摘要
目的探讨养心定悸胶囊治疗失眠伴焦虑、抑郁状态患者的临床疗效,并观察其对血清神经递质的影响。方法选取2019年4月—2020年6月期间石家庄市中医院收治的失眠伴焦虑、抑郁状态患者112例,按照随机数字表法分为观察组和对照组,每组各56例。对照组采用艾司唑仑片治疗,观察组在对照组基础上予以养心定悸胶囊治疗。两组患者均连续治疗12周后,观察比较临床疗效,中医证候积分,睡眠质量[匹兹堡睡眠质量指数量表(Pittsburgh sleep quality index,PSQI)评分],焦虑[汉密尔顿焦虑评估量表(Hamilton Anxiety Scale,HAMA)]、抑郁[汉密尔顿抑郁评估量表(Hamilton depression scale,HAMD)]评分,血清神经递质水平[血清五羟色胺(5-hydroxytryptamine,5-HT)、多巴胺(Dopamine,DA)、脑源性神经营养因子(Brain-derived neurotrophic factor,BDNF)、胶质细胞源性神经营养因子(Glialcellline-derivedneurotrophicfactor,GDNF)]及不良反应情况。结果治疗后观察组总有效率为89.29%(50/56)高于对照组69.64%(39/56),差异有统计学意义(P<0.05)。两组患者治疗后心悸失眠、头目眩晕、少气懒言、神疲乏力、肌肤干燥、肢体麻木各项证候积分均低于治疗前,差异有统计学意义(P<0.05);且观察组各项中医证候积分均低于对照组,差异有统计学意义(P<0.05)。两组患者治疗后PSQI、HAMA及HAMD评分均低于治疗前,差异有统计学意义(P<0.05);且观察组低于对照组,差异有统计学意义(P<0.05)。两组患者治疗后血清5-HT、BDNF、GDNF水平均高于治疗前,血清DA水平均低于治疗前,差异有统计学意义(P<0.05);且观察组血清5-HT、BDNF、GDNF水平均高于对照组,血清DA水平均低于对照组,差异有统计学意义(P<0.05)。治疗期间,观察组不良反应发生率为16.07%,对照组为14.29%,两组比较,差异无统计学意义(P>0.05)。结论养心定悸胶囊治疗失眠伴焦虑、抑郁状态患者疗效显著,可有效降低中医证候积分,提高睡眠质量,改善焦虑、抑郁情绪及相关神经递质水平,值得临床进一步推广应用。
Objective To investigate the clinical efficacy of Yangxin Dingji Capsules in the treatment of insomnia patients with anxiety and depression,and to observe its effect on serum neurotransmitters.Methods T A total of 112 patients with insomnia combined with anxiety and depression who were admitted to Shijiazhuang Hospital of Traditional Chinese Medicine from April 2019 to June 2020 were selected and divided into an observation group and a control group according to the random number table method,with 56 cases in each group.The control group was treated with Estazolam Tablets,and the observation group was treated with Yangxin Dingji Capsules on the basis of the control group.After continuous treatment for 12 weeks,the clinical efficacy,TCM syndrome score,sleep quality[Pittsburgh sleep quality index(PSQI)score]and anxiety[Hamilton Anxiety Scale(Hamilton Anxiety)]were observed and compared between the two groups of patients.Scale,HAMA),depression[Hamilton depression scale(HAMD)]score,serum neurotransmitter levels[serum serotonin(5-hydroxytryptamine,5-HT),dopamine(Dopamine,DA),brain source Neurotrophic factor(Brain-derived neurotrophic factor,BDNF),glial cell-derived neurotrophic factor(Glialcellline-derived neurotrophic factor,GDNF)]and adverse reactions during the treatment period are recorded and compared.Results After treatment,the total effective rate of the observation group was 89.29%(50/56),which was higher than that of the control group,69.64%(39/56),and the difference was statistically significant(P<0.05).After treatment,the syndrome scores of palpitations,insomnia,dizziness,lack of breath,lazy speech,mental fatigue,dry skin and limb numbness in the two groups were lower than those before treatment,and the difference was statistically significant(P<0.05);and the observation group The scores of various TCM syndromes were lower than those of the control group,and the difference was statistically significant(P<0.05).The PSQI,HAMA and HAMD scores of the two groups of patients after treatment were lower than those before treatment,and the difference was statistically significant(P<0.05).The serum levels of 5-HT,BDNF and GDNF in the two groups after treatment were higher than those before treatment,and the serum DA levels were lower than those before treatment,and the differences were statistically significant(P<0.05).The level of GDNF was higher than that of the control group,and the level of serum DA was lower than that of the control group,and the difference was statistically significant(P<0.05).During the treatment,the incidence of adverse reactions in the observation group was 16.07%,and that in the control group was 14.29%,and there was no significant difference between the two groups(P>0.05).Conclusion Yangxin Dingji Capsule is effective in treating patients with insomnia and anxiety and depression.It can effectively reduce TCM syndrome scores,improve sleep quality,and improve anxiety,depression and related neurotransmitters levels,which is worthy of further clinical application.
作者
赵扬
王彩娟
ZHAO Yang;WANG Cai-juan(Shijiazhuang Hospital of Traditional Chinese Medicine,Shijiazhuang Hebei 050051)
出处
《世界中西医结合杂志》
2022年第2期341-345,共5页
World Journal of Integrated Traditional and Western Medicine
基金
河北省中医药管理局科研计划项目(2020351)。
关键词
失眠
焦虑
抑郁
养心定悸胶囊
神经递质
Insomnia
Anxiety
Depression
Yangxin Dingji Capsule
Neurotransmitters
