抑郁性失眠症中医药疗法探析.doc

抑郁性失眠症中医药疗法探析 　 作者：杨曙民 龚晓会 回丽娟 【摘要】 　　目的 探讨中医药治疗抑郁性失眠症的疗效。方法将确诊为抑郁性失眠的 52 名女性患者随机分为治疗组和对照组，两组均服用刺五加和谷维素，治疗组同时加服四物汤合归脾汤加减。两组患者均符合心脾两虚，肝肾不足之症。结果治疗两周时，治疗组失眠及躯体症状明显好转率高于对照组（χ2=19.76，P＜0.01）；8周后，治疗组和对照组的治愈率分别为76.9%和23.1%，总有效率前者为92.3%，后者为42.3%。治疗组治愈率高于对照组（χ2=17.68，P＜0.01）；总有效率高于对照组（χ2=14.56，P＜0.01）。结论四物汤合归脾汤治疗抑郁性失眠（心脾两虚，肝肾不足之症）效果好，起效快，治愈率高，副作用小。 【关键词】 抑郁性失眠症； 四物汤； 归脾汤 　　Abstract：ObjectiveTo discuss the Chinese medical therapeutics on depression insomnia.Methods52 patients who were dignosed as depression insomnia were devided into two groups randomly, treatment group and control group.The two groups both took Radix abanthopanacissenticosi and oryzanli, at the same time,the treatment group took Chinese medicine Siwu Decoction and Guipi Decoction.The two groups both comform to the disease of weakness in heart and spleen as well as liver and kidney.ResultsAfter treatment for two weeks,the obvious recovering rate of insomnia and body symptom in treatment group was higher than that of control group (χ2=19.76 P＜0.01); After eight weeks, the curing rate of the treatment group was 76.9% and the control group was 23.1%.The total efficiency rate of the former team was 92.3% and the latter was 42.3%.The curing rate (χ2=17.68,p＜0.01) and the total efficiency rate(χ2=14.56,p＜0.01) of the treatment group were higher than that of the control group.ConclusionSiwu Decocion and Guipi Decoction have good effect on depressing insomnia (weakness in heart and spleen as well as liver and kidney). 　　Key words：Depression; Insomnia; Siwu Decoction; Guipi Decoction 失眠是由于各种原因引起的睡眠不足，一般包括睡眠时间、深度及体力的不足。可以有入睡困难，频频醒来以及早醒等形式。国外的大多数流行病学调查结果显示，每年大约 33% 的人出现过睡眠障碍；有 17% 的人为严重失眠。失眠在发达国家的发病率大约为 20% ，发展中国家大约在10%以上［1］。失眠在普通精神科门诊中占很大比例。失眠是作为一个症状通常不会引起医生的注意，病人也不会向医生述说导致失眠的原因。药物的滥用和依赖性给病人和家人造成极大的负担和伤害。抑郁导致的失眠即使是一些较大的综合性医院也往往容易被漏诊，从而延误及时的治疗。由于人们对失眠的识别诊断率很低，大约只有1/5 ～1/4 病人得到正确诊断，仅有 1/4～1/3 的病人得到有效的抗抑郁治疗［2］。因此，抑郁性失眠的及时诊断和治疗极为重要。笔者在2004-03～2006-04运用中西药结合疗法治疗抑郁性失眠患者 26 例，取得较为满意的临床疗效。现将有关资料报道如下。 　　1 对象与方法 　　1.1 对象 　　选自2