柴胡加龙骨牡蛎汤治疗少阳型消渴病伴不寐疗效观察
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摘要
目的:评价柴胡加龙骨牡蛎汤对少阳型消渴病伴不寐患者的临床疗效。方法:受试对象80例用随机分成两组,包括对照组38例,治疗组42例。对照组在原降糖方案治疗的基础上予艾司唑仑片治疗,治疗组在原降糖方案治疗的基础上予柴胡龙骨牡蛎汤口服,治疗周期为15 d。观察两组血糖水平、PSQI评分及中医证候积分的变化。结果:组内比较:治疗后,两组患者血糖、PSQI评分、中医证候积分均有显著性差异(P<0.05),提示两组治疗均有临床疗效。组间比较:治疗前,两组患者的血糖水平、PSQI评分及中医证候积分无显著差异(P>0.05),具有可比性。治疗后,与对照组相比,治疗组的血糖水平、中医证候积分有显著性差异(P<0.05),提示治疗组在改善血糖水平及中医证候积分方面显著优于对照组;而在改善PSQI评分方面,治疗组与对照组无显著性差异(P>0.05),提示在改善睡眠质量方面,尚不能认为两组有不同疗效。两组临床疗效有显著性差异(P<0.05),表明在改善治疗组的临床疗效优于对照组。且治疗组的不良反应显著低于对照组(P<0.05)。结论:两组治疗方案均可降低血糖水平、中医证候积分、PSQI评分,但治疗组在改善中医症状及降低血糖方面疗效显著优于对照组,而在改善PSQI评分方面则尚不能认为两组疗效有差异;柴胡龙骨牡蛎汤在改善整体症状方面疗效显著优于艾司唑仑组。表明睡眠质量与血糖水平有一定的联系,且柴胡加龙骨牡蛎汤在降血糖的同时,还具有镇静助睡眠的作用,且不良反应少,值得临床进一步推广。
Objective:To explore the clinical curative effects of Chaihu Longgu Muli Decoction on the treatment of Shaoyang T2 DM with insomnia. Methods:The 80 trial patients randomized into the control group and the treatment group,with the control group 38 cases and the treament group 42 cases,for 15 days treatment,the control group was given basic treatment and Eszolam tablet,and the treament group was treated with Chaihu Longgu Muli Decoction which were treated on the basis of the basic treatment.Observed the changes of blood glucose levels,PSQI scores and TCM syndrome scores. Results:Intragroup comparison:there were significant differences in blood glucose,PSQI scores,and TCM syndrome scores between the two groups after treatment(P<0.05),suggested that there were clinical efficacy in both groups. Comparison between groups:before treatment,there was no significant difference in blood glucose level,PSQI score and TCM syndrome score between the two groups(P>0.05),which means it was comparable. After treatment,there were significant differences in blood glucose level and TCM syndrome score between the treatment group and the control group(P<0.05),suggested that the treatment group was significantly better than the control group in improving blood glucose level and TCM syndrome scores. In terms of improving PSQI score,there was no significant differences between the treatment group and the control group(P>0.05),suggested that the two groups could not be considered to have different efficacy in improving sleep quality. There was significant differences in clinical efficacy between the two groups(P<0.05),suggested that the two groups could be considered to have a difference in the overall clinical efficacy. And the adverse reactions in the treatment group were significantly lower than those in the control group(P<0.05). Conclusion:Both the two treatment regimens could reduce blood glucose level,TCM syndrome scores and PSQI scores,but the treatment group was significantly better than the control group in improving TCM symptoms and reducing blood glucose,while the two groups could not be considered to have different efficacy in improving PSQI scores. The effect of Chaihu Longgu Muli Decoction on improving overall symptoms was significantly better than that of Eszolam group. The results showed that there was a certain relationship between sleep quality and blood glucose level,and could Chaihu Longgu Muli Decoction not only reduce blood glucose,but also had a sedative and sleep promoting effect,with few adverse reactions,which was worthy of further promotion in clinical practice.
Objective:To explore the clinical curative effects of Chaihu Longgu Muli Decoction on the treatment of Shaoyang T2 DM with insomnia. Methods:The 80 trial patients randomized into the control group and the treatment group,with the control group 38 cases and the treament group 42 cases,for 15 days treatment,the control group was given basic treatment and Eszolam tablet,and the treament group was treated with Chaihu Longgu Muli Decoction which were treated on the basis of the basic treatment.Observed the changes of blood glucose levels,PSQI scores and TCM syndrome scores. Results:Intragroup comparison:there were significant differences in blood glucose,PSQI scores,and TCM syndrome scores between the two groups after treatment(P<0.05),suggested that there were clinical efficacy in both groups. Comparison between groups:before treatment,there was no significant difference in blood glucose level,PSQI score and TCM syndrome score between the two groups(P>0.05),which means it was comparable. After treatment,there were significant differences in blood glucose level and TCM syndrome score between the treatment group and the control group(P<0.05),suggested that the treatment group was significantly better than the control group in improving blood glucose level and TCM syndrome scores. In terms of improving PSQI score,there was no significant differences between the treatment group and the control group(P>0.05),suggested that the two groups could not be considered to have different efficacy in improving sleep quality. There was significant differences in clinical efficacy between the two groups(P<0.05),suggested that the two groups could be considered to have a difference in the overall clinical efficacy. And the adverse reactions in the treatment group were significantly lower than those in the control group(P<0.05). Conclusion:Both the two treatment regimens could reduce blood glucose level,TCM syndrome scores and PSQI scores,but the treatment group was significantly better than the control group in improving TCM symptoms and reducing blood glucose,while the two groups could not be considered to have different efficacy in improving PSQI scores. The effect of Chaihu Longgu Muli Decoction on improving overall symptoms was significantly better than that of Eszolam group. The results showed that there was a certain relationship between sleep quality and blood glucose level,and could Chaihu Longgu Muli Decoction not only reduce blood glucose,but also had a sedative and sleep promoting effect,with few adverse reactions,which was worthy of further promotion in clinical practice.
引文
[1]吴晓缺,孙静.2型糖尿病睡眠障碍的研究进展[J].现代医药卫生,2018(34):283-285.
[2]刘宇翔.睡眠障碍与2型糖尿病患者血管并发症及治疗效果的相关性研究[D].天津:天津医科大学,2017:2-3.
[3]李明珍.2型糖尿病睡眠障碍的研究进展[J].中国慢性病预防与控制,2018,5(26):382-384.
[4]王秋虹,郑慧娟,张锦花.2型糖尿病伴失眠的中医治疗进展[J].世界睡眠医学杂志,2017,4(2):106-110.
[5]任凤艳,刘丽香,潘迪,等.消渴伴不寐的中医临床研究进展[J].湖南中医杂志,2017,33(2):159-161.
[6]Plantinga L,Rao M N,Schillinger D. Prevalence of self-reported sleep problems among people with diabetes in the United States[J].Preventing Chronic Disease,2012,9(2):76.
[7]路桃影,吴大嵘.匹兹堡睡眠质量指数的信度、效度及反应度研究[C]//中国中西医结合学会循证医学方法在中西医结合皮肤病临床研究中的应用研讨会.北京:中国中西医结合学会,2012.
[8]李佳琦,严悦蓉,余叶蓉.睡眠障碍与糖尿病的关系及其对糖代谢的影响研究进展[J].中国全科医学,2017,20(11):1300-1304.
[9]尹冬梅,许敏.改善睡眠障碍对糖尿病患者临床疗效的观察[J].农垦医学,2017,39(3):229-231.
[10]王绵,张力辉,苏胜偶.2017年内分泌代谢疾病重要临床进展[J].临床荟萃,2018,33(1):46-53.
[11]周小智,肖黎明,郭剑平,等.睡眠障碍及其干预对2型糖尿病患者血糖水平的影响[J].江西医药,2017,52(2):135-137.
[12]陈燕珊.李赛美教授中药治疗2型糖尿病的经验探讨[D].广州:广州中医药大学,2016.
[13]赵学敏,靳丽霞,闫冰.本草纲目拾遗[M].北京:中国中医药出版社,1998.
[14]许丹丹,杜纳纳,耿一玄,等.HPLC-ELSD测定柴胡加龙骨牡蛎汤改善睡眠有效部分中5种皂苷类成分的含量[J].中国药学杂志,2017,52(10):861-864.
[15]杨杉杉,周亚滨.柴胡加龙骨牡蛎汤的研究进展与临床应用概况[J].国医论坛,2018(1):68-70.
[16]王建云.柴胡加龙骨牡蛎汤治疗神经系统药理分析及运用研究简况[J].实用中医内科杂志,2013(10):63-63.
[17]徐萍,顾治平.黄连的药理作用研究进展[J].临床医药文献电子杂志,2017,4(27):5333.
[18]孙洁,严广华.黄连化学成分及有效成分药理活性的研究进展[J].中国继续医学教育,2018(8):141-143.
[19]魏世超,徐丽君,邹欣,等.黄连有效成分及其组合物对荷糖小鼠胰岛素和胰高血糖素样肽1(GLP-1)分泌影响的初步研究[J].中国医院药学杂志,2017(14):1343-1347.
[20]郭阳艳,刘萌萌,杨晓华,等.黄芩素对大鼠胰岛素分泌的作用及机制研究[J].中国药理学通报,2018(6):22-24.
[2]刘宇翔.睡眠障碍与2型糖尿病患者血管并发症及治疗效果的相关性研究[D].天津:天津医科大学,2017:2-3.
[3]李明珍.2型糖尿病睡眠障碍的研究进展[J].中国慢性病预防与控制,2018,5(26):382-384.
[4]王秋虹,郑慧娟,张锦花.2型糖尿病伴失眠的中医治疗进展[J].世界睡眠医学杂志,2017,4(2):106-110.
[5]任凤艳,刘丽香,潘迪,等.消渴伴不寐的中医临床研究进展[J].湖南中医杂志,2017,33(2):159-161.
[6]Plantinga L,Rao M N,Schillinger D. Prevalence of self-reported sleep problems among people with diabetes in the United States[J].Preventing Chronic Disease,2012,9(2):76.
[7]路桃影,吴大嵘.匹兹堡睡眠质量指数的信度、效度及反应度研究[C]//中国中西医结合学会循证医学方法在中西医结合皮肤病临床研究中的应用研讨会.北京:中国中西医结合学会,2012.
[8]李佳琦,严悦蓉,余叶蓉.睡眠障碍与糖尿病的关系及其对糖代谢的影响研究进展[J].中国全科医学,2017,20(11):1300-1304.
[9]尹冬梅,许敏.改善睡眠障碍对糖尿病患者临床疗效的观察[J].农垦医学,2017,39(3):229-231.
[10]王绵,张力辉,苏胜偶.2017年内分泌代谢疾病重要临床进展[J].临床荟萃,2018,33(1):46-53.
[11]周小智,肖黎明,郭剑平,等.睡眠障碍及其干预对2型糖尿病患者血糖水平的影响[J].江西医药,2017,52(2):135-137.
[12]陈燕珊.李赛美教授中药治疗2型糖尿病的经验探讨[D].广州:广州中医药大学,2016.
[13]赵学敏,靳丽霞,闫冰.本草纲目拾遗[M].北京:中国中医药出版社,1998.
[14]许丹丹,杜纳纳,耿一玄,等.HPLC-ELSD测定柴胡加龙骨牡蛎汤改善睡眠有效部分中5种皂苷类成分的含量[J].中国药学杂志,2017,52(10):861-864.
[15]杨杉杉,周亚滨.柴胡加龙骨牡蛎汤的研究进展与临床应用概况[J].国医论坛,2018(1):68-70.
[16]王建云.柴胡加龙骨牡蛎汤治疗神经系统药理分析及运用研究简况[J].实用中医内科杂志,2013(10):63-63.
[17]徐萍,顾治平.黄连的药理作用研究进展[J].临床医药文献电子杂志,2017,4(27):5333.
[18]孙洁,严广华.黄连化学成分及有效成分药理活性的研究进展[J].中国继续医学教育,2018(8):141-143.
[19]魏世超,徐丽君,邹欣,等.黄连有效成分及其组合物对荷糖小鼠胰岛素和胰高血糖素样肽1(GLP-1)分泌影响的初步研究[J].中国医院药学杂志,2017(14):1343-1347.
[20]郭阳艳,刘萌萌,杨晓华,等.黄芩素对大鼠胰岛素分泌的作用及机制研究[J].中国药理学通报,2018(6):22-24.