自拟安神宁心汤联合益神颗粒对于失眠症患者心理状态及血清神经肽Y、P物质表达的影响
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摘要
目的观察自拟安神宁心汤联合益神颗粒对于失眠症患者心理状态及血清神经肽Y(NPY)、P物质(SP)表达的影响。方法将180例失眠症患者随机分为2组,治疗组采用自拟安神宁心汤(每日1剂)联合益神颗粒(每次10 g,每日3次)治疗,对照组采用阿普唑仑(每次0.4 mg,每日1次)治疗,2组均以1周为1个疗程,持续治疗4个疗程,统计2组治疗后临床疗效,观察2组治疗前后匹兹堡睡眠质量指数(PSQI)、中医证候积分、焦虑抑郁评分及血清NPY、SP水平变化情况。结果 2组治疗后PSQI、中医证候积分、汉密尔顿焦虑量表(HAMA)评分与汉密尔顿抑郁量表(HAMD)评分均明显低于治疗前(P均<0.05),且治疗组均明显低于对照组(P均<0.05);治疗组中医疗效以及西医疗效总有效率均明显高于对照组(P均<0.05);2组治疗后血清NPY水平均明显升高、SP水平均明显降低(P均<0.05),治疗组治疗后NPY水平明显高于对照组、SP水平明显低于对照组(P均<0.05)。结论自拟安神宁心汤联合益神颗粒可以有效改善失眠症患者的睡眠质量及心理状态,可明显调节血清NPY、SP的表达,促进神经功能紊乱的恢复,效果优于西药治疗。
Objective It is to observe the effect of self prepared Anshen Ningxin Decoction combined with Yishen Granule on the psychological state and the expression of serum neuropeptide Y( NPY) and substance P( SP) in patients with insomnia. Methods One hundred and eighty patients with insomnia were randomly divided into two groups. The treatment group was treated with Anshen Ningxin Decoction( 1 doses per day) combined with Yishen Granule( 10 g per day,3 times daily). The control group was treated with alprazolam( 0. 4 mg per day,1 times a day). One weeks as one courses,and both groups were treated for 4 courses of treatment. The clinical curative effect of the 2 groups after treatment was analyzed.The changes of Pittsburgh Sleep Quality Index( PSQI),TCM syndrome score,anxiety and depression score,serum NPY and SP levels were observed before and after treatment in the 2 groups. Results The PSQI score,TCM symptom score,Hamilton Anxiety Scale( HAMA) score and Hamilton Depression Scale( HAMD) score after treatment were significantly lower than those before treatment( all P < 0. 05),and the treatment group was significantly lower than the control group( P <0. 05). The total effective rate of Chinese medicine and Western medicine in the treatment group was significantly higher than that in the control group( all P < 0. 05). The serum NPY levels of the two groups were increased significantly but the SP level were decreased significantly after treatment( P < 0. 05). The changes in the treatment group were more significant than those in the control group( all P < 0. 05). Conclusion Anshen Ningxin Decoction combined with Yishen Granule can effectively improve the sleep quality and mental state of insomniacs,and can obviously regulate the expression of serum NPY and SP and promote the recovery of nervous dysfunction,which is better than Western medicine.
Objective It is to observe the effect of self prepared Anshen Ningxin Decoction combined with Yishen Granule on the psychological state and the expression of serum neuropeptide Y( NPY) and substance P( SP) in patients with insomnia. Methods One hundred and eighty patients with insomnia were randomly divided into two groups. The treatment group was treated with Anshen Ningxin Decoction( 1 doses per day) combined with Yishen Granule( 10 g per day,3 times daily). The control group was treated with alprazolam( 0. 4 mg per day,1 times a day). One weeks as one courses,and both groups were treated for 4 courses of treatment. The clinical curative effect of the 2 groups after treatment was analyzed.The changes of Pittsburgh Sleep Quality Index( PSQI),TCM syndrome score,anxiety and depression score,serum NPY and SP levels were observed before and after treatment in the 2 groups. Results The PSQI score,TCM symptom score,Hamilton Anxiety Scale( HAMA) score and Hamilton Depression Scale( HAMD) score after treatment were significantly lower than those before treatment( all P < 0. 05),and the treatment group was significantly lower than the control group( P <0. 05). The total effective rate of Chinese medicine and Western medicine in the treatment group was significantly higher than that in the control group( all P < 0. 05). The serum NPY levels of the two groups were increased significantly but the SP level were decreased significantly after treatment( P < 0. 05). The changes in the treatment group were more significant than those in the control group( all P < 0. 05). Conclusion Anshen Ningxin Decoction combined with Yishen Granule can effectively improve the sleep quality and mental state of insomniacs,and can obviously regulate the expression of serum NPY and SP and promote the recovery of nervous dysfunction,which is better than Western medicine.
引文
[1]科技部“十一五”国家科技支撑计划重点课题心理疾患防治研究与示范项目研究课题组.基于个体化的失眠症中医临床实践指南[J].世界睡眠医学杂志,2016,3(2):65-79
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[3]中华医学会精神科学会,南京医科大学脑科医院.中国精神疾病分类方案与诊断标准[S].南京:东南大学出版社,1995:42
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[9]王祎晟,徐瑛,刘晏,等.益神颗粒治疗心脾两虚型白细胞减少症54例[J].西部中医药,2017,30(2):72-73
[10]王珍,梁丽娜,白昱旸,等.浅析国医大师唐由之运用制首乌及黄精经验[J].中国中医眼科杂志,2014,24(3):180-182
[11]杨金颖,孙芳芳.麦冬多糖的药理作用研究[J].天津药学,2016,28(2):52-55
[12]杨楠,叶晓川.酸枣仁汤的神经药理作用及分子机制研究进展[J].湖北中医药大学学报,2017,19(3):114-117
[13]赵辉,张小林,齐献忠,等.西酞普兰治疗首发抑郁症老年患者效果及对血清中脑源性神经营养因子和神经肽Y的影响[J].中国老年学杂志,2017,37(14):3566-3568
[14]陈兴阳,汤义平.安非他酮缓释片治疗抑郁症患者的效果及对血清P物质和神经肽Y水平的影响[J].中国医药导报,2014,11(9):107-109
[15]岳慧娟,岳慧玲.心肌梗死患者的焦虑、抑郁情绪调查及护理对策[J].辽宁医学杂志,2015,29(6):355-356
[2]廖继武,黄俏庭,潘集阳,等.原发性失眠患者与有失眠症状抑郁症患者的血清神经肽Y和P物质水平[J].中国心理卫生杂志,2012,26(7):490-494
[3]中华医学会精神科学会,南京医科大学脑科医院.中国精神疾病分类方案与诊断标准[S].南京:东南大学出版社,1995:42
[4]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,1994:31-32
[5]国家中医药管理局.中药新药治疗失眠的临床研究指导原则[S].北京:中国医药科技出版社,2002:186-187
[6]李超群,李秀玉,李静,等.常用安眠药物临床应用进展——从理论到实践[J].中国医刊,2016,51(1):43-48
[7]颜鸿,张蕊.佐匹克隆治疗失眠60例疗效观察[J].陕西医学杂志,2012,41(9):1259-1260
[8]陈聪,宋咏梅.基于现代中医医案的失眠辨证规律分析[J].安徽中医药大学学报,2014,33(3):6-8
[9]王祎晟,徐瑛,刘晏,等.益神颗粒治疗心脾两虚型白细胞减少症54例[J].西部中医药,2017,30(2):72-73
[10]王珍,梁丽娜,白昱旸,等.浅析国医大师唐由之运用制首乌及黄精经验[J].中国中医眼科杂志,2014,24(3):180-182
[11]杨金颖,孙芳芳.麦冬多糖的药理作用研究[J].天津药学,2016,28(2):52-55
[12]杨楠,叶晓川.酸枣仁汤的神经药理作用及分子机制研究进展[J].湖北中医药大学学报,2017,19(3):114-117
[13]赵辉,张小林,齐献忠,等.西酞普兰治疗首发抑郁症老年患者效果及对血清中脑源性神经营养因子和神经肽Y的影响[J].中国老年学杂志,2017,37(14):3566-3568
[14]陈兴阳,汤义平.安非他酮缓释片治疗抑郁症患者的效果及对血清P物质和神经肽Y水平的影响[J].中国医药导报,2014,11(9):107-109
[15]岳慧娟,岳慧玲.心肌梗死患者的焦虑、抑郁情绪调查及护理对策[J].辽宁医学杂志,2015,29(6):355-356