyperarousal state,psychological status,and cytokine levels before and after 4 weeks of treatment,as well as safety during treatment,were compared between the two groups.Results After 4 weeks of treatment,the effective rate of treatment in group B was 85.71%,which was higher than 53.06%in group A(P<0.05).Compared with before treatment,after 4 weeks of treatment,the sleep latency(SL)of both groups was shortened,and that of group B was shorter than that of group A.The sleep efficiency(SE),the proportion of non-rapid eye movement stage 3(N3)sleep time,and the proportion of rapid eye movement sleep stage(REM)to TST(REM/TST)in both groups increased,and group B was higher than group A.The total sleep duration(TST)was prolonged in all cases,and Group B was longer than Group A.The number of awakenings(NWAK)decreased in all cases,and group B was lower than group A(P<0.05).Compared with before treatment,after 4 weeks of treatment,the scores of the Parsons Insomnia Scale(AIS),the Excessive Arousal Scale(HAS),the Depression Screening Scale(PHQ-9),and the Generalized Anxiety Scale 7(GAD-7)in both groups decreased,and the scores in group B were lower than those in group A(P<0.05).The levels of serum 5-hydroxytryptamine(5-HT)and gamma-aminobutyric acid(GABA)in both groups after 4 weeks of treatment were higher than those before treatment,and compared with group A,they were higher in group B.The levels of serum cortisol(CORT),brain-derived neurotrophic factor(BDNF),glial fibrillary acidic protein(GFAP),and Irisin in both groups decreased,and those in group B were lower than those in group A(P<0.05).The incidence of adverse reactions in group A and group B was 14.29%and 6.12%respectively,and the difference was not statistically significant(P>0.05).Conclusions Ganmai Qixian Cishi Decoction is helpful in regulating the levels of factors such as 5-HT,GABA,CORT,BDNF,GFAP,and Irisin in elderly patients with chronic insomnia due to deficiency of both heart and spleen.It effectively improves the sleep quality and psychological state of elderly patients with chronic insomnia due to deficiency of both heart and spleen,thereby enhancing the therapeutic effect, and has good safety.
作者
赵博
ZHAO Bo(Department of Formulation,Zhengzhou Hospital of Traditional Chinese Medicine,Zhengzhou,Henan 450007,China)
出处
《中国医药指南》
2025年第20期150-153,共4页
Guide of China Medicine
关键词
慢性失眠
心脾两虚证
老年
甘麦芪仙磁石汤
Chronic insomnia
Heart and spleen deficiency syndrome
Elderly
Ganmai Qixian Cishi Decoction
