芪枣安神汤对心脾两虚型失眠症患者睡眠质量的影响

石春明+孙楠

[摘要] 目的 观察芪枣安神汤对心脾两虚型失眠症患者睡眠质量的影响。 方法 选择2015年1月～2016年1月在陕西省宝鸡市中医医院治疗的104例心脾两虚型失眠症患者作为研究对象。采用随机数字表法将其随机分为观察组和对照组，各52例。观察组予以芪枣安神汤治疗，每日1剂，早晚空腹分服。对照组给予艾司唑仑片，1 mg/d，晚睡时口服。两组均以1周作为1个疗程，持续治疗4个疗程。治疗前后采用匹兹堡睡眠质量指数量表（PSQI）评价患者睡眠质量，观察两组治疗后的临床效果，并记录治疗过程中发生的不良反应。 结果 治疗后，两组PSQI量表各因子评分及总分均较治疗前显著下降，差异均有统计学意义（P < 0.05）。观察组治疗后睡眠质量、睡眠时间、睡眠效率、睡眠障碍、日间功能损害评分及总分均显著低于对照组，差异均有统计学意义（均P < 0.05），两组入睡时间、镇静药物评分比较差异无统计学意义（P > 0.05）。治疗后，观察组总有效率（82.7%）显著高于对照组（69.2%），差异有高度统计学意义（P < 0.01）。治疗过程中，观察组未见明显不良反应发生，对照组发生口干3例、嗜睡2例、头晕2例、乏力1例。 结论 芪枣安神汤能明显改善心脾两虚型失眠症患者的睡眠质量，缓解临床症状和体征，且安全性较好，值得临床推广应用。

[关键词] 失眠；芪枣安神汤；心脾两虚；睡眠质量

[中图分类号] R256.23 [文献标识码] A [文章编号] 1673-7210（2016）10（c）-0146-04

[Abstract] Objective To observe the effect of Qizao Anshen Decoction on the sleep quality of nsomnia patients with syndrome of deficiency of both heart and spleen. Methods One hundred and four insomnia patients with syndrome of deficiency of both heart and spleen treated in Baoji Hospital of Traditional Chinese Medicine from January 2015 to January 2016 were selected as research objects， and they were randomly divided into observation group and control group by random number table， with 52 cases in each group. The observation group was given Qizao Anshen Decoction， one dose daily， taking on an empty stomach in the morning and evening respectively. The control group was given Estazolam Tablets， 1 mg/d， taking before sleep orally. Both groups took 1 week as one course of treatment， for 4 courses continuously. The sleep quality of the two groups before and after treatment was evaluated by Pittsburgh sleep quality index （PSQI）， the clinical efficacy of the two groups after treatment was observed， and the adverse reactions during the treatment were recorded. Results After treatment， the scores of each factor of PSQI and total scores in the two groups were all lower than those before treatment， the differences were all statistically significant （all P < 0.05）. The scores of sleep quality， sleep time， sleep efficiency， sleep disorders， daily function damage and total scores in the observation group after treatment were all lower than those of control group， the differences were all statistically significant （all P < 0.05）， while there were no statistically significant differences of the scores of fall-sleep time and sedative between the two groups （P > 0.05）. After treatment， the total effective rate of observation group （82.7%） was higher than that of control group （69.2%）， the difference was highly statistically significant （P < 0.01）. During the treatment， there were no obvious adverse reactions in the observation group， while there were 3 cases of dry mouth， 2 cases of drowsiness， 2 cases of dizzy， 1 case of lack of power in the control group. Conclusion Qizao Anshen Decoction can significantly improve the sleep quality of nsomnia patients with syndrome of deficiency of both heart and spleen， relieve the clinical symptoms and signs， and the safety is good， which is worthy of clinical promotion and application.

[Key words] Insomnia； Qizao Anshen Decoction； Syndrome of deficiency of both heart and spleen； Sleep quality

目前随着工作压力、就业压力的增大，生活节奏日趋加快，情志、心理、日常饮食生活规律等也随之发生变化，出现暴饮暴食、身心疲惫、思虑过度，久则损伤脾胃，导致脾胃功能失调，从而引发气血生化之源不足，气血亏虚、气机失调，心神失养或不安而不寐[1-3]。长期失眠严重影响患者的日常功能活动，给患者的身心健康带来不良后果，如引发心脑血管疾病、内分泌系统疾病等[4]。目前西医对于失眠症的治疗方法，大部分采用镇静催眠药物疗程治疗，对于长期服用镇静催眠药物的失眠症患者会造成耐药及药物依赖，极易产生镇静过度、胃肠刺激等副作用，这些情况都限制了其在临床的应用[5-6]。……