加味酸枣仁汤对高中生失眠症的治疗作用以及5-HTTLPR基因多态性对疗效的影响

目的 探讨加味酸枣仁汤对高中生失眠症的疗效以及5-羟色胺转运体启动子区域(serotonin transporter-linked promoter region,5-HTTLPR)基因多态性与疗效的关系。 方法 收集失眠症高中生对照组50例和加味酸枣仁汤组47例。对照组仅调整作息时间，加味酸枣仁汤组同时给予加味酸枣仁汤1周。测定治疗前后匹兹堡睡眠质量指数(PSQI)，用配对t检验比较差异。采集血液，测定5-HTTLPR基因型，用χ2检验分析与疗效的关系。 结果 加味酸枣仁汤治疗后，显著降低主观睡眠质量(2.17±0.38 vs. 0.77±0.48)、入睡时间(2.11±0.37 vs. 0.68±0.52)、睡眠时间(1.43±0.50 vs. 0.89±0.37)、睡眠效率(1.51±0.51 vs. 0.87±0.40)、睡眠障碍(1.40±0.54 vs. 0.85±0.42)、日间功能障碍(1.70±0.46 vs. 0.89±0.37)以及总分(10.32±1.07 vs. 4.96±0.95),均P＜0.001；该组治疗有效率72.34%(34/47)明显高于对照组6.00%(3/50)，差异有统计学意义(P＜0.001)；显效、有效患者LL基因型频率和L等位基因频率均高于无效者(P=0.007和P＜0.001)。 结论 加味酸枣仁汤对高中生失眠症有疗效，并受5-HTTLPR基因型影响。 

Treatment effect of Jiawei Suanzaoren decoction on insomnia of senior high school students and influence of 5-HTTLPR genetic polymorphism on the efficacy

Objective To evaluate the treatment effect of Jiawei Suanzaoren Decoction on insomnia of senior high school students and to identify the association between serotonin transporter-linked promoter region (5-HTTLPR) genetic polymorphism and its efficacy. Methods Senior high school students with insomnia (50 cases for the control group and 47 cases for the Jiawei Suanzaoren Decoction group) were recruited.Participants in the control group only required to adjust their rest time, and those in the Jiawei Suanzaoren Decoction group also received Jiawei Suanzaoren Decoction for 1 week. Pittsburgh Sleep Quality Index (PSQI) before and after treatment was tested and compared by paired-t test. Blood was collected for 5-HTTLPR genotype determination and their associations with different responses were analyzed by χ2 test. Results After treatment with Jiawei Suanzaoren Decoction, the scores of subjective sleep quality (2.17±0.38 vs. 0.77±0.48), sleep latency (2.11±0.37 vs. 0.68±0.52), sleep duration (1.43±0.50 vs. 0.89±0.37),habitual sleep efficiency (1.51±0.51 vs. 0.87±0.40), sleep disturbances (1.40±0.54 vs. 0.85±0.42), daytime dysfunction (1.70±0.46 vs. 0.89±0.37), and total score (10.32±1.07 vs. 4.96±0.95) of PSQI were obviously decreased as compared those of baseline(all P<0.001). The treatment effectiveness rate in the Jiawei Suanzaoren Decoction group (72.34%,34/47) was obviously higher than that of the control group (6.00%,3/50), P<0.001. LL genotype frequency and L allele frequency in the marked effective patients and effective patients treated with Jiawei Suanzaoren Decoction were significantly increased as compared with those of the ineffective patients(P=0.007, P<0.001). Conclusion Jiawei Suanzaoren Decoction has the treatment effect on insomnia of senior high school students and 5-HTTLPR genotypes may influence its efficacy.