Clinical Study of Xietu Huayu Decoction on Intractable Insomnia Phlegm and Blood Stasis in Interior

SONG Chun-xia; BAO Hong-ling; SHI Jing-jing; LONG Seng; LIU Yu-lan

doi:10.13422/j.cnki.syfjx.2017010185

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Clinical Study of Xietu Huayu Decoction on Intractable Insomnia Phlegm and Blood Stasis in Interior

更新时间：2024-01-04

- Clinical Study of Xietu Huayu Decoction on Intractable Insomnia Phlegm and Blood Stasis in Interior
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 23, Issue 1, Pages: 185-189(2017)
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- DOI：10.13422/j.cnki.syfjx.2017010185
  CLC： R256.23
- Published：2017
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SONG Chun-xia, BAO Hong-ling, SHI Jing-jing, et al. Clinical Study of Xietu Huayu Decoction on Intractable Insomnia Phlegm and Blood Stasis in Interior[J]. Chinese journal of experimental traditional medical formulae, 2017, 23(1): 185-189.
DOI：

SONG Chun-xia, BAO Hong-ling, SHI Jing-jing, et al. Clinical Study of Xietu Huayu Decoction on Intractable Insomnia Phlegm and Blood Stasis in Interior[J]. Chinese journal of experimental traditional medical formulae, 2017, 23(1): 185-189. DOI： 10.13422/j.cnki.syfjx.2017010185.

摘要

目的：探讨泻土化瘀汤治疗顽固性失眠痰瘀内阻证的临床疗效及对单胺类神经递质和炎症因子的影响。方法：将170例符合要求的患者，根据就诊先后，采用随机按数字表法分为对照组和观察组各85例。两组均给予睡眠卫生指导、认知行为治疗、心理疗法等非药物干预措施。对照组采用艾司唑仑片，1～2 mg·d-1，睡前服用。观察组采用泻土化瘀汤治疗，1剂/d。两组疗程均为4周。进行治疗前后匹兹堡睡眠质量指数量表（PSQI），抑郁自评量表（SDS）和焦虑自评量表（SAS）评分；进行治疗前后痰瘀内阻证评分；采用多导睡眠图监测记录两组患者治疗前后总睡眠时间、睡眠期时间、睡眠潜伏期时间和醒觉次数；检测治疗前后血清白介素-1β（IL-1β），肿瘤坏死因子-α（TNF-α），白细胞介素-6（IL-6），5-羟色胺（5-HT）和5-羟吲哚乙酸（5-HIAA）水平。结果：观察组临床疗效总有效率为93.9%，高于对照组的80.25%，（P<0.01）；治疗后观察组PSQI量表睡眠质量、睡眠时间、睡眠效率、催眠药物、日间功能5个因子评分和总分均低于对照组（P<0.01）；治疗后观察组SDS，SAS及痰瘀内阻证评分均低于对照组（P<0.01）；治疗后观察组总睡眠时间长于对照组，睡眠潜伏期时间和醒觉次数少于对照组（P<0.01）；治疗后观察组IL-1β和TNF-α水平高于对照组，IL-6水平低于对照组（P<0.01）；治疗后观察组5-HT和5-HIAA水平均高于对照组（P<0.01）。结论：泻土化瘀汤能改善痰瘀内阻证顽固性失眠患者的睡眠质量，延长睡眠时间，临床疗效优于艾司唑仑片，其作用机制可能与调节炎症介质和单胺类神经递质水平有关。

Abstract

Objective: To discuss the clinical effect of Xietu Huayu decoction on intractable insomnia (phlegm and blood stasis in the interior)

and its effect on monoamine neurotransmitter and inflammatory factor. Method: One hundred and seventy patients were randomly divided into control group (85 cases) and observation group (85 cases) by random number table. Both groups were given sleep hygiene guidance

cognitive-behavioral therapy and psychotherapy for non-pharmacological interventions. Patients in control group took Estazolam tablets at bed time

1-2 mg/day. Patients in observation group took Xietu Huayu decoction

1 dose/day. The courses of treatment were 4 weeks. Before and after the treatment

scores of pittsburgh sleep quality index (PSQI)

self-rating depression scale (SDS)

self-rating anxiety scale (SAS) and phlegm and blood stasis in the interior were scored. Total sleep time

sleep period time

sleep latency and awakening frequency were recorded by polysomnogram. Levels of interleukin-1β (IL-1β)

tumor necrosis factor-α (TNF-α)

interleukin-6 (IL-6)

5-hydroxytryptamine (5-HT) and 5-hydroxy indoleacetic acid (5-HIAA) were detected. Result: The total clinical effect rate in observation group was 93.9%which was higher than 80.25%in control group (P<0.01). Scores of sleep quality

sleep time

sleep efficiency

hypnotic

daytime function

the total scores and scores of SDS

SAS and phlegm and blood stasis in the interior were lower than those in control group (P<0.01). After the treatment

the total sleep time

sleep latency and awakening frequency were less than that in control group (P<0.01). Levels of IL-1β

TNF-α

5-HT and 5-HIAA were higher than control group (P<0.01)

whereas levels of IL-6 was lower than control group (P<0.01). Conclusion: Xietu Huayu decoction can ameliorate sleep quality

prolong sleep time of the patients' with intractable insomnia (phlegm and blood stasis in the interior)

with a superior clinical effect to Estazolam tablets

and its mechanism of action may be correlated to the regulation of levels of inflammatory mediator and monoamine neurotransmitter.

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