黄连阿胶汤加减治疗脑卒中后失眠阴虚火旺证的疗效观察

目的:观察黄连阿胶汤加减治疗脑卒中后失眠阴虚火旺证的疗效,探讨其作用机制。方法:将156例符合条件的患者随机分为对照组和治疗组,各78例。对照组口服右佐匹克隆+安眠补脑口服液,治疗组口服右佐匹克隆+黄连阿胶汤加减,疗程均为2个月。比较两组患者治疗前后匹兹堡睡眠质量指数量表(PSQI),日常生活活动能力量表(Barthel),神经功能症状缺损评定量表(NDS)和脑卒中后失眠中医辨证阴虚火旺证量表(中医证候)的评分;检测两组患者治疗前后血清白细胞介素-6(IL-6),降钙素基因相关肽(CGRP),多巴胺(DA)和过氧化脂质(LPO)的含量;比较两组有效率、复发率及不良反应发生率。结果:研究过程对照组脱落6例,治疗组脱落2例。治疗组总有效率98.7%,高于对照组的87.5%(P0.05);治疗组PSQI,Barthel,NDS和中医证候评分较对照组改善更为明显(P0.05);治疗组血清IL-6,CGRP,DA和LPO的含量改善优于对照组(P0.05);治疗组复发率和不良反应发生率低于对照组(P0.05)。结论:黄连阿胶汤加减治疗脑卒中后失眠阴虚火旺证的疗效明显,其作用机制可能与改善PSQI,Barthel,NDS,中医证候的评分及血清IL-6,CGRP,DA,LPO的含量有关。

Efficacy of Huanglian Ejiao Tang in Treating Post-stroke Insomnia of Yin-deficiency and Fire-hyperactivity Syndrome

Objective: To explore the therapeutic effect and mechanism of action modified Huanglian Ejiao Tang in treatment the post-stroke insomnia of Yin-deficiency and fire-hyperactivity syndrome. Method: A total of 156 eligible patients were randomly divided into control group and treatment group, with 78 cases in each group. The control group was orally given Eszopiclone and Anmian Bunao oral liquid, and the treatment group was given modified Huanglian Ejiao Tang and Eszopiclone. A course of treatment was 2 months. Pittsburgh sleep quality index scale (PSQI), barthel of daily life activities ability evaluation (Barthel), nerve function defect symptoms rating scale (NDS) and traditional Chinese medicine (TCM) scale for post-stroke Yin-deficiency and fire-hyperactivity syndromes between two groups were compared before and after treatment. Serum interleukin-6 (IL-6), calcitonin gene-related peptide (CGRP), dopamine (DA) and lipid peroxidated (LPO) were detected before and after treatment. The effective rate, recurrence rate and adverse reaction rate were compared in two groups. Result: Six cases were lost in control group, and 2 cases were lost in treatment group. The efficiency of the treatment group was 98.7%, which was better than 87.5% of control group (P<0.05). After treatment, the score of PSQI, Barthel, NDS and TCM symptom in the treatment group were improved more obviously (P<0.05). The improvement of serum IL-6, CGRP, DA and LPO in treatment group was superior to that in control group (P<0.05). The recurrence rate and adverse reaction rate in treatment group were lower than those in control group (P<0.05). Conclusion: Modified Huanglian Ejiao Tang treatment has a significant efficacy in treating post-stroke insomnia with Yin-deficiency and fire-hyperactivity syndrome, and its mechanism of action may be related to the improvement of PSQI, Barthel, NDS, TCM syndromes and the content of serum IL-6, CGRP, DA and LPO.