摘要
目的观察养血疏肝安神汤联合艾司唑仑治疗慢性失眠的临床效果,并探讨其治疗作用机制。方法纳入慢性失眠患者90例,根据随机数字表法将其分为联合组(n=46)、艾司唑仑组(n=44)。艾司唑仑组给予艾司唑仑(每晚睡前口服1 mg,疗程4周)治疗。联合组在艾司唑仑组治疗基础上给予养血疏肝安神汤(每日1剂,水煎服,分2次服用,疗程4周)治疗。疗程结束时评估治疗效果,其评价指标包括中医证候疗效、睡眠质量[匹兹堡睡眠质量指数(PSQI)、失眠严重程度指数(ISI)]、睡眠结构[睡眠效率(SE)、入睡后清醒时间(WASO)、睡眠潜伏期(SOL)、总睡眠时间(TST)]。采用酶联免疫吸附法检测血清细胞因子[5-羟色胺(5-HT)、皮质醇(CORT)、肿瘤坏死因子-α(TNF-α)]。计算不良反应总发生率。结果与艾司唑仑组比较,联合组中医证候总有效率高(P<0.05)。与治疗前比较,治疗后,两组PSQI、ISI评分均降低(P<0.05),两组SE升高,TST延长,WASO、SOL缩短(P<0.05),两组血清5-HT相对表达量均升高(P<0.05),血清CORT、TNF-α相对表达量均降低(P<0.05)。与艾司唑仑组比较,联合组PSQI、ISI评分均降低,SE升高,TST延长,WASO、SOL缩短(P<0.05);血清5-HT相对表达量升高,血清CORT、TNF-α相对表达量降低(P<0.05)。治疗期间两组未出现特殊不良反应。结论养血疏肝安神汤联合艾司唑仑可有效改善慢性失眠患者临床症状,提高睡眠质量,改善睡眠结构,其作用机制可能与调节血清5-HT、CORT、TNF-α水平有关。
Objective To explore the efficacy and regulatory mechanism of Yangxue Shugan Anshen Decoction combined with estazolam in the treatment of chronic insomnia.Methods A total of 90 patients with chronic insomnia were included and randomly divided into the estazolam group(n=44)treated with estazolam(1 mg orally before going to bed every night for 4 consecutive weeks)and the combination group(n=46)treated with Yangxue Shugan Anshen Decoction(One dose daily,decocted with water,taken in two divided portions for 4 consecutive weeks)on the basis of the estazolam group.Observation indicators included clinical efficacy,Pittsburgh Sleep Quality Index(PSQI),Insomnia Severity Index(ISI),sleep efficiency(SE),wake after sleep onset(WASO),sleep latency(SOL),and total sleep time(TST).Serum cytokines[5-hydroxytryptamine(5-HT),cortisol(CORT),tumor necrosis factor-α(TNF-α)]were detected by enzyme-linked immunosorbent assay.The total incidence of adverse reactions was calculated.Results Compared with the estazolam group,the total effective rate of TCM syndromes in the combined group was higher(P<0.05).After treatment,the scores of PSQI and ISI,WASO,SOL,the relative expression levels of serum CORT and TNF-α in both groups decreased compared with those before treatment(P<0.05),with more significant decreases in the combination group(P<0.05);SE,TST,the relative expression levels of serum 5-HT in both groups increased compared with those before treatment(P<0.05),with more significant increases in the combination group(P<0.05).No special adverse reactions occurred in either group during the treatment period.Conclusion The combination of Yangxue Shugan Anshen Decoction and estazolam can effectively improve the clinical symptoms of patients with chronic insomnia,enhance sleep quality,improve sleep structure,which may be associated with regulating the levels of serum 5-HT,CORT and TNF-α.
作者
谷丽莎
朱欧鸰
孙卓璇
白建乐
GU Lisha;ZHU Ouling;SUN Zhuoxuan(Graduate School of Hebei University of Chinese Medicine,Shijiazhuang 050011,China)
出处
《精神医学杂志》
2025年第3期271-274,共4页
Journal of Psychiatry
基金
河北省中医药管理局科研计划项目(编号:2022453)。
关键词
养血疏肝安神汤
艾司唑仑
慢性失眠
睡眠结构
5-羟色胺
皮质醇
肿瘤坏死因子-α
Yangxue Shugan Anshen Decoction
Estazolam
Chronic insomnia
Sleep structure
5-hydroxytryptamine
Cortisol
Tumor necrosis factor alpha
