清心汤合枕中丹加减治疗心肾不交型失眠的临床观察

闫雪丽; 于远东; 杨丹丹

doi:10.13422/j.cnki.syfjx.20200324

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清心汤合枕中丹加减治疗心肾不交型失眠的临床观察

临床 | 更新时间：2021-02-09

- 清心汤合枕中丹加减治疗心肾不交型失眠的临床观察
- Clinical Efficacy of Qingxintang Combined with Zhenzhongdan in Treatment of Cardionephric Disharmony Type Insomnia Case
- 中国实验方剂学杂志 2020年26卷第9期页码：64-68
- 作者机构：
  
  河南省直第三人民医院，郑州　 450006
- 作者简介：
  
  [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
- 基金信息：
  
  河南省医学科技攻关计划项目(201702303)
- DOI：10.13422/j.cnki.syfjx.20200324
  中图分类号： R22; R242; R2-031;R287
- 收稿日期：2019-06-23，
  
  网络出版日期：2019-10-17，
  
  纸质出版日期：2020-05-05
- 稿件说明：
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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.

摘要

目的：

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：

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

-内啡肽(

-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：

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)(

0.05)；治疗组患者PSQI评分明显低于对照组(

0.05)；治疗组患者TST，SE和RL较对照组升高(

0.05)，AWT，SL，AT较对照组降低(

0.05)；治疗组患者5-HIAA，5-HT和

-EP含量高于对照组(

0.05)，NE含量低于对照组(

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：

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。

Abstract

Objective:

To observe the clinical efficacy of modified therapy of Qingxintang combined Zhenzhongdan in the treatment of cardionephric disharmony type insomnia.

Method:

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

-endorphin (

-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:

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 (

0.05). The PSQI score in treatment group was significantly

which was lower than that in control group (

0.05). TST

RL in treatment group were higher than those in control group (

0.05)

while AWT

AT were lower than those in control group (

0.05). The 5-HIAA

5-HT and

-EP levels in treatment group were higher than those in control group (

0.05)

whereas the NE levels were lower than those in control group (

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:

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.

关键词

Keywords

references

K AKIRA , T HIROMITSU ． Suvorexant for the treatment of primary insomnia: a systematic review and Meta-analysis [J]． Sleep Med Revi , 2017 , 35 ( 10 ): 1 - 7 .

F FENG , Y S ZHANG , J HOU , et al . Can music improve sleep quality in adults with primary insomnia? A systematic review and network Meta-analysis [J]． Int J Nurs Stud , 2018 , 77 ( 2 ): 189 - 196 .

F P EDWARD , P Z JARED , M B RYAN , et al . Resting state functional connectivity in primary insomnia, generalized anxiety disorder and controls [J]． Psychiatry Res Neuroimaging , 2017 , 265 ( 30 ): 26 - 34 .

谢光璟，黄攀攀，王平．天王补心丹加减改善PCPA失眠大鼠Trx系统氧化损伤的机制探讨 [J]．中国实验方剂学杂志， 2019 ， 25 ( 6 )： 32 - 38 .

X YIN , M H GOU , J XU , et al . Efficacy and safety of acupuncture treatment on primary insomnia: a randomized controlled trial [J]． Sleep Med , 2017 , 37 ( 9 ): 193 - 200 .

魏砚君，卞宏生，叶晓楠，等．睡眠剥夺动物模型及其在中医药改善睡眠研究中的应用 [J]．中国实验方剂学杂志， 2018 ， 24 ( 10 )： 227 - 234 .

J M LI , Z N MU , J XIE , et al . Effectiveness and safety of Chinese herbal medicine Xiaoyaosan for the treatment of insomnia: protocol for a systematic review and Meta-analysis [J]． Medicine , 2019 ， 98 ( 29 )： e16481 - e16487 .

周红霞，王彦华，刘向哲，等．黄连阿胶汤加减治疗脑卒中后失眠阴虚火旺证的疗效观察 [J]．中国实验方剂学杂志， 2018 ， 24 ( 10 )： 187 - 192 .

赵杰荣，赵书豪，郑伟峰．六味地黄丸合黄连阿胶汤加减治疗老年原发性失眠(肝肾阴虚证)的临床观察 [J]．中国实验方剂学杂志， 2019 ， 25 ( 20 )： 94 - 99 .

蔡艳，叶玉妹，张涛，等．桂枝甘草龙骨牡蛎汤加减治疗阴虚火旺型更年期失眠疗效及对患者睡眠质量、神经递质的影响 [J]．中国实验方剂学杂志， 2019 ， 25 ( 9 )： 38 - 42 .

American psychiatric association . Diagnostic and statistical mannual of mental disorders .4 th ed . text version ( DSM - IV ) [M]． Washington DC : Am Psych Assoc , 2000 ： 51 - 52 .

中华人民共和国卫生部．中药新药临床研究指导原则 [M]．北京：中国医药科技出版社， 1993 ： 186 .

国家中医药管理局．中医病证诊断疗效标准 [M]．南京：南京大学出版社， 1995 : 22 - 23 .

路桃影，李艳，夏萍，等．匹兹堡睡眠质量指数的信度及效度分析 [J]．重庆医学， 2014 , 43 ( 3 ): 260 - 263 .

余翔，任辉，尚奇，等．龟板诱导干细胞归巢预防绝经后骨质疏松症的机制探讨 [J]．中华中医药杂志， 2019 ， 34 ( 5 )： 2071 - 2075 .

陈若冰，张丽艳，梁茂新．基于数据挖掘和分析石菖蒲的潜在功能分析 [J]．中国实验方剂学杂志， 2017 ， 23 ( 17 )： 217 - 221 .

B K DANIEL , T K HELMET , P H BRANT , et al . Impact of acute sleep restriction on cerebral glucose metabolism during recovery non-rapid eye movement sleep among individuals with primary insomnia and good sleeper controls [J]． Sleep Med ， 2019 , 55 ( 3 ): 81 - 91 .

H MATTHIEU , S CHRISTELLE , J P LANQUART , et al . Hyperarousal during sleep in untreated primary insomnia sufferers: A polysomnographic study [J]． Psychiatry Res , 2017 , 153 ( 5 ): 71 - 78 .

S Y YU , B J GUO , Z F SHEN , et al . The imbalanced anterior and posterior default mode network in the primary insomnia [J]． J Psychiatry Res , 2018 , 103 ( 8 ): 97 - 103 .

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