摘要
目的:探讨老年失眠患者应用安宁汤治疗的临床效果及对血浆5-羟色胺(5-HT)和多巴胺(DA)水平的影响。方法:选取符合纳入标准的94例老年失眠患者,按照随机数表法分为对照组和观察组。对照组给予西医常规治疗;观察组在对照组基础上予以自拟安宁汤治疗。记录比较两组临床疗效;治疗前后焦虑自评量表(SAS)、抑郁自评量表(SDS)及匹兹堡睡眠质量指数(PSQI)总评分,多导睡眠图(PSG)指标,血浆5-HT、DA水平;并评价两组用药安全性。结果:疗程结束后,观察组总有效率为89.4%(42/47)优于对照组72.3%(34/47)(P<0.05)。与本组治疗前比较,两组治疗后SAS、SDS及PSQI总评分,均显著下降(P<0.01);且观察组治疗后SAS、SDS及PSQI总评分,均显著低于对照组(P<0.01)。两组治疗后SL、AT及TST,均显著优于治疗前(P<0.01);与对照组同期对比,观察组治疗后PSG指标改善效果均更为显著(P<0.01)。与本组治疗前相比,两组治疗后血浆5-HT水平均显著升高(P<0.01),血浆DA水平均显著降低(P<0.01);且观察组治疗后血浆5-HT、DA水平,均显著优于对照组(P<0.01)。观察组不良反应率为4.3%(2/47)明显低于对照组的17.0%(8/47)(P<0.05),观察组停药观察期间反跳性失眠发生率为0与对照组的10.6%(5/47)相比,明显更低(P<0.05)。结论:老年失眠患者应用安宁汤治疗能更有效缓解临床症状,消除不良情绪,调节中枢神经递质水平,提高睡眠质量,疗效显著,且安全可靠。
Objective： To explore clinical effect of Anning Decoction on senile insomnia and its impact on 5-hydroxytryptamine（5-HT） and dopamine（DA）. Methods： 94 cases of senile insomnia were randomly divided into the control group and the observation group. The control group was treated with routine western treatment; on which basis, the observation group was also treated with Anning Decoction. Clinical effect were compared between the two groups; overall scores of self-rating anxiety scale（SAS）, self-rating depression scale（SDS）, and Pittsburgh sleep quality index（PSQI）, index of polysomnography（PSG）, and serum levels of 5-HT and DA were compared before and after the treatment in the two groups; medication safety was also evaluated in the two groups. Results： The overall effective rate was 89.4%（42/47） in the observation group, which was significantly higher than 72.3%（34/47） in the control group（ P 〈0.05）. The overall scores of SAS, SDS and PSQI were significantly decreased after the treatment compared to those before the treatment in the two groups（ P 〈0.01）; the decrease was more significant in the observation group compared to that in the control group（ P 〈0.01）. SL, AT, and TST were greatly improved after the treatment in the two groups（ P 〈0.01）, the improvements were more significant in the observation group than those in control group（ P 〈0.01）. 5-HT level was increased significantly, and DA level was decreased significantly in the two groups after the treatment（ P 〈0.01）; the observation group was superior to the control group in terms of the improvement（ P 〈0.01）. The adverse reaction rate was 4.3%（2/47） in the observation group, which was significantly lower than 17.0%（8/47） in the control group（ P 〈0.05）. During the withdrawal, the incidence rate of rebound insomnia was 0% in the observation group, which was significantly lower than 10.6%（5/47） in the control group（ P 〈0.05）. Conclusion： The application of
作者
张利平
ZHANG Liping(Zhengzhou TCM Hospital,Zhengzhou 450007,China)
出处
《中医药信息》
2018年第6期45-49,共5页
Information on Traditional Chinese Medicine
