孙涛 杨晓明 叶文倩

[摘要] 目的 探讨痰湿内阻证阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者应用化湿醒鼾汤的临床疗效，并分析其对呼吸暫停低通气指数（AHI）、匹兹堡睡眠质量指数（PSQI）评分及Epworth嗜睡量表（ESS）评分的影响。 方法 前瞻性选取2018年9月至2020年4月我院呼吸科收治的60例OSAHS患者作为研究对象，随机数字表法分成两组，各30例。对照组为常规治疗，观察组在常规治疗基础上加用化湿醒鼾汤。比较两组患者临床疗效，AHI、ODI及血清丙二醛（MDA）、神经元特异性烯醇化酶（NSE）水平及 PSQI评分、ESS评分。 结果 观察组治疗总有效率高达93.33%，显著高于对照组的73.33%，差异有统计学意义（P<0.05）。两组患者治疗12周后AHI、ODI及血清MDA、NSE水平均显著下降，差异有统计学意义（P<0.05），治疗12周后观察组患者AHI、ODI及血清MDA、NSE水平均显著低于对照组患者，差异有统计学意义（P<0.05）。两组患者PSQI评分、ESS评分均随时间延长而显著下降，差异有统计学意义（P<0.05），观察组患者治疗4、8及12周PSQI 评分、ESS评分均显著低于对照组患者，差异有统计学意义（P<0.05）。 结论 对痰湿内阻证OSAHS患者应用化湿醒鼾汤可显著降低AHI、PSQI评分、ESS评分，并提高临床治疗效果。

[关键词] OSAHS;化湿醒鼾汤;痰湿内阻证;AHI;PSQI评分;ESS评分

[中图分类号] R259          [文献标识码] B          [文章编号] 1673-9701（2021）32-0006-05

[Abstract] Objective To explore the clinical efficacy of Huashixinghan Decoction on patients with obstructive sleep apnea-hypopnea syndrome （OSAHS） with internal obstruction of phlegm-dampness， and to analyze its effects on apnea-hypopnea index （AHI）， Pittsburgh sleep quality index （PSQI） and Epworth sleepiness scale （ESS）. Methods A total of sixty OSAHS patients admitted to the respiratory department of our hospital from September 2018 to April 2020 were prospectively selected as the research objects. They were divided into two groups according to the random number table method， with 30 cases in each group. The control group was treated with conventional treatment， while the observation group was treated with Huashixinghan Decoction on the basis of conventional treatment. The clinical efficacy， AHI， ODI， serum malondialdehyde （MDA）， neuron-specific enolase （NSE） levels， PSQI score and ESS score were compared between the two groups. Results The total effective rate of the observation group was as high as 93.33%， which was significantly higher than that of the control group（73.33%）， the difference was statistically significant（P<0.05）. After 12 weeks of treatment， the levels of AHI， ODI and serum MDA and NSE in the two groups were significantly decreased，the difference was statistically significant （P<0.05）. After 12 weeks of treatment， the levels of AHI， ODI and serum MDA and NSE were significantly lower in the observation group than those in the control group，the difference was statistically significant （P<0.05）. The scores of PSQI and ESS in the two groups decreased significantly with time，the difference was statistically significant （P<0.05）. The scores of PSQI and ESS were significantly lower in the observation group than those in the control group at 4 weeks， 8 weeks and 12 weeks of treatment，the difference was statistically significant （P<0.05）. Conclusion Huashixinghan Decoction can significantly reduce AHI， PSQI score and ESS score， and improve the clinical efficacy for OSAHS patients with internal obstruction of phlegm-dampness.

[Key words] OSAHS; Huashixinghan Decoction; Internal obstruction of phlegm-dampness; AHI; PSQI score; ESS score

當前已发现阻塞性睡眠呼吸暂停低通气综合征（Obstructive sleep apnea hypopnea syndrome，OSAHS）可累及内分泌、心血管、神经等多个系统、器官[1-2]，严重影响患者身心健康。当前临床对OSAHS的处理较为局限。西医多以扁桃体切除术、消融术、舌根悬吊术等手段治疗OSAHS[3-4]，虽然可快速缓解OSAHS临床症状，但手术创伤大，并发症多、复发率高，且长期效果也有待于观察。……