滋肾安神汤合复方枣仁胶囊治疗心肾不交型失眠临床的研究.docVIP

滋肾安神汤合复方枣仁胶囊治疗心肾不交型失眠临床的研究 　　摘要：目的 观察滋肾安神汤合复方枣仁胶囊交替使用治疗心肾不交型失眠患者的疗效及其对睡眠质量指数的影响。方法 将70例心肾不交型失眠患者随机分为治疗组和对照组。治疗组在常规按需服用镇静催眠药基础上加用滋肾安神汤（下午及晚饭后）与复方枣仁胶囊（睡前），对照组常规按需服用艾司唑仑片，连续治疗14 d。比较2组治疗前后匹茨堡睡眠质量指数量表（PSQI）评分及艾司唑仑用量。结果 治疗组的日间功能障碍、催眠药物评分下降差值均比对照组明显，艾司唑仑用量减少，差异有统计学意义（P0.05）。结论 滋肾安神汤合复方枣仁胶囊交替使用治疗失眠可以改善患者日间功能，效果优于艾司唑仑片，并可减少苯二氮卓类药物用量。 　　关键词：滋肾安神汤；复方枣仁胶囊；失眠；心肾不交 　　DOI：10.3969/j.issn.1005-5304.2014.06.008 　　中图分类号：R256.23 文献标识码：A 文章编号：1005-5304（2014）06-0021-03 　　Abstract：Objective To observe the efficacy of Zishen Anshen Decoction combined with Compound Zaoren （Ziziphi Spinosae Semen） Capsule on insomnia patients with disharmony between heart-yang and kidney-yin syndrome and its effect on sleep quality index. Methods Seventy insomnia patients were randomly divided into treatment group and control group. Both groups conventionally took estazolam as needed， the treatment group was additionally given Zishen Anshen Decoction （in the afternoon and after dinner） and Compound Zaoren Capsule （before sleep at night） for 14 d. The Pittsburgh sleep quality index （PSQI） score and dosage of estazolam were used as evaluation indexes for the comparison between the two groups. Results PSQI score of daytime function disorder and hypnotics dosage of the treatment group was significantly lower than that of the control group， and the dosages of estazolam were reduced （P0.05）. Conclusion The alternative application of Zishen Anshen Decoction and Compound Zaoren Capsule on insomnia treatment can not only improve daytime function， but also reduce the dosage of benzodiazepine， with better effect than estazolam. 　　Key words：Zishen Anshen Decoction；Compound Zaoren Capsule；insomnia；disharmony between heart-yang and kidney-yin 　　失眠是一种常见的临床症状，严重影响人们的生活、工作和身心健康[1]。苯二氮卓类镇静催眠药不良反应大且容易耐药。新型抗失眠药物的研究方向为不改变夜间睡眠结构和日间正常学习工作[2]。中药治疗失眠，无明显依赖、耐受及日久困倦等不良反应，故研究中医药治疗失眠的疗效及机制具有重要意义。 　　中医学认为失眠与肾阴盛衰有关，肾阴虚是失眠发生的重要病机之一。失眠是由阳不入阴所致，脏腑辨证的关键在于心肾。《内经》对人体阴阳变化与天地自然的阴阳变化进行了详细论证，指出人与阴阳天地相应，昼醒而夜寐，在某些病理情况下，阴阳不能顺利转变，阳不入阴或人体不能适应自