基于"肝心同治"理论探讨高兴汤加减治疗肝郁化火型失眠疗效及对患者执行能力的影响OA

Objective It is to observe the effects of modified Gaoxing decoction on sleep quality,levels of dopamine(DA)and serotonin(5-HT)and executive function of patients with insomnia with syndrome of liver depression transfor-ming into fire.Methods A total of 124 patients with insomnia with syndrome of liver depression transforming into fire were enrolled from September 2023 to August 2024.These patients were treated at the Endocrinology(Geriatrics)Department outpatient clinic and inpatient ward of the Third Affiliated Hospital of Heilongjiang University of Chinese Medicine,as well as at the Nationally Renowned Senior TCM Expert JIANG Deyou Inheritance Studio.The patients were randomly assigned to two groups by a random number table:finally 56 cases in the treatment group and 60 cases in the control group completed the study.The treatment group was treated with modified Gaoxing Decoction,while the control group was treated with es-tazolam tablet,both groups were treated for 4 weeks.The following parameters were observed and compared between the two groups:traditional Chinese medicine syndrome scores,Pittsburgh Sleep Quality Index(PSQI)scores,Fatigue Scale-14(FS-14)scores,Hamilton Depression Rating Scale(HAMD)scores,Hamilton Anxiety Rating Scale(HAMA)scores,Short Form Health Survey(SF-36)scores,serum levels of DA and 5-HT,and indicators of Stroop Color-Word Test(SC-WT).Results Compared with before treatment,the traditional Chinese medicine syndrome scores,PSQI scores,FS-14 scores,HAMD scores,HAMA scores,and the time-consumes of card B,card C,and Stroop interference effect(SIE)in SCWT of patients in the treatment group were significantly decreased(all P<0.05),while the SF-36 scores and serum levels of DA and 5-HT were significantly increased(all P<0.05),the correct responses for card A,card B,and card C were significantly increased(all P<0.05),while the correct responses for SIE were significantly decreased(all P<0.05);the traditional Chinese medicine syndrome scores,PSQI scores,HAMD scores,HAMA scores of patients in the control group were significantly decreased(all P<0.05),while the SF-36 scores and serum levels of DA and 5-HT,the time-consumes of card C and SIE,the correct responses for card A,card B and SIE were significantly increased(all P<0.05).After treatment,the traditional Chinese medicine syndrome scores,FS-14 scores,HAMD scores,HAMA scores,and the time-consumes of card B,card C and SIE in SCWT of patients in the treatment group were significantly lower,the SF-36 scores and serum levels of DA and 5-HT were significantly higher,the correct responses for card A and card C were significantly more,while the correct responses for SIE were significantly less than those in the control group(all P<0.05).Conclusion Modified Gaoxing Decoction can significantly alleviate symptoms,improve sleep quality,executive function,and quality of life,and regulate emotions of patients with insomnia with syndrome of liver depression transforming into fire.The mechanism may be related to targeting the GABAergic system and increasing levels of DA and 5-HT.