黄连温胆汤辅以脑电仿生电刺激仪治疗卒中后痰热扰心型睡眠障碍疗效观察
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摘要
目的探讨黄连温胆汤辅以脑电仿生电刺激仪治疗脑卒中后痰热扰心型睡眠障碍的临床疗效。方法将符合纳入与排除标准的90例脑卒中后痰热扰心型睡眠障碍患者随机分为中药组、脑电仿生电刺激组和联合组各30例,中药组予以黄连温胆汤口服,脑电仿生电刺激组将电极放置在患者双侧乳突穴进行脑电仿生电刺激治疗,联合组予以黄连温胆汤联合脑电仿生电刺激治疗,3组均治疗30 d。观察3组治疗前后中医证候积分、匹兹堡睡眠质量指数(PSQI)变化情况,统计3组中医证候疗效、睡眠障碍疗效和不良反应发生情况。结果 3组患者治疗30 d后中医证候各项积分和总分、PSQI积分和总分均较治疗前明显降低(P均<0.05);联合组中医证候中睡眠不安、胸闷脘痞、口苦痰多、头晕目眩、舌红、苔黄腻积分及总分和PSQI各单项积分及总分均明显低于脑电仿生电刺激组(P均<0.05),中医证候各项积分和总分与中药组比较差异均无统计学意义(P均>0.05),但PSQI中睡眠质量、睡眠障碍、日间功能障碍积分和总分均明显低于中药组(P均<0.05);中药组中医证候中睡眠不安、胸闷脘痞、口苦痰多、头晕目眩、舌红、苔黄腻积分及总分和PSQI中入睡时间、睡眠时间、睡眠效率、睡眠障碍、日间功能障碍积分及总分均明显低于脑电仿生电刺激组(P均<0.05)。联合组中医证候总有效率和睡眠障碍总有效率均明显高于脑电仿生电刺激组(P均<0.05),但中药组和脑电仿生电刺激组、联合组比较差异均无统计学意义(P均>0.05)。3组均无明显不良反应发生。结论黄连温胆汤联合脑电仿生电刺激仪治疗卒中后痰热扰心型睡眠障碍疗效明显优于单纯黄连温胆汤治疗和单纯脑电仿生电刺激仪治疗,且无明显不良反应。
Objective It is to investigate the clinical efficacy of Huanglian Wendan Decoction combined with electroencephalogram biomimetic stimulator on post-stroke sleep disorder of pattern of phlegm-heat harassing the heart. Methods Ninety patients with sleep disorder of pattern of phlegm-heat harassing the heart who met the inclusion and exclusion criteria were randomly divided into the Chinese medicine group, the electroencephalogram biomimetic stimulation group(ECG group) and the combined group, 30 cases in each group. The Chinese medicine group was given Huanglian Wendan Decoction orally. The ECG group was treated with electroencephalogram biomimetic stimulator by placing the electrodes in the bilateral mastoid points of the patients. The combined group was treated with Huanglian Wendan Decoction combined with EEG biomimetic stimulation. All the three groups were treated for 30 days. The changes of TCM syndrome scores and Pittsburgh Sleep Quality Index(PSQI) before and after treatment were observed. The efficacy of TCM syndromes, sleep disorders and adverse reactions were assessed. Results After 30 days of treatment, the scores of every item and total scores of TCM syndrome, PSQI scores and total scores were significantly lower than those before treatment in the two groups(P<0.05), the scores of TCM syndromes like restless sleep, chest tightness, bitter taste and excessive sputum, dizziness, red tongue, yellow greasy and total score, scores of every item and total scores of PSQI were significantly lower in the combined group than those in the EEG group(P<0.05). There was no significant difference in the scores of every item and total scores of TCM syndrome between the Chinese medicine group and combined group(P>0.05), but the scores of sleep quality, sleep disturbance, daytime dysfunction score and total score in PSQI were significantly lower in the combined group than those in the traditional Chinese medicine group(P<0.05). The scores of sleeplessness, chest tightness, bitterness, dizziness, redness, yellow greasy and total score and the scores of sleep time, sleep efficiency, sleep disturbance, daytime dysfunction and total scores in PSQI were significantly lower in the Chinese medicine group than those of the EEG group(P<0.05). The total effective rate of TCM syndrome and the total effective rate of sleep disorders in the combined group were significantly higher than those in the ECG group(P<0.05), but there was no statistical difference between the Chinese medicine group and the EEG group and the combined group(P>0.05). No significant adverse reactions occurred in the 3 groups. Conclusion Huanglian Wendan Decoction combined with EEG biomimetic stimulator is better than Huanglian Wendan Decoction or EEG biomimetic stimulator used alone in the treatment of post-stroke sleep disorder of pattern of phlegm-heat harassing the heart, and there is no obvious adverse reaction.
Objective It is to investigate the clinical efficacy of Huanglian Wendan Decoction combined with electroencephalogram biomimetic stimulator on post-stroke sleep disorder of pattern of phlegm-heat harassing the heart. Methods Ninety patients with sleep disorder of pattern of phlegm-heat harassing the heart who met the inclusion and exclusion criteria were randomly divided into the Chinese medicine group, the electroencephalogram biomimetic stimulation group(ECG group) and the combined group, 30 cases in each group. The Chinese medicine group was given Huanglian Wendan Decoction orally. The ECG group was treated with electroencephalogram biomimetic stimulator by placing the electrodes in the bilateral mastoid points of the patients. The combined group was treated with Huanglian Wendan Decoction combined with EEG biomimetic stimulation. All the three groups were treated for 30 days. The changes of TCM syndrome scores and Pittsburgh Sleep Quality Index(PSQI) before and after treatment were observed. The efficacy of TCM syndromes, sleep disorders and adverse reactions were assessed. Results After 30 days of treatment, the scores of every item and total scores of TCM syndrome, PSQI scores and total scores were significantly lower than those before treatment in the two groups(P<0.05), the scores of TCM syndromes like restless sleep, chest tightness, bitter taste and excessive sputum, dizziness, red tongue, yellow greasy and total score, scores of every item and total scores of PSQI were significantly lower in the combined group than those in the EEG group(P<0.05). There was no significant difference in the scores of every item and total scores of TCM syndrome between the Chinese medicine group and combined group(P>0.05), but the scores of sleep quality, sleep disturbance, daytime dysfunction score and total score in PSQI were significantly lower in the combined group than those in the traditional Chinese medicine group(P<0.05). The scores of sleeplessness, chest tightness, bitterness, dizziness, redness, yellow greasy and total score and the scores of sleep time, sleep efficiency, sleep disturbance, daytime dysfunction and total scores in PSQI were significantly lower in the Chinese medicine group than those of the EEG group(P<0.05). The total effective rate of TCM syndrome and the total effective rate of sleep disorders in the combined group were significantly higher than those in the ECG group(P<0.05), but there was no statistical difference between the Chinese medicine group and the EEG group and the combined group(P>0.05). No significant adverse reactions occurred in the 3 groups. Conclusion Huanglian Wendan Decoction combined with EEG biomimetic stimulator is better than Huanglian Wendan Decoction or EEG biomimetic stimulator used alone in the treatment of post-stroke sleep disorder of pattern of phlegm-heat harassing the heart, and there is no obvious adverse reaction.
引文
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[13] 陈小芳,毕宏烨,张美云,等.急性脑梗死患者的睡眠障碍研究[J].中国神经免疫学和神经病学杂志,2015,22(6):416-417
[14] 严钢莉,刘登华,李朝武,等.阿尔兹海默病患者睡眠脑电图分析[J].神经损伤与功能重建,2015,10(3):210-212
[15] 邓小鹏,周丽芳,郭伟,等.脑电生物反馈辅助治疗老年失眠症的疗效观察[J].精神医学杂志,2014,27(2):110-112
[16] 杨云霜,张蓉,张箫月,等.从心论治失眠的中医理论探析[J].中国医药,2015,10(6):917-919
[17] 周珏,许良.不寐病五脏论治研究进展[J].世界睡眠医学杂志,2018,5(1):109-110
[18] 王一斯,王莹,赵红.卒中后睡眠障碍的中医诊疗新进展[J].河北中医,2016,38(8):1271-1276
[19] 黄湲,朱广旗.温胆汤治疗不寐症的理论探讨[J].陕西中医,2017,38(2):246-247
[20] 叶守姣,常柏.黄连温胆汤加减与舒乐安定治疗失眠的临床观察[J].天津中医药大学学报,2015,34(4):211-214
[21] 姜浩,刘巧巧,余仁欢.黄连温胆汤现代研究进展[J].北京中医药,2014,33(4):314-316
[2] 王智敏,李亚函,李和军,等.脑卒中与睡眠障碍的相关性分析[J].临床合理用药杂志,2014,7(13):105-106
[3] 陈东,王文安.急性脑卒中患者睡眠障碍的异质性研究[J].卒中与神经疾病,2014,21(5):286-288;293
[4] 陆峥.失眠症的诊断和药物治疗现状[J].世界临床药物,2011,32(4):193-199
[5] Machado AG,Baker KB,Schuster D,et al.Chronic electrical stimmulition of the contrahsional lateral cerebellar nucleus enhances recover of motor function after cerebral ischemia in rats[J].Brain Res,2009,1280(16):107-116
[6] 沈惠强.脑循环功能治疗仪的作用机理及临床效果[J].生物医学工程学进展,2009,30(4):245-246
[7] 高井亮,章显宝,梁发俊,等.中西医治疗卒中后睡眠障碍的研究进展[J].中华针灸电子杂志,2015,4(5):230-231
[8] 饶明俐.中国脑血管病防治指南[S].北京:人民卫生出版社,2007:28-46
[9] 中华医学会精神科分会.中国精神障碍分类与诊断标准(CCMD-3)[M].济南:山东科学技术出版社,2001:118-119
[10] 周仲英.中医内科学[M].北京:中国中医药出版社,2003:157
[11] 国家中医药管理局.中医病证诊断疗效标准[S].北京:中国医药科技出版社,2012:31
[12] 路桃影,李艳,夏萍,等.匹兹堡睡眠质量指数的信度及效度分析[J].重庆医学,2014,43(3):260-263
[13] 陈小芳,毕宏烨,张美云,等.急性脑梗死患者的睡眠障碍研究[J].中国神经免疫学和神经病学杂志,2015,22(6):416-417
[14] 严钢莉,刘登华,李朝武,等.阿尔兹海默病患者睡眠脑电图分析[J].神经损伤与功能重建,2015,10(3):210-212
[15] 邓小鹏,周丽芳,郭伟,等.脑电生物反馈辅助治疗老年失眠症的疗效观察[J].精神医学杂志,2014,27(2):110-112
[16] 杨云霜,张蓉,张箫月,等.从心论治失眠的中医理论探析[J].中国医药,2015,10(6):917-919
[17] 周珏,许良.不寐病五脏论治研究进展[J].世界睡眠医学杂志,2018,5(1):109-110
[18] 王一斯,王莹,赵红.卒中后睡眠障碍的中医诊疗新进展[J].河北中医,2016,38(8):1271-1276
[19] 黄湲,朱广旗.温胆汤治疗不寐症的理论探讨[J].陕西中医,2017,38(2):246-247
[20] 叶守姣,常柏.黄连温胆汤加减与舒乐安定治疗失眠的临床观察[J].天津中医药大学学报,2015,34(4):211-214
[21] 姜浩,刘巧巧,余仁欢.黄连温胆汤现代研究进展[J].北京中医药,2014,33(4):314-316
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