夏氏睡眠1号治疗虚证型抑郁性睡眠障碍的效果
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摘要
目的探讨夏氏睡眠1号治疗虚证型抑郁性睡眠障碍的临床效果及对患者5-羟色胺(5-HT)、去甲肾上腺素(NE)水平的影响。方法将丽水市第二人民医院2016年12月—2017年12月收治的120例经中医辨证为虚证型抑郁性睡眠障碍患者采用随机数字法分为2组,每组60例。对照组给予盐酸氟西汀胶囊治疗,观察组在对照组的基础上加用夏氏睡眠1号治疗。治疗后,比较2组患者汉密尔顿抑郁量表(HAMD)评分、阿森斯失眠量表(AIS)评分、血清5-HT、血清NE水平的变化及不良反应(头晕头痛、恶心、食欲减退、口干、便秘、失眠)发生情况与临床疗效。结果观察组总有效率(88. 33%)大于对照组(68. 33%,P <0. 05)。治疗后,2组HAMD、AIS评分均明显降低(均P <0. 05),且观察组显著低于对照组(均P <0. 05)。治疗后,2组血清5-HT、NE水平均显著升高(均P <0. 05),且观察组明显高于对照组(均P <0. 05)。观察组不良反应发生率为18. 33%,对照组不良反应发生率为41. 67%,差异有统计学意义(P <0. 05)。结论夏氏睡眠1号治疗虚证型抑郁性睡眠障碍临床疗效显著,可有效缓解患者失眠症状,不良反应少,其作用机制可能与夏氏睡眠1号能够上调患者血清5-HT及NE水平有关。
Objective To investigate the clinical effect of Xiashi Shuimian Yihao on depressive sleep disorder with deficiency syndrome and its effect on serotonin( 5-HT) and norepinephrine( NE). Methods A total of 120 patients with depressive sleep disorder diagnosed as deficient syndrome of TCM in our hospital from December 2016 to December 2017 were divided into two groups by random number method,with 60 cases in each group. The control group was treated with fluoxetine hydrochloride capsules,and the observation group was treated with Xiashi Shuimian Yihao based on the control group. After treatment,Hamilton Depression Scale( HAMD) score,Ascension Insomnia Scale( AIS) score,serum5-HT,serum NE level,adverse reactions( dizziness headache,nausea,loss of appetite,dry mouth),and effect of two groups were compared. Results Total effective rate of observation group( 88. 33%) was significantly higher than that of the control group( 68. 33%,P < 0. 05). After treatment,the HAMD and AIS scores of the two groups were significantly lower( all P < 0. 05),the HAMD and AIS scores of observation group was lower than control group( all P < 0. 05). After treatment,serum 5-HT and NE levels were significantly increased in the two groups( all P < 0. 05),and serum 5-HT and NE levels of observation group was significantly higher than the control group( all P < 0. 05). The adverse incidence of observation group( 18. 33%) was significantly lower than control group( 41. 67%,P < 0. 05). Conclusion Xiashi Shuimian Yihao could effectively treat depressive sleep disorder with deficiency syndrome,alleviate the symptoms of insomnia and reduce the adverse reactions. The mechanism may be related to its upregulation of serum serotonin and norepinephrine.
Objective To investigate the clinical effect of Xiashi Shuimian Yihao on depressive sleep disorder with deficiency syndrome and its effect on serotonin( 5-HT) and norepinephrine( NE). Methods A total of 120 patients with depressive sleep disorder diagnosed as deficient syndrome of TCM in our hospital from December 2016 to December 2017 were divided into two groups by random number method,with 60 cases in each group. The control group was treated with fluoxetine hydrochloride capsules,and the observation group was treated with Xiashi Shuimian Yihao based on the control group. After treatment,Hamilton Depression Scale( HAMD) score,Ascension Insomnia Scale( AIS) score,serum5-HT,serum NE level,adverse reactions( dizziness headache,nausea,loss of appetite,dry mouth),and effect of two groups were compared. Results Total effective rate of observation group( 88. 33%) was significantly higher than that of the control group( 68. 33%,P < 0. 05). After treatment,the HAMD and AIS scores of the two groups were significantly lower( all P < 0. 05),the HAMD and AIS scores of observation group was lower than control group( all P < 0. 05). After treatment,serum 5-HT and NE levels were significantly increased in the two groups( all P < 0. 05),and serum 5-HT and NE levels of observation group was significantly higher than the control group( all P < 0. 05). The adverse incidence of observation group( 18. 33%) was significantly lower than control group( 41. 67%,P < 0. 05). Conclusion Xiashi Shuimian Yihao could effectively treat depressive sleep disorder with deficiency syndrome,alleviate the symptoms of insomnia and reduce the adverse reactions. The mechanism may be related to its upregulation of serum serotonin and norepinephrine.
引文
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[9]伍远菲,丁国安,徐琰.针灸联合加味逍遥汤对抑郁症患者Hcy、5-HT、细胞因子及疗效影响分析[J].世界中医药,2016,11(11):2408-2410,2414.
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[11]陆峥.伴发睡眠障碍抑郁症的治疗[J].中华精神科杂志,2013,46(3):179.
[12]汪瑶,胡珂.胡珂运用小柴胡汤治疗失眠经验浅析[J].中医药通报,2018,17(3):15-16.
[13]余月华.甘麦大枣汤联合耳穴压豆对抑郁伴睡眠障碍患者症状量表评分及SF-36评分的影响[J].中医临床研究,2017,9(12):93-94.
[14]夏朝云,夏承义.夏氏夏氏睡眠1号治疗中学生考前失眠临床观察[J].中华中医药学刊,2014,32(7):1639-1641.
[15] STANER L,KEMPENAERS C,SIMONNET M P,et al. 5-HT2 receptor antagonism and slow-wave sleep in major depression[J]. Acta Psychiatr Scand,1992,86(2):133-137.
[16]张涛,赵芳,张潇,等.复方柴归方抗抑郁作用及其调控5-羟色胺代谢途径机制研究[J].中草药,2018,49(6):1338-1344.
[17]董介正,李秀荣,邱龄山,等.归脾汤联合氟西汀对抑郁模型大鼠行为学及海马区NE、5-HT及DA的影响研究[J].中药材,2017,40(2):457-461.
[18]刘茹,王化冰,张素芬,等.丁苯酞联合银杏叶胶囊治疗帕金森症伴抑郁、睡眠障碍患者的疗效评价[J].国际精神病学杂志,2018,45(3):522-524.
[19]程丽娟,周勇杰,房茂胜,等.睡眠障碍与重性抑郁障碍患者生活质量的相关性分析[J].国际精神病学杂志,2017,44(5):887-889.
[20]杨芳,金硕果,陈卫银,等.三甲复脉汤加减对PIGD型帕金森病抑郁和睡眠障碍的影响及其机制研究[J].辽宁中医杂志,2017,44(10):2131-2134.
[21]谢娜,张建春,王彩娟,等.疏肝解郁治则对围绝经期睡眠障碍(焦虑抑郁型)心理及BDNF影响[J].辽宁中医药大学学报,2017,19(10):135-138.
[22]余月华.甘麦大枣汤联合耳穴压豆对抑郁伴睡眠障碍患者症状量表评分及SF-36评分的影响[J].中医临床研究,2017,9(12):93-94.
[2] SHILYANSKY C,WILLIAMS L M,GYURAK A,et al. Effect of antidepressant treatment on cognitive impairments associated with depression:a randomised longitudinal study[J]. Lancet Psychiat,2016,3(5):425-435.
[3]钟巍,姚卫海.柴胡加龙骨牡蛎汤加减治疗肝郁型失眠疗效观察[J].北京中医药,2018,37(6):562-564.
[4]陈波,张集慧,鲁建瑞.经颅磁刺激治疗仪对抑郁症睡眠障碍的疗效评述[J].临床医药文献杂志,2016,3(12):2263,2266.
[5]顾翠,可秦,张平,等.米氮平联合西酞普兰治疗抑郁症患者睡眠障碍的临床观察[J].中国药房,2017,28(5):670-673.
[6] LIN C H,HUANG C J,CHEN C C. ECT has greater efficacy than fluoxetine in alleviating the burden of illness for patients with major depressive disorder:A taiwanese pooled analysis[J]. Int J Neuropsychopharmacol,2018,21(1):63-72.
[7]潘燕军,谢静涛.抑郁症患者睡眠障碍的中西医研究进展[J].湖南中医杂志,2016,32(9):180-182.
[8]夏朝云,夏承义,吴素琴,等.夏氏夏氏睡眠1号治疗抑郁性睡眠障碍50例[J].山东中医杂志,2013,32(2):89-90.
[9]伍远菲,丁国安,徐琰.针灸联合加味逍遥汤对抑郁症患者Hcy、5-HT、细胞因子及疗效影响分析[J].世界中医药,2016,11(11):2408-2410,2414.
[10] HAN Y,YUAN Y,ZHANG L,et al. Sleep disorder status of nurses in general hospitals and its influencing factors[J]. Psychiatr Danub,2016,28(2):176-183.
[11]陆峥.伴发睡眠障碍抑郁症的治疗[J].中华精神科杂志,2013,46(3):179.
[12]汪瑶,胡珂.胡珂运用小柴胡汤治疗失眠经验浅析[J].中医药通报,2018,17(3):15-16.
[13]余月华.甘麦大枣汤联合耳穴压豆对抑郁伴睡眠障碍患者症状量表评分及SF-36评分的影响[J].中医临床研究,2017,9(12):93-94.
[14]夏朝云,夏承义.夏氏夏氏睡眠1号治疗中学生考前失眠临床观察[J].中华中医药学刊,2014,32(7):1639-1641.
[15] STANER L,KEMPENAERS C,SIMONNET M P,et al. 5-HT2 receptor antagonism and slow-wave sleep in major depression[J]. Acta Psychiatr Scand,1992,86(2):133-137.
[16]张涛,赵芳,张潇,等.复方柴归方抗抑郁作用及其调控5-羟色胺代谢途径机制研究[J].中草药,2018,49(6):1338-1344.
[17]董介正,李秀荣,邱龄山,等.归脾汤联合氟西汀对抑郁模型大鼠行为学及海马区NE、5-HT及DA的影响研究[J].中药材,2017,40(2):457-461.
[18]刘茹,王化冰,张素芬,等.丁苯酞联合银杏叶胶囊治疗帕金森症伴抑郁、睡眠障碍患者的疗效评价[J].国际精神病学杂志,2018,45(3):522-524.
[19]程丽娟,周勇杰,房茂胜,等.睡眠障碍与重性抑郁障碍患者生活质量的相关性分析[J].国际精神病学杂志,2017,44(5):887-889.
[20]杨芳,金硕果,陈卫银,等.三甲复脉汤加减对PIGD型帕金森病抑郁和睡眠障碍的影响及其机制研究[J].辽宁中医杂志,2017,44(10):2131-2134.
[21]谢娜,张建春,王彩娟,等.疏肝解郁治则对围绝经期睡眠障碍(焦虑抑郁型)心理及BDNF影响[J].辽宁中医药大学学报,2017,19(10):135-138.
[22]余月华.甘麦大枣汤联合耳穴压豆对抑郁伴睡眠障碍患者症状量表评分及SF-36评分的影响[J].中医临床研究,2017,9(12):93-94.