摘要
目的:观察安神定志汤联合经颅磁刺激(TMS)治疗心胆气虚型失眠的临床疗效。方法:选取98例心胆气虚型失眠患者,按随机数字表法分为对照组和研究组各49例。对照组给予艾司唑仑片治疗,研究组给予安神定志汤联合TMS治疗。2组均治疗4周。比较2组临床疗效、中医证候积分、匹兹堡睡眠质量指数(PSQI)评分、睡眠进程参数、神经递质及不良反应发生率。结果:治疗4周后,研究组总有效率89.80%,高于对照组73.47%(P<0.05)。2组睡眠时间、睡眠质量、入睡时间、睡眠障碍、睡眠效率、日间功能障碍评分均较治疗前降低(P<0.05),研究组上述6项PSQI细则评分均低于对照组,差异均有统计学意义(P<0.05)。2组睡眠潜伏期、快速眼动睡眠(REM)潜伏期、觉醒时间均较治疗前缩短(P<0.05),总睡眠时间均较治疗前延长(P<0.05),睡眠效率均较治疗前提高(P<0.05);研究组睡眠潜伏期、REM潜伏期、觉醒时间均短于对照组(P<0.05),总睡眠时间长于对照组(P<0.05),睡眠效率高于对照组(P<0.05)。2组主症、次症积分及中医证候总分均较治疗前降低(P<0.05),研究组主症、次症积分及中医证候总分均低于对照组(P<0.05)。2组5-羟色胺(5-HT)水平均较治疗前升高,多巴胺(DA)水平均较治疗前降低(P<0.05);研究组5-HT水平高于对照组,DA水平低于对照组(P<0.05)。治疗期间,研究组不良反应发生率4.08%,低于对照组18.37%(P<0.05)。结论:安神定志汤联合TMS治疗心胆气虚型失眠临床疗效较好,可有效改善睡眠质量,调节神经递质,安全性好。
Objective:To observe the clinical effect of Anshen Dingzhi Decoction combined with transcranial magnetic stimulation(TMS)for insomnia of heart-gallbladder qi deficiency type.Methods:A total of 98 cases of insomnia patients of heart-gallbladder qi deficiency type were selected and divided into the control group and the study group according to the random number table method,with 49 cases in each group.The control group was treated with Eszolam Tablets,and the study group was treated with Anshen Dingzhi Decoction combined with TMS.Both groups were treated for four weeks.The clinical effects,traditional Chinese medicine(TCM)syndrome scores,Pittsburgh Sleep Quality Index(PSQl)scores,sleep process parameters,neurotransmitter levels,and incidence of adverse reactions were compared between the two groups.Results:After four weeks of treatment,the total effective rate was 89.80%in the study group,higher than that of 73.47%in the control group(P<0.05).The sleep time,sleep quality,sleep onset time,sleep disorders,sleep efficiency,and daytime dysfunction scores in the two groups were all decreased when compared with those before treatment(P<0.05),and the above six PSQl scores in the study group were lower than those in the control group(P<0.05).The sleep latency,rapid ege movement sleep(REM)latency,and awakening time in the two groups were shortened when compared with those before treatment(P<0.05),and the total sleep time was prolonged when compared with that before treatment(P<0.05),and the sleep efficiency was improved when compared with that before treatment(P<0.05);the sleep latency,REM latency,and awakening time in the study group were shorter than those in the control group(P<0.05),and the total sleep time was longer than that in the control group(P<0.05),and the sleep efficiency was higher than that in the control group(P<0.05).The main and secondary symptom scores and total scores in the two groups were decreased when compared with those before treatment(P<0.05),and the main and secondary symptom scores and total scores in the study group were lower than those in the control group(P<0.05).The 5-HT levels in the two groups were increased when compared with those before treatment(P<0.05),and the DA levels were decreased when compared with those before treatment(P<0.05):the 5-hydroxytryptamine(5-HT)level in the study group was higher than that in the control group(P<0.05),and the dopamine(DA)level was lower than that in the control group(P<0.05).During treatment,the incidence of adverse reactions was 4.08%in the study group,lower than that of 18.37%in the control group(P<0.05).Conclusion:Anshen Dingzhi Decoction combined with TMs has a good clinical effect in the treatment of insomnia of heart-gallbladder qi deficiency type,which can effectively improve sleep quality,regulate neurotransmitters,and have good safety.
作者
徐欢欢
黎斌
陈克龙
张妤婷
陈凌
XU Huanhuan;LI Bin;CHEN Kelong;ZHANG Yuting;CHEN Ling(Wenzhou Traditional Chinese Medicine Hospital of Zhejiang Chinese Medical University,Wenzhou Zhejiang 325000,China)
出处
《新中医》
CAS
2024年第14期64-69,共6页
New Chinese Medicine
基金
温州市科技计划项目(2022Y0935)。
关键词
失眠
心胆气虚
安神定志汤
经颅磁刺激
睡眠质量
神经递质
不良反应
Insomnia
Heart-gallbladder qi deficiency:Anshen Dingzhi Decoction
Transcranial magnetic stimulation
Sleep quality
Neurotransmitter:Adverse reactions
