摘要
目的探讨柴芪宁神安眠汤(CNAD)联合腕踝针(WAA)对心脾两虚慢性失眠(CI)患者的临床疗效。方法选取2022年4月至2023年4月北京中医医院怀柔医院诊治的CI患者,并根据随机数字表法,随机纳入艾司唑仑片(ET)组和联合组(CNAD联合WAA),两组分别50例。本研究主要观察结局是临床疗效[采用中医证候积分(TCMSI)评估]。次要研究结局是治疗前后两组患者认知功能[蒙特利尔认知评估量表(MoCA)评估]、焦虑程度[汉密顿焦虑量表(HAMA)评估]、睡眠质量[匹兹堡睡眠质量指数(PSQI)评估]、糖化血清白蛋白(GA)、5-羟色胺(5-HT)、白细胞介素-1β(IL-1β)和C-反应蛋白(CRP)变化情况。结果治疗前,两组患者TCMSI评分差异无统计学意义(P>0.05)。治疗后,联合组TCMSI评分显著低于ET组(P<0.05),治疗有效率显著高于ET组(P<0.05)。治疗前,两组患者MoCA评分、HAMA评分、PSQI评分、血清GA水平、血清5-HT水平、血清IL-1β水平和血清CRP水平差异无统计学意义(P>0.05)。治疗后,联合组MoCA评分、血清GA水平和血清5-HT水平显著高于ET组(P<0.05),而HAMA评分、PSQI评分、血清IL-1β水平和血清CRP水平显著低于ET组(P<0.05)。结论相对于ET,CNAD联合WAA可显著改善心脾两虚CI患者的失眠症状,提高患者认知功能和睡眠质量,降低焦虑程度,其可能与上调血清5-HT和IL-1β、抑制体内炎症反应有关。
Objective To explore the clinical efficacy of Chaiqi Ningshen Anmian Decoction(CNAD)combined with wrist ankle acupuncture(WAA)in treating chronic insomnia(CI)patients with heart and spleen deficiency.Methods CI patients diagnosed and treated at the Beijing Huairou Hospital of Traditional Chinese Medicine from April 2022 to April 2023 were selected,and patients were randomly divided into the Eszolam(ET)group and the combination group(CNAD combined with WAA)according to the random number table method,with 50 cases in each group.The primary outcome was clinical efficacy[evaluated by the Traditional Chinese Medicine Syndrome Integral(TCMSI)].Secondary outcomes included changes in cognitive function[assessed by the Montreal Cognitive Assessment(MoCA)],anxiety level[assessed by the Hamilton Anxiety Scale(HAMA)],sleep quality[assessed by the Pittsburgh Sleep Quality Index(PSQI)],glycated serum albumin(GA),serotonin(5-HT),interleukin-1β(IL-1β),and C-reactive protein(CRP)before and after treatment in both groups.Results Before treatment,there was no significant differences in total TCMSI between the two groups(P>0.05).After treatment,the total TCMSI of the combination group was significantly lower than that of the ET group(P<0.05),and the treatment effectiveness rate was significantly higher in the combination group(P<0.05).Before treatment,there were no significant differences in MoCA score,HAMA score,PSQI score,serum GA level,serum 5-HT level,serum IL-1 level and serum CRP level between the groups(P>0.05).After treatment,the MoCA score,serum GA level,and serum 5-HT level in the combination group were significantly higher than those in the ET group(P<0.05),while the HAMA score,PSQI score,serum IL-1βlevel,and serum CRP level were significantly lower in the combination group(P<0.05).Conclusion Compared with ET,CNAD combined with WAA significantly improves insomnia symptoms in CI patients with heart and spleen deficiency,enhances cognitive function and sleep quality,and reduces anxiety levels.This may be related to the upregulation of serum 5-HT,IL-1βand the inhibition of the inflammatory response.
作者
李玉娇
任珊
董致郅
段娜
田文文
陈志刚
LI Yujiao;REN Shan;DONG Zhizhi;DUAN Na;TIAN Wenwen;CHEN Zhigang(Department of Brain Disease,Beijing Huairou Hospital of Traditional Chinese Medicine,Beijing 101400,China;Department of Brain Disease,Dongfang Hospital,Beijing University of Traditional Chinese Medicine,Beijing 100071,China)
出处
《中国药师》
CAS
2024年第6期1055-1062,共8页
China Pharmacist
基金
国家中医药管理局“十一五”重点专科(专病)建设项目(33J1XIL102K103)
北京中医医院怀柔医院科研项目(2020-MP14)。
关键词
慢性失眠
心脾两虚
柴芪宁神安眠汤
腕踝针
Chronic insomnia
Heart and spleen deficiency
Chaiqi Ningshen Anmian Decoction
Wrist ankle acupuncture
