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1.广州中医药大学 第二临床医学院,广州 510405
2.广州中医药大学 深圳医院(福田), 广东 深圳 518000
3.广州中医药大学 第二附属医院,广东省中医院, 广州 510120
郑浪花,在读硕士,副主任医师,从事中医养生与治未病研究,E-mail:772465108@qq.com
林嬿钊,博士,主任医师,从事中医养生与治未病研究,E-mail:linyanzhao@163.com
纸质出版日期:2023-12-05,
网络出版日期:2023-10-23,
收稿日期:2023-08-21,
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郑浪花,梁丽嫦,黄学成等.基于红外热像特征探讨柴芍龙牡汤加减治疗肝郁脾虚型失眠的疗效观察[J].中国实验方剂学杂志,2023,29(23):106-113.
ZHENG Langhua,LIANG Lichang,HUANG Xuecheng,et al.Clinical Effect of Chaishao Longmu Decoction on Insomnia in Patients with Liver Depression and Spleen Deficiency Based on Infrared Thermal Images[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(23):106-113.
郑浪花,梁丽嫦,黄学成等.基于红外热像特征探讨柴芍龙牡汤加减治疗肝郁脾虚型失眠的疗效观察[J].中国实验方剂学杂志,2023,29(23):106-113. DOI: 10.13422/j.cnki.syfjx.20232324.
ZHENG Langhua,LIANG Lichang,HUANG Xuecheng,et al.Clinical Effect of Chaishao Longmu Decoction on Insomnia in Patients with Liver Depression and Spleen Deficiency Based on Infrared Thermal Images[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(23):106-113. DOI: 10.13422/j.cnki.syfjx.20232324.
目的
2
观察柴芍龙牡汤加减对肝郁脾虚型失眠的疗效,以及红外热成像与肝郁脾虚型失眠的相关性。
方法
2
选取2022年5月至2022年12月,广州中医药大学深圳医院(福田)治未病科门诊72例失眠患者,随机分为治疗组和对照组,各36例。治疗组采用柴芍龙牡汤加减,对照组采用右佐匹克隆片,治疗4周。观察两组治疗前后临床疗效、匹兹堡睡眠质量指数(PSQI)评分、中医证候积分及红外热成像表现特征(额部睡眠线、额部、躯干前区、中脘、任脉、左胁、右胁、躯干背区、督脉温度及温差变化)。
结果
2
治疗后,两组临床有效率分别为91.67%(33/36)、66.67%(24/36),治疗组优于对照组(
Z
=-2.617,
P
<
0.01)。与本组治疗前比较,两组PSQI评分、中医证候积分显著降低(
P
<
0.01),治疗后与对照组比较,治疗组PSQI评分、中医证候积分降低更显著(
P
<
0.01)。治疗后,治疗组睡眠线改善总有效率为86.11%(31/36),对照组睡眠线改善总有效率为66.67%(24/36),治疗组明显高于对照组(
Z
=-2.591,
P
<
0.05)。与本组治疗前比较,两组额部温度显著降低(
P
<
0.01);与本组治疗前比较,两组躯干前区、中脘、任脉、左胁、右胁、躯干背区、督脉温度显著上升(
P
<
0.01);治疗后与对照组比较,治疗组额部温度下降更显著(
P
<
0.01);治疗后与对照组比较,治疗组躯干前区、中脘、任脉、左胁、右胁、躯干背区、督脉温度上升更显著(
P
<
0.01)。与本组治疗前比较,治疗组督脉区域温差(
∆
T)显著减小(
P
<
0.01),中脘、任脉、左胁、右胁
∆
T明显增大(
P
<
0.05,
P
<
0.01);对照组中脘
∆
T显著增大(
P
<
0.01);治疗后与对照组比较,治疗组督脉
∆
T显著减小(
P
<
0.01),中脘、任脉、左胁、右胁
∆
T明显增大(
P
<
0.05,
P
<
0.01)。与本组治疗前比较,两组督脉与任脉温度差明显上升(
P
<
0.01),根据红外热像特征,督脉与任脉温度差正常值在0.5~1,治疗组治疗后的中位数为0.69(0.52,0.88),处于温差正常范围内,表明治疗组明显优于对照组。
结论
2
柴芍龙牡汤加减能有效改善短期失眠,具有疏肝健脾、调和枢机、通调任督二脉之功效,临床疗效确切,值得推广。同时研究发现肝郁脾虚型失眠红外热像可以通过额温、睡眠线、中脘∆T、任脉∆T、督脉与任脉温度差作为诊断和评价指标。
Objective
2
To observe the therapeutic effect of Chaishao Longmu decoction on insomnia in the patients with the syndrome of live depression and spleen deficiency and explore the correlation between infrared thermal imaging and insomnia with liver depression and spleen deficiency.
Method
2
A total of 72 insomnia patients treated in the outpatient department of Shenzhen Hospital of Guangzhou University of Chinese Medicine (Futian) from May to December in 2022 were selected and randomized into a treatment group and a control group, with 36 patients in each group. The patients in the treatment group were treated with Chaishao Longmu decoction and those in the control group with eszopiclone for 4 weeks. The clinical efficacy, Pittsburgh sleep quality index (PSQI) score, TCM syndrome score and infrared thermal imaging characteristics [temperature and temperature changes of frontal sleep line, frontal region, anterior trunk, Zhongwan (CV12), conception vessel (CV), left hypochondrium, right hypochondrium, dorsal trunk, and governor vessel (GV)] of two groups were determined before and after treatment.
Result
2
After treatment, the clinical response rate in treatment group was 91.67% (33/36), which was higher than that (66.67%, 24/36) in the control group (
Z
=-2.617,
P
<
0.01). The treatment in both groups decreased the PSQI score and TCM syndrome score (
P
<
0.01), and the decreases were more significant in treatment group than in the control group (
P
<
0.01). After treatment, the total response rate of sleep line improvement in the treatment group was 86.11% (31/36), which was higher than that (66.67%, 24/36) in the control group (
Z
=-2.591,
P
<
0.05). The frontal temperature of the two groups decreased (
P
<
0.01) after treatment. Compared with those before treatment, the temperatures of anterior trunk, CV12, CV, left hypochondrium, right hypochondrium, dorsal trunk, and GV rose after treatment (
P
<
0.01). After treatment, the treatment group had lower frontal temperature and higher temperatures of anterior trunk, CV12, CV, left hypochondrium, right hypochondrium, dorsal trunk, and GV than the control group (
P
<
0.01). The treatment in the treatment group reduced the
∆
T values of GV (
P
<
0.01) and increased that of the CV12, CV, left hypochondrium, and right hypochondrium (
P
<
0.05,
P
<
0.01). The treatment in the control group increased the
∆
T value of CV12 (
P
<
0.01). After treatment, the treatment group had lower
∆
T values of GV (
P
<
0.01) and higher
∆
T value of CV12, CV, left hypochondrium, and right hypochondrium (
P
<
0.05,
P
<
0.01) than the control group. Compared with that before treatment, the temperature difference between GV and CV in the two groups increased after treatment (
P
<
0.01). According to the infrared thermal image characteristics, the normal temperature difference between GV and CV was within the range of 0.5-1. The median value after treatment in the treatment group was 0.69 (0.52, 0.88), which was within the normal range, indicating that the treatment group outperformed the control group.
Conclusion
2
Chaishao Longmu decoction can alleviate short-term insomnia by soothing liver, invigorating spleen, harmonizing the middle energizer, and regulating GV and CV. With definite clinical effect, this decoction deserves promotion. Furthermore, the frontal temperature, sleep line, CV12, CV
∆
T, and temperature difference between GV and CV revealed by the infrared thermal images could be used for the diagnosis and of insomnia with liver depression and spleen deficiency.
失眠柴芍龙牡汤红外热成像肝郁脾虚
insomniaChaishao Longmu decoctioninfrared thermal imagingliver depression and spleen deficiency
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