加味大柴胡汤治疗痰瘀阻窍型阻塞性睡眠呼吸暂停低通气综合征52例

目的:观察加味大柴胡汤治疗痰瘀阻窍型阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的临床疗效及对患者生活质量的影响.方法:将78例痰瘀阻窍型OSAHS患者按(1∶2)随机按数字法分为对照组26例和治疗组52例.对照组采用基础治疗、合并症治疗、药物治疗、气道内正压通气治疗等综合治疗方法;治疗组在对照组基础上加用加味大柴胡汤.疗程15d.采用多导睡眠图(PSG)监测睡眠呼吸暂停低通气指数(AHI)、夜间平均SaO2、夜间最低SaO2,采用Epworth嗜睡量表(ESS)评价白天过度嗜睡情况,采用SF-36量表评价患者生活质量.结果:治疗组总有效率为96.15％优于对照组的80.77％(P＜0.05);治疗后治疗组AHI、ESS评分及SaO2＜90％比例均少于对照组(P ＜0.05,P＜0.01),治疗组夜间最低SaO2水平高于对照组(P＜0.01);治疗组生理功能、社会功能、生理职能、精神健康、情感职能、活力、总体健康各维度评分均高于对照组(P＜0.01).结论:加味大柴胡汤能改善OSAHS临床症状、体征,提高患者生活质量,提高临床疗效,值得临床使用.

Observations on The Therapeutic Efficacy of Jiawei Da Chaihu Tang Treating 52 Cases of Phlegm-stasis Blocking Type Obstructive Sleep Apnea-hypopnea Syndrome

Objective: To observation the clinical efficacy Jiawei Dachaihu Tang in the treatment of phlegm-stasis blocking type obstructive sleep apnea-hypopnea syndrome(OSAHS). Method: Seventy-eight patients with phlegm-stasis blocking type obstructive sleep apnea-hypopnea syndrome were randomly divided into treated group (n=52) and control group (n=26). Patients in the control groups were treated with basic treatment, complications therapy, drug therapy, airway pressure therapy and other comprehensive treatment. Jiawei Dachaihu tang was used in the treated group and 15 days as one cycle. Using polysomnography (PSG) monitoring the sleep apnea-hypopnea index (AHI), mean nocturnal SaO₂, minimum SaO₂ of the night, using the Epworth Sleepiness Scale (ESS) Evaluation of excessive daytime sleepiness, using the SF-36 scale evaluation of patients living quality. Result: The total efficacy of the treated group (96.15%) was significantly better than the control group (80.77%) (P<0.05). After treatment, AHI, ESS score and SaO₂<90% ratio of treated group were less than the control group(P<0.05,P<0.01). Nighttime minimum SaO₂ level of treated groups were with higher than control group(P<0.01). Physiological function, social function, physical function, mental health, role emotional, vitality, general health scores of patients in treated group were higher than patients in control group (P<0.01). Conclusion: The Jiawei Dachaihu tang in treating of OSAHS have significant clinical effect, it can improve the clinical symptoms and clinical signs, improve patient quality of life, improve clinical outcomes, worthy of clinical use and is worth for clinical use.