加味酸枣仁汤联合地西泮治疗焦虑性失眠的临床研究

Clinical Study of Jiawei Suanzaoren Decoction combined with diazepam in the treatment of anxiety insomnia

关键词:  焦虑性失眠  加味酸枣仁汤  地西泮  临床疗效

Key words:  anxiety insomnia  Jiawei Suanzaoren Decoction  diazepam  efficacy

摘要:

[目的]探讨加味酸枣仁汤联合地西泮治疗焦虑性失眠的临床疗效。[方法]选择2016年1月—2018年5月本院收治的100例焦虑性失眠患者，随机分为对照组（50例）和研究组（50例）。对照组给予地西泮治疗，研究组给予加味酸枣仁汤联合地西泮治疗，两组均给予治疗4周。评价并比较两组临床疗效。比较两组治疗前后的汉密尔顿焦虑量表（HAMA）评分、焦虑自评量表（SAS）评分、匹兹堡睡眠质量指数量表（PSQI）评分及血清多巴胺（DA）、5-羟色胺（5-HT）、肿瘤坏死因子-α（TNF-α）水平及外周血CD4⁺、CD8⁺水平和CD4⁺/CD8⁺比值。[结果]研究组的总有效率为94.00%（47/50），对照组为76.00%（38/50），两组比较差异有统计学意义（χ²=6.353，P=0.012）。治疗后，两组HAMA评分、SAS评分及PSQI评分均明显低于治疗前，且研究组HAMA评分、SAS评分及PSQI评分的变化幅度均明显大于对照组（P<0.05）。治疗后，两组血清DA、5-HT水平及外周血CD4⁺水平、CD4⁺/CD8⁺比值均明显高于治疗前，血清TNF-α水平和外周血CD8⁺水平均明显低于治疗前，且研究组血清DA、5-HT、TNF-α水平及外周血CD4⁺、CD8⁺水平、CD4⁺/CD8⁺比值的变化幅度均明显大于对照组（P<0.05）。[结论]加味酸枣仁汤联合地西泮能够明显改善睡眠，减轻焦虑情绪，调节机体神经递质水平，纠正细胞免疫功能紊乱，且安全性较好。

Abstract:

[Objective] To explore the clinical efficacy of Jiawei Suanzaoren Decoction combined with diazepam in the treatment of anxiety insomnia.[Methods] One hundred patients with anxiety insomnia admitted to our hospital from January 2016 to May 2018 were enrolled in this study. The subjects were randomly divided into the control group (n=50) and the experiment group (n=50) randomly. The control group was treated with diazepam,while the experiment group was treated with Jiawei Suanzaoren Decoction combined with diazepam. The two groups were treated for 4 weeks. The clinical efficacy of the two groups was compared. The score of Hamilton Anxiety Scale (HAMA),Self-rating Anxiety Scale (SAS),Pittsburgh Sleep Quality Index (PSQI),serum dopamine (DA),5-hydroxytryptamine (5-HT),tumor necrosis factor-α(TNF-α) and peripheral blood CD4⁺,CD8⁺ level and CD4⁺/CD8⁺ ratioswas were compared before and after treatment.[Results] The total effective rate of the experiment group was 94.00% (47/50),which was significantly higher than 76.00% (38/50) of the control group (χ²=6.353,P=0.012). After treatment,the HAMA score,SAS score,PSQI score of the two groups was significantly lower than before treatment (P<0.05),and the change of HAMA score,SAS score and PSQI score in the experiment group was significantly greater than those in the control group (P<0.05). After treatment,the level of serum DA,5-HT,CD4⁺ and CD4⁺/CD8⁺ ratio in both groups was significantly higher than those before treatment,while the level of serum TNF-α and CD8⁺ in peripheral blood was significantly lower than those before treatment. The change of serum DA,5-HT,TNF-α,CD4⁺,CD8⁺ level and CD4⁺/CD8⁺ ratio in the experiment group was significantly greater than those in the control group (P<0.05).[Conclusion] Jiawei Suanzaoren Decoction combined with diazepam can obviously improve sleep,alleviate anxiety,regulate the level of neurotransmitters,correct the disorder of cellular immune function,and has good safety.