1 南京中医药大学第二附属医院神经内科，南京 210017
目的：观察调肝安神方治疗失眠症肝郁血瘀证患者的临床疗效及对匹兹堡睡眠质量指数(Pittsburgh Sleep Quality Index，PSQI)评分的影响。方法：选取南京中医药大学第二附属医院神经内科失眠专病门诊患者96例，采用随机数字表法随机分为2组。对照组48例，给予艾司唑仑1~2 mg睡前口服；治疗组48例，在对照组基础上加用调肝安神方治疗。比较2组中医证侯疗效及PSQI分值的变化。结果：治疗组临床痊愈9例，显效16例，有效18例，无效5例，愈显率65.8%，总有效率89.6%；对照组临床痊愈3例，显效10例，有效19例，无效16例，愈显率34.2%，总有效率66.7%。治疗组临床愈显率及总有效率均明显高于对照组(均P<0.05)。治疗后，对照组睡眠质量、入睡时间、睡眠时间、睡眠效率PSQI因子积分及总积分均较治疗前明显下降(均P<0.05)；治疗组睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、日间功能PSQI各因子积分及总积分均较治疗前明显下降(均P<0.01)，且均显著低于对照组(均P<0.05)。结论：调肝安神方治疗失眠症肝郁血瘀证患者疗效确切，能显著延长总睡眠时间，增加睡眠深度，减轻睡眠障碍，缓解日间功能，改善睡眠质量，显著提高睡眠效率，值得临床进一步研究。
Clinical effect of “tiaogan anshen decoction” on insomnia patients with stagnation of liver and blood stasis syndrome and influence on PSQI score
This work was supported by the Science and Technology Research Funding Program of The Second Affiliated Hospital of Nanjing University of Chinese Medicine, China (SEZJJZ2018009).
Objective: To evaluate the clinical effect of tiaogan anshen decoction on insomnia patients with stagnation of liver-qi and blood stasis syndrome and influence on Pittsburgh Sleep Quality Index (PSQI) score. Methods: A total of 96 patients of Insomnia Outpatient Clinic in Neurology Department were randomly divided into 2 groups. The Control Group (48 cases) was given oral Estazolam 1–2 mg before sleep, and the Treatment Group (48 cases) was given tiaogan anshen decoction on the basis of the control group. After Treatment, observe the curative effect of TCM Syndromes and the change of PSQI score in 2 groups. Results: After treatment, In the treatment group, 9 cases were clinically cured, 16 cases were markedly effective, 18 cases were effective, 5 cases were ineffective, the good improvement rate was 65.8%, and the total effective rate was 89.6%. In the control group, 3 cases were clinically cured, 10 cases were markedly effective, 19 cases were effective and 16 cases were ineffective, the marked rate was 34.2%, and the total effective rate was 66.7%. The clinical markedly effective rate and total effective rate of the treatment group were significantly higher than those of the control group (P<0.05). After treatment, the PSQI factor scores and total scores of sleep quality, sleep time, sleep efficiency in the control group were significantly lower than those before treatment (both P<0.05); the PSQI factor scores and total scores of sleep quality, sleep latency time, length of sleep bedtime, sleep efficiency, sleep disorder, daytime function in the treatment group were significantly lower than those before treatment (P<0.01), and It was significantly lower than that of the control group (both P<0.05). Conclusion: Tiaogan anshen decoction is effective in treating insomnia patients with stagnation of liver-qi and blood stasis syndrome. It can significantly prolong the total sleep time, increase the sleep depth, alleviate sleep disorders, alleviate daytime function, improve sleep quality and sleep efficiency. It is worthy of further clinical study.
insomnia; insomnia; stagnation of liver and blood stasis syndrome; observation of curative effect