黄连阿胶汤辨证加减对阴虚火旺型老年卒中后失眠患者总体睡眠状态及失眠药物剂量的影响

摘要

目的 探讨黄连阿胶汤辨证加减对阴虚火旺型老年卒中后失眠患者总体睡眠状态及失眠药物剂量的影响.方法 回顾性分析2010年3月—2015年10月北京中医医院顺义医院收治的100例阴虚火旺型老年卒中后失眠患者的临床资料,采用随机数表法分为观察组和对照组,各50例,对照组给予艾司唑仑等常规西药治疗,观察组在此基础上给予黄连阿胶汤,2组均治疗1个月,对比其治疗有效率及失眠药剂量,应用匹茨堡睡眠质量指数量表(PSQI)、失眠严重程度指数(ISI)评价其睡眠状态,同时采用汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评价2组情绪改善情况,并观察不良反应.结果 观察组治疗有效率明显高于对照组(P<0.05);与对照组相比,治疗后的观察组PSQI、ISI、HAMA、HAMD评分均降低,差异有统计学意义.与治疗前相比,观察组与对照组在治疗后PSQI、ISI、HAMA、HAMD评分均降低,差异具有统计学意义,但观察组PSQI、ISI、HAMA、HAMD评分下降更明显.观察组不良反应发生率与对照组比较差异无统计学意义(χ2=0.544,P>0.05).结论 黄连阿胶汤辨证加减可有效改善老年卒中后失眠患者总体睡眠状态,降低其失眠药用药剂量,且不会增加西药不良反应,值得在临床推广应用.%Objective To investigate the effect of modified Huanglian Ejiao decoction on sleep quality and dose of insomnia medicine in elderly patients of insomnia after fire excess from yin deficiency type stroke.Methods The clinical data of 100 elderly patients with insomnia after fire excess from yin deficiency type stroke who were admitted to our hospital between March 2010 and October 2015 was retrospectively analyzed. The subjects were equally divided into the observation group and the control group by the random number table method. The control group was treated with estazolam and routine western medicine while the observation group was additionally treated with Huanglian Ejiao decoction. Both groups were treated for 1 month, and the effective rate of treatment and dose of insomnia medicine were compared. Sleep quality of these patients was evaluated by Pittsburgh sleep quality index (PSQI) and insomnia severity index (ISI), while emotion was evaluated by the hamilton anxiety scale (HAMA) and hamilton depression scale (HAMD). Adverse reactions were observed.Results The effective rate of treatment in the observation group was significantly higher than that in the control group (P<0.05). Compared with the control group, PSQI, ISI, HAMA and HAMD scores were significantly lower in the observation group after treatment. PSQI, ISI, HAMA and HAMD scores were decreased in the two groups after treatment, especially in the observation group. There was no significant difference in the incidence of adverse reactions between the two groups (χ2=0.544,P>0.05).Conclusion Modified huanglian ejiao decoction can effectively improve the sleep quality of elderly patients after stroke, reduce the dose of insomnia medicine, without increasing the adverse reactions of western medicine. It is worthy of clinical application.