益神宁心方对慢性失眠患者睡眠质量及焦虑、抑郁情绪的影响
|
摘要
目的观察益神宁心方治疗气阴两虚型慢性失眠患者的临床疗效及其对焦虑、抑郁情绪的影响。方法将符合诊断标准的80例慢性失眠患者随机分为治疗组和对照组,每组各40例。治疗组予益神宁心方治疗,对照组予阿普唑仑片治疗,疗程为8周。比较两组患者的临床疗效,治疗前后采用匹兹堡睡眠质量评估表(PSQI)评价患者的睡眠质量,采用焦虑自评量表(SAS)与抑郁自评量表(SDS)评定患者的负性情绪。结果治疗后,治疗组的疗效优于对照组(P<0.05);与治疗前比较,治疗组PSQI各项评分及总分均显著下降(P<0.01),对照组睡眠障碍、日间功能障碍无显著变化(P>0.05),睡眠质量、入睡时间、睡眠时间和睡眠效率均显著下降(P<0.05,P<0.01)。治疗后,治疗组与对照组比较除入睡时间无显著差异(P>0.05),其余各项指标及PSQI总分均显著下降(P<0.01);与治疗前比较,两组治疗后SAS、SDS评分均明显下降(P<0.05,P<0.01),且治疗组SAS和SDS评分显著低于对照组(P<0.05,P<0.01)。结论益肾宁心方能改善气阴两型慢性失眠患者的睡眠质量,缓解焦虑、抑郁情绪,临床疗效较好。
Objective To evaluate the clinical efficacy of Yishen Ningxin decoction in treatment of chronic insomnia with syndrome of qi and yin deficiency,and to observe its effects on emotion of anxiety and depression in such cases. Methods 80 cases of patients were randomly divided into treatment group and control group,40 cases in each group. Control group was treated with alprazolam tablets,while treatment group was given Yishen Ningxin decoction. The therapeutic courses were 8 weeks. The outcomes were evaluated according to effective rats,Pittsburgh Sleep Quality Index(PSQI),Self-Rating Anxiety Scale(SAS) and Self-Rating Depression Scale(SDS). Results After treatment,the curative effect was higher in treatment group,showing statistically significant differences than control group(P<0.05); compared with before treatment,PSQI and its contents were statistically lower in treatment group after treatment(P<0.01),while sleep disorder and daytime feeling had no differences in control group after treatment(P>0.05). PSQI and its different contents were better improved in treatment group than control group after 8 weeks except the sleep latency item(P<0.05,P<0.01); SAS and SDS were better improved in treatment group than control group after 8 weeks(P<0.05,P<0.01). Conclusion Yishen Ningxin decoction shows a definitely clinical effectiveness in improving sleep quality in chronic insomnia patients with qi and yin deficiency syndrome. Also,it can reducethe anxiety and depression in such cases as well as reducing the side effects.
Objective To evaluate the clinical efficacy of Yishen Ningxin decoction in treatment of chronic insomnia with syndrome of qi and yin deficiency,and to observe its effects on emotion of anxiety and depression in such cases. Methods 80 cases of patients were randomly divided into treatment group and control group,40 cases in each group. Control group was treated with alprazolam tablets,while treatment group was given Yishen Ningxin decoction. The therapeutic courses were 8 weeks. The outcomes were evaluated according to effective rats,Pittsburgh Sleep Quality Index(PSQI),Self-Rating Anxiety Scale(SAS) and Self-Rating Depression Scale(SDS). Results After treatment,the curative effect was higher in treatment group,showing statistically significant differences than control group(P<0.05); compared with before treatment,PSQI and its contents were statistically lower in treatment group after treatment(P<0.01),while sleep disorder and daytime feeling had no differences in control group after treatment(P>0.05). PSQI and its different contents were better improved in treatment group than control group after 8 weeks except the sleep latency item(P<0.05,P<0.01); SAS and SDS were better improved in treatment group than control group after 8 weeks(P<0.05,P<0.01). Conclusion Yishen Ningxin decoction shows a definitely clinical effectiveness in improving sleep quality in chronic insomnia patients with qi and yin deficiency syndrome. Also,it can reducethe anxiety and depression in such cases as well as reducing the side effects.
引文
[1]Sateia MJ.International classifications of sleep disorders--third edition:highlights and modifications[J].Chest,2014,146(5):1387-1394.
[2]American Association.Sleep-wake Disorders.Diagnostic and statistical manual of Mental Disorders,Fifth Edition(DSM-5)[M].Arlington,VA:AmericanPsychiatricAssociation,2013:362.
[3]Cutler AJ.The Role of Insomnia in Depression and Anxiety:Its Impact on Functioning,Treatment,and outcomes[J].Journal of Clinical Psychiatry,2016,77(8):1010.
[4]顾鑫,顾平,刘义晗,等.慢性失眠患者焦虑、抑郁情绪及交感神经皮肤反应的相关性[J].中华神经科杂志,2017,50(9):665-670.
[5]中华医学会神经病学分会.中国成人失眠诊断与治疗指南(2017版)[J].中华神经科杂志,2018,5(51):324-335.
[6]国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994:19-20.
[7]沈自尹,王文健.中医虚证辨证参考标准[J].中国中西医结合杂志,1986(10):598.
[8]中国睡眠研究会.中国失眠症诊断和治疗指南[J].中华医学杂志,2017,97(24):1844-1860.
[9]国家中医药管理局.中医病证诊断疗效标准(2012版)[S].北京:中国医药科技出版社,2012:228.
[10]刘贤臣,唐茂芹,胡蕾,等.匹兹堡睡眠质量指数的信度效度研究[J].中华精神科杂志,1996(29):103-107.
[11]Buysse DJ,Reynolds CF,Monk TH,et al.The Pittsburgh sleep quality index:A new instrument for psychiatric practice and research[J].Psychiatry Research,1989,28(2):193-213.
[12]Middeldorp CM,Cath DC,Van Dyck R,et al.The co-morbidity of anxiety and depression in the perspective of genetic epidemiology.A review of twin and family studies[J].Psychological Medicine,2005,35(5):611-624.
[13]Inkster B,Rao AW,Ridler K,et al.Structural brain changes in patients with recurrent major depressive disorder presenting with anxiety symptoms[J].J Neuroimaging,2011,21(4):375-382.
[14]和昱辰,张波,瞿玮,等.血清单胺类神经递质及其代谢产物在重度抑郁症及抑郁共病焦虑障碍诊断中的应用[J].第三军医大学学报,2014,36(8):806-810.
[15]马凤丽,杨胜林,熊洪艳.失眠症古今医案辨证论治规律研究[J].云南中医中药杂志,2015,36(2):7-10.
[16]王重卿,张振贤.“益神颗粒”对于心脾两虚型失眠患者的疗效观察与安全性评价[J].基因组学与应用生物学,2018,37(4):1752-1760.
[2]American Association.Sleep-wake Disorders.Diagnostic and statistical manual of Mental Disorders,Fifth Edition(DSM-5)[M].Arlington,VA:AmericanPsychiatricAssociation,2013:362.
[3]Cutler AJ.The Role of Insomnia in Depression and Anxiety:Its Impact on Functioning,Treatment,and outcomes[J].Journal of Clinical Psychiatry,2016,77(8):1010.
[4]顾鑫,顾平,刘义晗,等.慢性失眠患者焦虑、抑郁情绪及交感神经皮肤反应的相关性[J].中华神经科杂志,2017,50(9):665-670.
[5]中华医学会神经病学分会.中国成人失眠诊断与治疗指南(2017版)[J].中华神经科杂志,2018,5(51):324-335.
[6]国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994:19-20.
[7]沈自尹,王文健.中医虚证辨证参考标准[J].中国中西医结合杂志,1986(10):598.
[8]中国睡眠研究会.中国失眠症诊断和治疗指南[J].中华医学杂志,2017,97(24):1844-1860.
[9]国家中医药管理局.中医病证诊断疗效标准(2012版)[S].北京:中国医药科技出版社,2012:228.
[10]刘贤臣,唐茂芹,胡蕾,等.匹兹堡睡眠质量指数的信度效度研究[J].中华精神科杂志,1996(29):103-107.
[11]Buysse DJ,Reynolds CF,Monk TH,et al.The Pittsburgh sleep quality index:A new instrument for psychiatric practice and research[J].Psychiatry Research,1989,28(2):193-213.
[12]Middeldorp CM,Cath DC,Van Dyck R,et al.The co-morbidity of anxiety and depression in the perspective of genetic epidemiology.A review of twin and family studies[J].Psychological Medicine,2005,35(5):611-624.
[13]Inkster B,Rao AW,Ridler K,et al.Structural brain changes in patients with recurrent major depressive disorder presenting with anxiety symptoms[J].J Neuroimaging,2011,21(4):375-382.
[14]和昱辰,张波,瞿玮,等.血清单胺类神经递质及其代谢产物在重度抑郁症及抑郁共病焦虑障碍诊断中的应用[J].第三军医大学学报,2014,36(8):806-810.
[15]马凤丽,杨胜林,熊洪艳.失眠症古今医案辨证论治规律研究[J].云南中医中药杂志,2015,36(2):7-10.
[16]王重卿,张振贤.“益神颗粒”对于心脾两虚型失眠患者的疗效观察与安全性评价[J].基因组学与应用生物学,2018,37(4):1752-1760.