解郁清肝安神飲治療肝郁化火型失眠癥臨床觀察
發(fā)布時(shí)間：2018-10-12 14:59
【摘要】：目的:運(yùn)用隨機(jī)對(duì)照的方法,以阿普唑侖片為對(duì)照藥物,通過(guò)觀察治療前后的匹茲堡睡眠質(zhì)量指數(shù)(Pittsburgh sleep quality index,PSQI)積分、多導(dǎo)睡眠圖(Polysomnogram,PSG)參數(shù)的變化情況,評(píng)價(jià)解郁清肝安神飲治療肝郁化火型失眠癥的臨床療效和安全性,并從臨床角度分析其治療肝郁化火型失眠癥的優(yōu)勢(shì),為其臨床應(yīng)用提供科學(xué)的依據(jù)。方法:選擇自2015年4月~2016年2月在河南省中醫(yī)院腦病科門診就診的失眠癥患者62例,按隨機(jī)數(shù)字表法將其分為治療組與對(duì)照組,兩組各31例。治療組應(yīng)用解郁清肝安神飲,由河南省中醫(yī)院煎藥室自動(dòng)煎藥機(jī)煎煮,每劑煎2袋,200ml/袋,每天服2袋,早晚飯后半小時(shí)各溫服1袋;對(duì)照組應(yīng)用阿普唑侖片,每次0.4mg,睡前半小時(shí)服用。兩組療程均為4周。治療前、療程結(jié)束后各觀察兩組PSQI積分、PSG參數(shù)的變化情況,并評(píng)價(jià)兩組的臨床療效和安全性。數(shù)據(jù)應(yīng)用SPSS20.0軟件進(jìn)行分析。結(jié)果:1.PSQI評(píng)定結(jié)果:兩組PSQI總分及各單項(xiàng)積分較治療前均有降低(P值均0.05);治療后兩組間比較,在PSQI總分上無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),各單項(xiàng)積分比較,在日間功能這一方面,治療組優(yōu)于對(duì)照組(P0.05)。說(shuō)明在改善患者總體睡眠狀況上,兩組治療方法效果相當(dāng),治療組的治療方法能更好的改善患者日間功能。2.PSG評(píng)定結(jié)果:兩組睡眠潛伏期(Sleep latency,SL)較治療前均減少,總睡眠時(shí)間(Total sleep time,TST)均增加,差異均有統(tǒng)計(jì)學(xué)意義(P值均0.05);治療后兩組間比較,在SL、TST上,差異均無(wú)統(tǒng)計(jì)學(xué)意義(P值均0.05)。治療組N1期比例較治療前減少(P0.05),對(duì)照組N1期比例與治療前相比差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);治療組N2期比例較治療前減少(P0.05),對(duì)照組N2期比例較治療前增加(P0.05);治療組N3期比例較治療前增加(P0.05),對(duì)照組N3期比例較治療前減少(P0.05);治療后兩組間比較,在N1、N2、N3期比例改善情況上,治療組均優(yōu)于對(duì)照組(P值均0.05)。說(shuō)明在改善SL和TST上,兩組的治療方法效果相當(dāng);在非快速眼動(dòng)睡眠(Non-Rapid Eye Movement,NREM)各期比例變化情況上,治療組的治療方法能減少N1、N2期淺睡眠,增加N3期深睡眠,對(duì)照組的治療方法能增加N2期淺睡眠,減少N3期深睡眠。3.療效評(píng)定結(jié)果:治療組痊愈6例,顯效12例,有效9例,無(wú)效4例,總有效率為87.10%;對(duì)照組痊愈5例,顯效8例,有效12例,無(wú)效6例,總有效率為80.65%;治療組與對(duì)照組療效相當(dāng)(P0.05)。結(jié)論:1.解郁清肝安神飲治療肝郁化火型失眠癥療效與阿普唑侖相當(dāng)。2.解郁清肝安神飲能有效的改善患者的總體睡眠狀況,且能較好的改善患者日間功能狀態(tài)。3.解郁清肝安神飲能縮短患者的SL,增加TST,且能改善睡眠結(jié)構(gòu),減少N1、N2期淺睡眠,增加N3期深睡眠。4.解郁清肝安神飲在治療過(guò)程中未見(jiàn)任何不良反應(yīng),是治療肝郁化火型失眠癥的安全有效藥物。
[Abstract]:Objective: to observe the changes of Pittsburgh sleep quality index (Pittsburgh sleep quality index,PSQI) and polysomnography (Polysomnogram,PSG) parameters before and after treatment with alprazolam tablets. To evaluate the clinical efficacy and safety of Jieyu Qinggan Anshen decoction in treating insomnia of the type of liver depression and fire, and to analyze its advantages in the treatment of insomnia of the type of liver depression and fire from the clinical point of view, and to provide scientific basis for its clinical application. Methods: from April 2015 to February 2016, 62 patients with insomnia were selected and divided into treatment group (n = 31) and control group (n = 31). The treatment group was treated with Jieyu Qinggan Anshen decoction, which was prepared by automatic decoction machine in the decoction Room of Henan traditional Chinese Medicine Hospital, with 2 bags per dose, 200ml/ bag, 2 bags a day, 1 bag each half an hour after morning and evening, while the control group was treated with alprazolam tablets, and the control group was treated with alprazolam tablets. Take 0.4 mg each time, half an hour before bedtime. The course of treatment was 4 weeks in both groups. Before and after treatment, the changes of PSQI scores and PSG parameters were observed, and the clinical efficacy and safety of the two groups were evaluated. The data is analyzed by SPSS20.0 software. Results: the results of 1.PSQI evaluation showed that the total score and individual score of PSQI in the two groups were lower than those before treatment (P < 0. 05), but there was no significant difference in the total score of PSQI between the two groups after treatment (P0.05), and there was no significant difference in the total score of PSQI between the two groups (P0.05). The treatment group was superior to the control group (P0.05). The results showed that the two groups had the same effect in improving the overall sleep status, and the treatment methods in the treatment group could better improve the daytime function of the patients. The results of 2.PSG evaluation showed that the sleep latency (Sleep latency,SL) of the two groups was lower than that of before treatment. The total sleep time (Total sleep time,TST) increased and the difference was statistically significant (P < 0. 05), but there was no significant difference in SL,TST between the two groups after treatment (P < 0. 05). The proportion of N1 phase in treatment group was lower than that before treatment (P0.05), the proportion of N1 phase in control group was not significantly different from that before treatment (P0.05), the proportion of N2 phase in treatment group was lower than that before treatment (P0.05), the proportion of N2 phase in control group was higher than that before treatment (P0.05), and the ratio of N2 phase in treatment group was higher than that before treatment (P0.05). The proportion of N3 phase in the control group was lower than that before treatment (P0.05), and the ratio between the two groups after treatment was higher than that before treatment (P0.05). The ratio of N _ 1 and N _ 2N _ 3 in the treatment group was better than that in the control group (P < 0.05). The results showed that the two groups had the same effect in improving SL and TST, and in the case of non-rapid eye movement sleep (Non-Rapid Eye Movement,NREM), the treatment methods of the treatment group could reduce the N _ 1N _ 2 shallow sleep and increase the N _ 3 deep sleep. The treatment of control group can increase N 2 shallow sleep and reduce N 3 deep sleep. Results: in the treatment group, 6 cases were cured, 12 cases were effective, 9 cases were effective, 4 cases were ineffective, and the total effective rate was 87.101.In the control group, 5 cases were cured, 8 cases were effective, 12 cases were effective, 6 cases were ineffective, and the total effective rate was 80.65. The curative effect of the treatment group was similar to that of the control group (P0.05). Conclusion: 1. The curative effect of Jieyu Qinggan Anshen decoction in treating insomnia of the type of liver depression and fire was equivalent to alprazolam. 2. 2. Jieyu Qinggan Anshen decoction can effectively improve the overall sleep status of patients, and can better improve the daytime function of patients. 3. Jieyu Qinggan Anshen decoction could shorten SL, and increase TST, improve sleep structure, decrease shallow sleep in N _ 1 / N _ 2 stage, and increase deep sleep in N _ 3 phase. 4. Jieyu Qinggan Anshen Yin is a safe and effective drug for the treatment of liver-depression and fire insomnia.
【學(xué)位授予單位】：河南中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R256.23
本文編號(hào)：2266571
[Abstract]:Objective: to observe the changes of Pittsburgh sleep quality index (Pittsburgh sleep quality index,PSQI) and polysomnography (Polysomnogram,PSG) parameters before and after treatment with alprazolam tablets. To evaluate the clinical efficacy and safety of Jieyu Qinggan Anshen decoction in treating insomnia of the type of liver depression and fire, and to analyze its advantages in the treatment of insomnia of the type of liver depression and fire from the clinical point of view, and to provide scientific basis for its clinical application. Methods: from April 2015 to February 2016, 62 patients with insomnia were selected and divided into treatment group (n = 31) and control group (n = 31). The treatment group was treated with Jieyu Qinggan Anshen decoction, which was prepared by automatic decoction machine in the decoction Room of Henan traditional Chinese Medicine Hospital, with 2 bags per dose, 200ml/ bag, 2 bags a day, 1 bag each half an hour after morning and evening, while the control group was treated with alprazolam tablets, and the control group was treated with alprazolam tablets. Take 0.4 mg each time, half an hour before bedtime. The course of treatment was 4 weeks in both groups. Before and after treatment, the changes of PSQI scores and PSG parameters were observed, and the clinical efficacy and safety of the two groups were evaluated. The data is analyzed by SPSS20.0 software. Results: the results of 1.PSQI evaluation showed that the total score and individual score of PSQI in the two groups were lower than those before treatment (P < 0. 05), but there was no significant difference in the total score of PSQI between the two groups after treatment (P0.05), and there was no significant difference in the total score of PSQI between the two groups (P0.05). The treatment group was superior to the control group (P0.05). The results showed that the two groups had the same effect in improving the overall sleep status, and the treatment methods in the treatment group could better improve the daytime function of the patients. The results of 2.PSG evaluation showed that the sleep latency (Sleep latency,SL) of the two groups was lower than that of before treatment. The total sleep time (Total sleep time,TST) increased and the difference was statistically significant (P < 0. 05), but there was no significant difference in SL,TST between the two groups after treatment (P < 0. 05). The proportion of N1 phase in treatment group was lower than that before treatment (P0.05), the proportion of N1 phase in control group was not significantly different from that before treatment (P0.05), the proportion of N2 phase in treatment group was lower than that before treatment (P0.05), the proportion of N2 phase in control group was higher than that before treatment (P0.05), and the ratio of N2 phase in treatment group was higher than that before treatment (P0.05). The proportion of N3 phase in the control group was lower than that before treatment (P0.05), and the ratio between the two groups after treatment was higher than that before treatment (P0.05). The ratio of N _ 1 and N _ 2N _ 3 in the treatment group was better than that in the control group (P < 0.05). The results showed that the two groups had the same effect in improving SL and TST, and in the case of non-rapid eye movement sleep (Non-Rapid Eye Movement,NREM), the treatment methods of the treatment group could reduce the N _ 1N _ 2 shallow sleep and increase the N _ 3 deep sleep. The treatment of control group can increase N 2 shallow sleep and reduce N 3 deep sleep. Results: in the treatment group, 6 cases were cured, 12 cases were effective, 9 cases were effective, 4 cases were ineffective, and the total effective rate was 87.101.In the control group, 5 cases were cured, 8 cases were effective, 12 cases were effective, 6 cases were ineffective, and the total effective rate was 80.65. The curative effect of the treatment group was similar to that of the control group (P0.05). Conclusion: 1. The curative effect of Jieyu Qinggan Anshen decoction in treating insomnia of the type of liver depression and fire was equivalent to alprazolam. 2. 2. Jieyu Qinggan Anshen decoction can effectively improve the overall sleep status of patients, and can better improve the daytime function of patients. 3. Jieyu Qinggan Anshen decoction could shorten SL, and increase TST, improve sleep structure, decrease shallow sleep in N _ 1 / N _ 2 stage, and increase deep sleep in N _ 3 phase. 4. Jieyu Qinggan Anshen Yin is a safe and effective drug for the treatment of liver-depression and fire insomnia.
【學(xué)位授予單位】：河南中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R256.23
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