吕改兰

【摘要】 目的：探討龙胆泻肝汤治疗对肝火扰心型失眠患者临床效果及睡眠质量的影响。方法：选取2017年1月-2019年12月于本院就诊的120例失眠患者，按照随机数字表法分为对照组和研究组，各60例。对照组采用艾司唑仑治疗，研究组采用龙胆泻肝汤治疗。比较两组中医证候积分、睡眠质量、心理状态、临床疗效。结果：治疗后，两组便秘溲赤、口苦咽干、目赤耳鸣、头晕头胀、胸闷胁痛、急躁易怒、不寢积分均低于治疗前，且研究组各项积分均低于对照组，差异均有统计学意义（P<0.05）。治疗后，两组快速动眼期睡眠时间长于治疗前，觉醒次数少于治疗前，且研究组快速动眼期睡眠时间长于对照组，觉醒次数少于对照组，差异均有统计学意义（P<0.05）。治疗后，两组SDS、SAS评分均低于治疗前，且研究组SDS、SAS评分均低于对照组，差异均有统计学意义（P<0.05）。研究组临床总有效率高于对照组，差异有统计学意义（P<0.05）。结论：使用龙胆泻肝汤治疗肝火扰心失眠，临床取得很好的疗效，宁心安神、清肝去火，症状、体征均去除，睡眠质量也有明显提高，夜间睡眠时间显著延长，患者心理状态得到有效改善，龙胆泻肝汤是治疗失眠的有效药物，值得临床推广。

【关键词】 心理状态 睡眠质量 中医症候症状 肝火扰心型失眠症 龙胆泻肝汤

Effect of Longdan Xiegan Decoction on Clinical Efficacy and Sleep Quality of Patients with Liver Fire Disturbing Heart Type Insomnia/LYU Gailan. //Medical Innovation of China， 2021， 18（10）： 0-037

[Abstract] Objective： To explore the effect of Longdan Xiegan Decoction on the clinical efficacy and sleep quality of patients with liver fire disturbing heart type insomnia. Method： A total of 120 patients with insomnia treated in our hospital from January 2017 to December 2019 were selected， they were divided into control group and study group according to random number table method， 60 cases in each group. The control group was treated with Estazolam， the study group was treated with Longdan Xiegan Decoction. The scores of TCM syndromes， sleep quality， mental state， clinical efficacy were compared between two groups. Result： After treatment， the scores of constipation short urination， bitter mouth and dry throat， red eyes and tinnitus， dizziness and distension of the head， chest tightness and flank pain， irritability and restless sleep in two groups were lower than those of before treatment， the all scores of the study group were lower than those of the control group， the differences were statistical significance （P<0.05）. After treatment， the REM sleep times of two groups were longer than those of before treatment， the wakefulness frequency were less than those of before treatment， the REM sleep time of the study group was longer than that of the control group， the wakefulness frequency was less than that of the control group， the differences were statistically significant （P<0.05）. After treatment， SDS and SAS scores in two groups were lower than before treatment， SDS and SAS scores in the study group were lower than those in the control group， the differences were statistical significance （P<0.05）. The clinical total effective rate of the study group was higher than that of the control group， the difference was statistically significant （P<0.05）. Conclusion： Longdan Xiedan Decoction for patients with liver fire disturbing heart type insomnia， the clinical effect is good， it calms the mind and calms the mind， clears the liver and removes the fire， the symptoms and signs are removed， the quality of sleep is also significantly improved， the night sleep time is significantly prolonged， the condition has been effectively improved， Longdan Xiegan Decoction is an effective drug for treating insomnia， which is worthy of clinical promotion.

[Key words] Mental state Sleep quality TCM symptoms Liver fire disturbing heart type insomnia Longdan Xiegan Decoction

First-authors address： Shuangqiao Hospital， Beijing 100121， China

doi：10.3969/j.issn.1674-4985.2021.10.008

睡眠质量影響着人体的健康状况，若人体出现睡眠障碍极易引发焦躁不安、精神抑郁、记忆力降低、免疫力降低等不良情况，严重还会导致发生心脑血管意外、心理疾病、高血压、神经衰弱等，甚至可能引发猝死[1]。随着工作压力的增加，生活习惯的改变，越来越多的人养成了诸多不良习惯，如心理抑郁、夜生活、过度饮酒等，导致失眠的发生率越来越高，对患者的身体健康、日常生活质量产生严重影响[2]。失眠已成为目前临床高发疾病之一。中医学认为失眠症通常是因肝郁化火所致，主要表现为睡眠深度、时间不足，重者彻夜不寝，轻者则醒后不能在寝，或时寐时醒，或寐而不酣，入睡困难[3]。失眠症是否能够使用中医进行有效治疗一直是临床的关注重点、热点。龙胆泻肝汤能够有效去除体内的肝胆实火，是由龙胆草、黄芩等相关中草药组成[4]。……