摘要
目的 观察祛痰除湿汤治疗痰湿型阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome, OSAHS)的临床效果。方法 选择2022年1月-2022年12月收治的116例OSAHS患者作为研究对象,随机分为对照组和观察组,每组58例,对照组应用常规基础治疗联合无创正压通气,观察组在对照组基础上予以口服祛痰除湿汤。观察并比较两组患者的临床疗效,以及干预前后的睡眠质量、血清炎症因子水平及血脂水平。结果 对照组患者的有效率为65.52%(38/58),观察组患者的有效率为82.76%(48/58),与对照组比较,观察组的有效率明显升高(P<0.05)。治疗8周后,观察组患者的呼吸暂停低通气指数(AHI)相较于对照组明显下降,而最低氧饱和度(LSaO2)则明显升高(P<0.01);观察组患者的打鼾、憋醒、嗜睡以及倦怠等症候积分水平相较于对照组均明显降低(P<0.01)。治疗前两组患者的睡眠质量评分水平差异无统计学意义(P>0.05)。治疗8周后,与对照组比较,观察组患者的Epworth嗜睡量表(ESS)评分和匹兹堡睡眠指数(PSQI)评分水平相较于对照组均明显降低(P<0.01);并且观察组患者血清白介素-6(IL-6)、C反应蛋白(CRP)及肿瘤坏死因子-α(TNF-α)水平相较于对照组均明显降低(P<0.01,P<0.05)。治疗前两组患者的血脂水平差异无统计学意义(P>0.05)。治疗8周后,观察组患者总胆固醇(TC)、甘油三酯(TG)、以及低密度脂蛋白胆固醇(LDL-C)水平相较于对照组均明显降低,而高密度脂蛋白胆固醇(HDL-C)水平则明显升高(P<0.01,P<0.05)。结论 祛痰除湿汤联合无创正压辅助通气治疗痰湿型OSAHS具有良好的临床疗效,能够明显改善患者的临床症状和睡眠质量,并提高血氧饱和度,其作用机制与抑制体内炎症反应、降低血脂水平相关。
Objective To observe the clinical effect of Qutan Chushi Decoction(祛痰除湿汤)on phlegm-dampness type of obstructive sleep apnea syndrome(OSAHS).Methods A total of 116 patients with OSAHS admitted to the respiratory department of the hospital from January 2022 to December 2022 were selected as research objects and randomly divided into control group and observation group,with 58 cases in each group.The control group was given conventional basic treatment combined with non-invasive positive pressure ventilation,and the observation group was given Qutan Chushi Decoction orally on the basis of the control group.The clinical efficacy,sleep quality,serum inflammatory factors and blood lipid levels before and after intervention were observed and compared between the two groups.Results The effective rate of the control group was 65.52%,and that of the observation group was 82.76%.Compared with that of the control group,the effective rate of the observation group was significantly higher(P<0.05).After 8 weeks of treatment,apnea hypopnea index(AHI)in the observation group was significantly decreased compared with that in the control group,while the lowest oxygen saturation(LSaO,)was significantly increased(P<0.01).The scores of snoring,lethargy,lethargy and other symptoms in the observation group were significantly lower than those in the control group(P<0.01).There was no significant difference in sleep quality scores between the two groups before treatment(P>0.05).After 8 weeks of treatment,TheEpworthSleepingScale(ESS)score and Pittsburgh sleep quality index(PSQI)score in the observation group were significantly decreased compared with those of the control group(P<0.01).The levels of interleukin-6(IL-6),C-reactive protein(CRP)and tumor necrosis factor-α(TNF-α)in the observation group were significantly decreased compared with those of the control group(P<0.01,P<0.05).There was no significant difference in blood lipid levels between the two groups before treatment(P>0.05).After 8 weeks of treatment,the levels of triglyceride(TG),total cholesterol(TC)and low density lipoprotein cholesterol(LDL-C)in the observation group were significantly decreased compared with those of the control group,while the level of high density lipoprotein cholesterol(HDL-C)was significantly increased(P<0.01,P<0.05).Conclusion Qutan Chushi Decoction combined with non-invasive positive pressure assisted ventilation in the treatment of phlegm-dampness type of OSAHS has good clinical efficacy,which can significantly improve the clinical symptoms and sleep quality of patients,and increase blood oxygen saturation.Its mechanism of action is related to inhibiting inflammation in vivo and reducing lipid levels..
作者
胡旭贞
陈希尔
俞亚丽
HU Xuzhen;CHENXier;YUYali(Ningbo Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University,Ningbo315000,Zhejiang,China)
出处
《中华中医药学刊》
CAS
北大核心
2023年第8期72-76,共5页
Chinese Archives of Traditional Chinese Medicine
基金
国家中医药管理局全国名老中医药专家传承工作室项目(国中医药人教发[2016]42号)
宁波市自然科学基金项目(2019A610365)。
