李静 潘美均 黄惠琼 陈晓东 王丽

【摘 要】   目的： 观察补中益气安神汤对心脾气虚型失眠患者的疗效。 方法： 共选取惠州市中医医院共90例患者，随机分为治疗组和对照组各45例。对照组采用基础治疗;治疗组使用补中益气汤结合经验药对“夜交藤、合欢皮”与“酸枣仁、茯神”。治疗前后分别以中医症候积分、匹兹堡睡眠质量指数（PSQI）、生活质量量表（SF-36）进行评价。 结果： ①两组临床疗效、中医症候积分评定方面，治疗组总有效率高于对照组，症候积分较对照组低，差异有统计学意义（P<0.05）;②治疗后，两组PSQI部分因子及总分较治疗前明显降低（P<0.05）;③生活质量评价方面，两组治疗前后比较，SF、RE、GH3个维度差异具有统计学意义（P<0.05）。 结论： 补中益气汤安神汤能够有效改善睡眠质量，提高生活质量，治疗效果显著，值得在临床上推广应用。

【关键词】  补中益气汤;失眠;不寐;心脾气虚

【中图分类号】R256.23   【文献标志码】 A    【文章编号】1007-8517（2020）11-0095-05

Clinical Observation of modified Buzhongyiqi Anshen Tang on Insomnia Belonging to Type of Heart and Spleen Qi Deficiency

LI Jing1 PAN Meijun2 HUANG Huiqiong1 CHEN Xiaodong1 WANG Li1

1.Huizhou traditional Chinese Medicine Hospital，Huizhou 516000，China;

2.Guangzhou University of traditional Chinese Medicine，Guangzhou 510405，China

Abstract： Objective To observe the effects of modified Buzhongyiqi Anshen Tang on clinical syndromes in insomnia.Methods A total of 90 patients from the Huizhou hospital of traditional Chinese medicine were randomly divided into the treatment group and the control group，45 cases in each group. The control group was treated with basic treatment， while the treatment group was treated with modified Buzhongyiqi Tang with Chinese medicine “Caulis Polygoni Multiflori， Cortex Albizziae” and “Semen Zizyphi Spinosae，Fushen”. Before and after treatment， TCM syndrome score， Pittsburgh sleep quality index （PSQI） and quality of life scale （SF-36） were used for evaluation. Results ①In terms of clinical efficacy evaluation and TCM syndrome scores between the two groups， the total effective rate of the treatment group was higher than that of the control group （P=0.05）， and the syndrome scores was lower than that of the control group （P<0.05）. ②After the treatment， the total scores of PSQI in the two groups were significantly decreased compared with that before treatment.（P< 0.05）. （3） In terms of life quality evaluation， 3 factor scores of SF-36 had statistical significance， which were SF， RE， GH （P<0.05）. Conclusion Modified Buzhongyiqi Anshen Tangcan effectively improve the quality of sleep and life， which is worthy of clinical application.

Key words： Buzhongyiqi Tang; Insomnia; Heart and Spleen Qi Deficiency

失眠是常見的睡眠障碍，现代医学认为失眠是个体对睡眠时间和（或）睡眠质量不满意并严重影响日间社会功能的一种不良主观感受[1]。随着现代社会中生活方式及生活习惯的改变，失眠的发病率呈上升趋势[2]。中国睡眠研究会调查结果显示，我国成年人中失眠发生率高达38.2%[3]。目前失眠的临床治疗仍以苯二氮卓类、褪黑素等药物为主，起效快、疗效显著，但会产生依赖性、成瘾性[4]。近年来，中医学在失眠的诊疗中逐渐突出其优势，因其疗效显著、药物副作用小，临床应用的潜力巨大[5]。补中益气安神汤为广东省名中医王丽主任多年临床经验总结，由补中益气汤结合经验药对“夜交藤、合欢皮”与“酸枣仁、茯神”组成。补中益气汤出自李东垣《脾胃论》，具有补中益气、升阳举陷之功效，符合心脾气虚型失眠的病机，夜交藤—合欢皮、酸枣仁—茯神为王丽主任治疗失眠的常用经验药对。……