归脾汤对心脾两虚型失眠患者下丘脑-垂体-甲状腺激素水平的影响

目的:探讨归脾汤对心脾两虚型失眠患者下丘脑-垂体-甲状腺激素水平的影响。方法:将80例患者按区组随机化方法分为两组。治疗组50例,给予归脾汤,每次100mL,每日2次;对照组30例,给予艾司唑仑片1mg,每晚睡前口服1次,两组疗程均为8周;另选取同一医院的健康体检者30例作为健康对照组。采用放射免疫分析法测定失眠患者治疗前后的血清T3、T4、TSH及TRH水平,并与健康体检组比较,疗效评定采用匹兹堡睡眠质量指数(PSQI)量表。结果:心脾两虚型失眠患者的血清T3、T4、TSH及TRH水平较健康体检组明显降低(P<0.05)。给予归脾汤治疗后,治疗组的PSQI总分值、入睡时间分值及日间功能障碍分值均较对照组改善显著(P<0.05);治疗组的血清T3、T4、TSH及TRH水平较对照组上升显著(P<0.05),其中T3、T4与健康体检组无差异(P>0.05)。结论:心脾两虚型失眠患者存在下丘脑-垂体-甲状腺轴的功能减退,归脾汤对心脾两虚型失眠患者PSQI、血清T3、T4、TSH及TRH有明显的改善作用。

Effects of Guipi Decoction on Hypothalamus-Hypophysis-Thyroid Hormones of Insomnia Patients with Heart and Spleen Deficiency

Objective:To study the effects of Guipi decoction on hypothalamus-hypophysis-thyroid hormones of insomnia patients with heart and spleen deficiency.Methods:80 patients were randomly divided into two groups,50 in the treatment group and 30 in the control group.The treatment group took Guipi decoction,100mL each time,twice a day.The control group took 1mg estazolam tablet orally once a day before sleeping at night.The treatment course for both groups was eight weeks.Besides,a normal control group of 30 healthy subjects from medical examination of the same hospital was set up.The curative effect was evaluated by scales of PSQI and levels of serum T3,T4,TSH and TRH through radio immunoassay.Results:The levels of serum T3,T4,TSH and TRH of insomnia patients with heart and spleen deficiency were obviously lower than those of the healthy subjects(P<0.05).Through the treatment of Guipi decoction,the PSQI scales of the treatment group were more significantly improved than those of the control group(P<0.05).The levels of serum T3,T4,TSH and TRH were more apparently increased than those of the control group(P<0.05).However,the levels of serum T3 and T4 of the treatment group showed no difference with those of the healthy group(P>0.05).Conclusion:The hypofunction of hypothalamus-hypophysis-thyroid hormones can be observed in the insomnia patients with heart and spleen deficiency.Guipi decoction makes more differences in the improvement of the levels of PSQI and serum T3,T4,TSH and TRH.