Observation of Addition and Subtraction Therapy of Liuwei Dihuangwan Combined with Huanglian Ejiaotang to Primary Insomnia in Elderly Liver and Kidney Yin Deficiency Syndrome
10.13422/j.cnki.syfjx.20191833
- VernacularTitle: 六味地黄丸合黄连阿胶汤加减治疗老年原发性失眠肝肾阴虚证的临床观察
- Author:
Jie-rong ZHAO
1
;
Shu-hao ZHAO
2
;
Wei-feng ZHENG
3
Author Information
1. Puyang Medical College, Puyang 457000, China
2. Puyang People's Hospital, Puyang 457000, China
3. The Second Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhenzhou 450002, China
- Publication Type:Research Article
- Keywords:
primary insomnia;
the elderly;
liver and kidney Yin deficiency syndrome;
Liuwei Dihuangwan;
Huanglian Ejiaotang;
neurotransmitter
- From:
Chinese Journal of Experimental Traditional Medical Formulae
2019;25(20):94-99
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To observe the clinical efficacy of addition and subtraction therapy of Liuwei Dihuangwan combined with Huanglian Ejiaotang to primary insomnia in the elderly (liver and kidney Yin deficiency syndrome), and to investigate its regulation effect on neurotransmitter. Method:Randomly 136 patients were divided into control group (68 cases) and observation group (68 cases) by number table. Patients in control group got Estazolam tablets by oral administration before going to bed, 1-2 mg/time, 1 time/day. Patients in observation group got addition and subtraction therapy of Liuwei Dihuangwan combined with Huanglian Ejiao tang, 1 dose/day. Both groups of patients received sleep guidance and cognitive behavior guidance, with treatment course of 8 weeks. During the observation period, physical therapy and acupuncture could not been used. Before and after treatment, pittsburgh sleep quality index (PSQI), whole night polysomnography, sleep latency (SL), awakening times (AT), sleep efficiency (SE), rapid eye movement (REM), latency (RL), total actual sleep time (TST) and proportion of N1, N2, N3 and REM in the whole sleep stage were recorded. Scores of self-rating depression scale (SDS), self-rating anxiety scale (SAS), kidney Yin deficiency syndrome score and treatment emergent symptom scale (TESS) were graded, and levels of 5-hydroxytryptamine (5-HT), 5-hydroxyindole acetic acid(5-HIAA), gamma-aminobutyric acid (GABA), norepinephrine (NE) and dopamine (DA) were detected. Result:In rank sum test, clinical efficacy in observation group was better than that in control group (Z=2.115, P<0.05). Scores of various PSQI factors and total scores of PSQI in observation group were significantly lower than those in control group (P<0.01). SL, RL, N2, AT were less than those in control group (P<0.01).TST, Nl and N3 were longer than those in control group (P<0.01). SE and REM proportions were higher than those in control group (P<0.01). Scores of SDS, SAS, liver and kidney Yin deficiency syndrome and TESS were lower than those in control group (P<0.01). Levels of 5-HT, GABA and 5-HIAA in observation group were higher than those in control group (P<0.01), while levels of NE and DA were lower than those in control group (P<0.01). Cumulative incidence of adverse reactions in observation group was 8.2%, lower than 31.03%in control group (χ2=9.945, P<0.01). Conclusion:Addition and subtraction therapy of Liuwei Dihuangwan combined with Huanglian Ejiaotang can improve sleep quality, prolong sleep time, alleviate depression, anxiety, and can also regulate neurotransmitters to improve sleep effect. The efficacy of PSQI is better than that of Estazolam tablets.
