黄连阿胶汤治疗脑卒中后失眠疗效观察OA
Efficacy Observation of Coptis and Donkey-Hide Gelatin Decoction in the Treatment of Post-Stroke Insomnia
目的:观察黄连阿胶汤治疗脑卒中后失眠(post-stroke insomnia,PSI)的临床疗效及其对患者 γ-氨基丁酸(gamma-aminobutyric acid,GABA)、5-羟色胺(5-hydroxytryptamine,5-HT)水平、谷氨酸(glutamic acid,Glu)/GABA 比值的影响.方法:将120 例 PSI 患者按照随机数字表法分为治疗组和对照组,每组各60 例.对照组给予常规西医治疗,治疗组在对照组治疗的基础上给予黄连阿胶汤.比较两组患者的临床疗效、不良反应发生率及治疗前后睡眠质量[匹兹堡睡眠质量指数(Pitts-burgh sleep quality index,PSQI)、失眠严重程度指数(insomnia severity index,ISI)]、多导睡眠图相关指标[快速眼动(rapid eye movement,REM)睡眠潜伏期、睡眠潜伏期(sleep latency,SL)、入睡后觉醒时间(wake after sleep onset,WASO)]、神经递质水平(GABA、5-HT、Glu/GABA)变化情况.结果:对照组有效率为78.33％,治疗组有效率为93.33％,两组患者有效率比较,差异具有统计学意义(P<0.05).两组患者治疗后 PSQI 和 ISI 评分低于本组治疗前,且治疗后治疗组低于对照组,差异具有统计学意义(P<0.05).两组患者治疗后 REM 睡眠潜伏期高于本组治疗前,SL、WASO 低于本组治疗前,且治疗后组间比较,差异具有统计学意义(P<0.05).两组患者治疗后 GABA、5-HT 水平高于本组治疗前,Glu/GABA 比值低于本组治疗前,且治疗后组间比较,差异具有统计学意义(P<0.05).两组患者不良反应发生率比较,差异无统计学意义(P>0.05).结论:黄连阿胶汤治疗 PSI,可改善患者的睡眠质量,优化客观睡眠结构,其作用机制可能与调节 GABA、5-HT 及 Glu/GABA 等神经递质表达有关.
Objective:To observe the clinical efficacy of Coptis and Donkey-Hide Gelatin Decoction in the treatment of post-stroke insom-nia(PSI)and its effects on gamma-aminobutyric acid(GABA),5-hydroxytryptamine(5-HT),and the glutamic acid(Glu)/GABA ra-tio in patients.Methods:A total of 120 PSI patients were randomly divided into the treatment group and the control group using the ran-dom number table method,with 60 cases in each group.The control group received conventional Western medicine,while the treatment group received Coptis and Donkey-Hide Gelatin Decoction in addition to the conventional Western medicine.Then clinical efficacy,inci-dence of adverse reactions,and changes in sleep quality[Pittsburgh sleep quality index(PSQI)score,insomnia severity index(ISI)score],polysomnography parameters[rapid eye movement percentage(REM％),non-rapid eye movement stage 3 percentage(N3％),wake after sleep onset(WASO)],and neurotransmitter levels(GABA,5-HT,Glu/GABA ratio)before and after treatment were com-pared between the two groups.Results:The effective rate was 78.33％in the control group and 93.33％in the treatment group,with a statistically significant difference between the two groups(P<0.05).After treatment,PSQI and ISI scores in both groups were lower than those before treatment,and the scores in the treatment group were lower than those in the control group,with statistically significant differences(P<0.05).REM％and N3％increased,while WASO decreased in both groups compared with baseline,with statistically significant differences between the two groups(P<0.05).GABA and 5-HT levels increased,and the Glu/GABA ratio decreased in both groups compared with baseline,with statistically significant differences between the two groups(P<0.05).However,no significant difference was observed in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Coptis and Donkey-Hide Gelatin Decoction can improve sleep quality and optimize objective sleep architecture in patients with PSI.Its mechanism may be associ-ated with the regulation of neurotransmitters such as GABA,5-HT,and the Glu/GABA ratio.
卢雁冰;朱梦婷;董文征
周口市中心医院,河南 周口 466000周口市中心医院,河南 周口 466000周口市中心医院,河南 周口 466000
医药卫生
脑卒中后失眠黄连阿胶汤艾司唑仑片中西医结合疗法《伤寒论》张仲景
post-stroke insomnia(PSI)Coptis and Donkey-Hide Gelatin DecoctionEstazolam Tabletsintegrated traditional Chinese and Western medicine therapyTreatise on Cold Damage DiseasesZhang Zhongjing
《河南中医》 2026 (8)
1163-1168,6
河南省医学科技攻关计划项目(LHGJ20240998)
评论