摘要
目的:探讨养心滋肾安神汤联合针刺对失眠(心肾不交型)的应用效果及对多导睡眠监测(PGS)参数影响。方法:选取2022年1月至2024年12月上海中医药大学附属岳阳中西医结合医院收治的失眠患者120例作为研究对象,按照随机数字表法分为对照组和观察组,每组60例。对照组给予常规口服艾司唑仑片治疗,观察组给予口服艾司唑仑的同时增加养心滋肾安神汤联合针刺,2组均持续治疗15 d。采用Alice PDX多导睡眠监测系统(飞利浦伟康)对2组患者展开多导睡眠监测(PGS),记录总睡眠时间、睡眠潜伏期、睡眠效率、入睡后清醒时间、觉醒指数;应用酶联免疫吸附试验法检测褪黑素、多巴胺(DA)水平;采用生命质量综合评定问卷-74(GQOLI-74)评价2组患者的生命质量。结果:治疗后,观察组总有效率显著高于对照组,差异有统计学意义(P<0.05);治疗后,2组总睡眠时间、睡眠效率均有提高,且观察组显著高于对照组,差异有统计学意义(P<0.05);治疗后,观察组睡眠潜伏期、入睡后清醒时间、觉醒指数均有所降低,且观察组显著低于对照组,差异有统计学意义(P<0.05);治疗后,2组褪黑素、DA升高,观察组显著高于对照组,差异有统计学意义(P<0.05);治疗后,2组患者生命质量综合评定问卷-74(GQOLI-74)评分均有升高,且观察组显著高于对照组,差异有统计学意义(P<0.05)。结论:对心肾不交型失眠患者采取养心滋肾安神汤联合针刺治疗可提升其综合疗效,改善患者睡眠质量,提升患者生命质量,其具体机制可能与改善患者神经递质水平相关。
Objective:To explore the application effect of Yangxin Zishen Anshen Tang combined with acupuncture on insomnia(syndrome of disharmony between heart and kidney)and its impact on polysomnography(PGS)parameters.Methods:A total of 120 insomnia patients admitted to Yueyang Integrated Traditional Chinese and Western Medicine Hospital affiliated to Shanghai University of Traditional Chinese Medicine from January 2022 to December 2024 were selected as the research subjects.They were randomly divided into a control group and an observation group by random number table,with 60 patients in each group.The control group was given conventional treatment with orally-taking escitalopram tablets,while the observation group was given escitalopram combined with Yangxin Zishen Anshen Tang and acupuncture.Patients in both groups were treated continuously for 15 days.The Alice PDX PSG(Philips Respironics)was used to monitor sleep of patients in both the groups,recording their total sleep hours,sleep latency,sleep efficiency,wakefulness after sleep onset,and arousal index;enzyme-linked immunosorbent assay was applied to detect levels of melatonin and dopamine(DA).The quality of life of patients in the two groupswas evaluated by the Generic Quality of Life Inventory 74(GQOLI-74).Results:After the treatment,the total effective rate of the observation group was significantly higher than that of the control group,and the difference between the two groups was statistically significant(P<0.05);the total sleep hours and sleep efficiency of the both groups were improved and the observation group was significantly higher than the control group,with a statistically significant difference between the two groups(P<0.05).The sleep latency,wakefulness after sleep onset,and arousal index of the observation group all reduced,and the reduction in the observation group was significantly lower than that of the control group,showing that the difference between the two groups was statistically significant(P<0.05).Melatonin and DA levels increased in both groups,and the levels of the observation group were significantly higher than those of the control group.The difference between the two groups was statistically significant(P<0.05).The scores of the GQOLI-74 after the treatment in both groups of patients increased,and the observation group had significantly higher scores compared to the control group,indicating that the difference between the two groups was statistically significant(P<0.05).Conclusion:The combination of Yangxin Zishen Anshen Decoction and acupuncture treatment can improve the total efficacy,sleep quality,and quality of life of patients with insomnia of syndrome of disharmony between heart and kidney.The specific mechanism may be related to the improvement of neurotransmitters.
作者
陈准立
黄正阳
熊莉琦
CHEN Zhunli;HUANG Zhengyang;XIONG Liqi(Yueyang Integrated Traditional Chinese and Western Medicine Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China;Shuguang Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)
出处
《世界睡眠医学杂志》
2025年第5期1033-1037,共5页
World Journal of Sleep Medicine
基金
上海市进一步加快中医药传承创新发展三年行动计划项目(2021年—2023年)[ZY(2021-2023-0104-02-JS-07)]。
关键词
心肾不交型
失眠症
养心滋肾安神汤
针刺
多导睡眠监测
生命质量
Syndrome of disharmony between heart and kidney
Insomnia
Yangxin Zishen Anshen Decoction
Acupuncture
Polysomnography(PGS)
Quality of life
