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河南省直第三人民医院,郑州 450006
[第一作者] 闫雪丽,硕士,住院医师,从事中医睡眠的研究,E-mail:yanxueli888888@163.com
*于远东,主治医师,从事睡眠的研究,E-mail:yuyuandong@126.com
纸质出版日期:2020-05-05,
网络出版日期:2019-10-17,
收稿日期:2019-06-23,
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闫雪丽, 于远东, 杨丹丹. 清心汤合枕中丹加减治疗心肾不交型失眠的临床观察[J]. 中国实验方剂学杂志, 2020,26(9):64-68.
Xue-li YAN, Yuan-dong YU, Dan-dan YANG. Clinical Efficacy of Qingxintang Combined with Zhenzhongdan in Treatment of Cardionephric Disharmony Type Insomnia Case[J]. Chinese Journal of Experimental Traditional Medical Formulae, 2020,26(9):64-68.
闫雪丽, 于远东, 杨丹丹. 清心汤合枕中丹加减治疗心肾不交型失眠的临床观察[J]. 中国实验方剂学杂志, 2020,26(9):64-68. DOI: 10.13422/j.cnki.syfjx.20200324.
Xue-li YAN, Yuan-dong YU, Dan-dan YANG. Clinical Efficacy of Qingxintang Combined with Zhenzhongdan in Treatment of Cardionephric Disharmony Type Insomnia Case[J]. Chinese Journal of Experimental Traditional Medical Formulae, 2020,26(9):64-68. DOI: 10.13422/j.cnki.syfjx.20200324.
目的:
2
观察清心汤合枕中丹加减治疗心肾不交型失眠的临床疗效。
方法:
2
将100例患者根据入组先后顺序,按随机数字表法随机分为对照组和治疗组,各50例。对照组口服艾司唑仑,1.0 mg/次,睡前服用;观察组口服清心汤合枕中丹加减,1日/剂,2次/日,连续服用6日,休息1日。疗程均为8周。比较两组患者匹兹堡睡眠质量指数(PSQI),监测多导睡眠图[觉醒时间(AWT),睡眠总时间(TST),睡眠维持率(SE),睡眠潜伏期(SL),快动眼睡眠相潜伏期(RL),觉醒次数(AT)],检测血清单胺类神经递质[5-羟吲哚乙酸(5-HIAA),5-羟色胺(5-HT),去甲肾上腺素(NE)和
β
-内啡肽(
β
-EP)]的含量,观察两组治疗后及随访(治疗后30 d)临床疗效,研究期间不良反应发生率。
结果:
2
研究期间脱落7例。治疗组总有效率89.6%(43/48),高于对照组的71.1%(32/45)(
P
<
0.05);治疗组患者PSQI评分明显低于对照组(
P
<
0.05);治疗组患者TST,SE和RL较对照组升高(
P
<
0.05),AWT,SL,AT较对照组降低(
P
<
0.05);治疗组患者5-HIAA,5-HT和
β
-EP含量高于对照组(
P
<
0.05),NE含量低于对照组(
P
<
0.05);对照组不良反应发生率22.2%(10/45),治疗组未见明显不良反应。
结论:
2
清心汤合枕中丹加减可明显改善心肾不交型失眠的临床症状,单胺类神经递质,不良反应发生率低,值得临床推广应用。
Objective:
2
To observe the clinical efficacy of modified therapy of Qingxintang combined Zhenzhongdan in the treatment of cardionephric disharmony type insomnia.
Method:
2
A total 100 cases were randomly divided into control group and treatment group according to the random number table method on the basis of the inclusion order
with 50 cases in each group.The control group was given esazolam
1.0 mg·d
-1
before bedtime.The observation group was treated with Qingxintang and Zhenzhongdan
1 dose per day
2 times per day
for 6 days continuously
and rested for a day.The course of treatment was both 8 weeks.Pittsburgh sleep quality index (PSQI) score was compared between the two groups before and after treatment.The polysomnography monitor for [awakening time (AWT)
total sleep time (TST)
sleep maintenance rate (SE)
sleep latency (SL)
rapid eye movement sleep latency (RL)
awakening times (AT)] was used to monitor sleep progress.The monoamine neurotransmitters [5-hydroxyindoleacetic acid (5-HIAA)
5-hydroxy-tryptamine (5-HT)
norepinephrine (NE) and
β
-endorphin (
β
-EP)] were measured.The clinical efficacy was observed in two groups after treatment for 30 d
and the incidence of adverse reactions was researched during the study.
Result:
2
Totally 7 cases were lost during the study.The total effective rate in the observation group was 89.6% (43/48)
which was higher than 71.1% (32/45) in the control group (
P
<
0.05). The PSQI score in treatment group was significantly
which was lower than that in control group (
P
<
0.05). TST
SE
RL in treatment group were higher than those in control group (
P
<
0.05)
while AWT
SL
AT were lower than those in control group (
P
<
0.05). The 5-HIAA
5-HT and
β
-EP levels in treatment group were higher than those in control group (
P
<
0.05)
whereas the NE levels were lower than those in control group (
P
<
0.05). The incidence of adverse reactions was 22.2% (10/45) in control group
and no significant adverse reactions were observed in treatment group.
Conclusion:
2
Qingxintang and Zhenzhongdan could obviously alleviate clinical symptoms of cardionephric disharmony type insomnia
and monoamine neurotransmitters
with a low incidence of adverse reactions
and thus is worthy of clinical promotion and application.
清心汤枕中丹心肾不交型失眠单胺类神经递质
QingxintangZhenzhongdancardionephric disharmony typeinsomniamonoamine neurotransmitters
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