Sleep Phase And Neuroendocrine After Jiawei Xiaoyao San Administration In Patients With Psychological Stress Insomnia

ObjectiveTo investigate Effect of Jiawei Xiaoyao San on Sleep phase and neuroendocrine in Patients with psychological stress insomnia and to provide basis and theoretical support for further clinical application as well as later developmentMethodsA randomized double-blinded and controlled study was conducted in 33 cases of psychological stress insomnia.They were assigned to the TCM group (treated with Jiawei Xiaoyao San),the western medicine group(treated with Estazolam),the integrated medicine group(treated with Jiawei Xiaoyao San and Estazolam)and the control group(treated with placebo).The subjective sleep,objective sleep,emotion trait,personality and behavior type and Biochemical were detected before and at the 6th week of the treatment.Results1.Subjective sleep:(1)Compared with domestic norm,psychological stress insomniacs scores of PSQI and SRSS were significantly higher.(2)After 6weeks of treatment,the scores of PSQI and SRSS were decreased in theTCM,integrated medicine and control group(P＜0.05),while the scores of PSQI and SRSS was no significant difference in western medicine group(P＞0.05).2.Objective sleep:(1)Compared with norms of sleep parameters,total sleep time,sleep latency,sleep efficiency,sleep phase,sleep structure and short waking time were changed in normal range,but long waking time increased obviously.(2)No difference of TST,S1,S2,SWS,REM,SL,REM sleep latency,long waking and short waking time were observed in all group(P＞0.05)。After treatment,SE was significantly increased and trend toward higher TST was observed in the integrated medicine group(P＜0.05=.Trend toward higher SE and TST was observed in the TCM group(P＞0.05)3.Emotion trait:(1)Compared with domestic norm,psychological stress insomniacs scores of SAS and SDS were.significantly higher.(2)Compared with classification standard of SAS and SDS,54 patients were with slight or moderate anxiety(96.4%)and 50 with slight or moderate depression(89.3 %)in 57 psychological stress insomniac.(3)After 6 weeks of treatment, the scores of SAS was decreased significantly in the integrated medicine group (P＜0.05),the scores of SAS was no significant difference in TCM,western medicine and control group(P＞0.05).(4)Trend toward lower scores of SDS was observed in all group(P＞0.05),but the the scores of SDS was decreased mostly in integrated medicine group(P＞0.05).4.Personality and behavior type:(1)Total average score of TABP of psychological stress insomniacs was 30.5,belonging to type A- behavior,the factor average scores of Time Hurry(TH)and Competition and Hostility(CH) were 15.4 and 15.1 respectively and no differerce were observed between them. (2)The number of type A-behavior psychological stress insomniacs was 22, obviously more than type A(8),type M(5),type B-(13)and type B(9).5.Serum and uriary levels of neurotransmitters:(1)After 6 weeks of treatment,trend towards lower level of AVP was observed in the TCM,western medicine and control group(P＞0.05),but the serum AVP level was decreased significantly in the integrated medicine group(P＜0.05).Serum and uriary levels of CORT andβ-EP were not different(P＞0.05).(2)NE:After 6 weeks of treatment,serum levels of NE was no significant difference in TCM,western medicine and integrated medicine group(P＞0.05)but the serum NE level was decreased in control group(P＜0.05).DA:After 6 weeks of treatment,the serum DA level was increased in TCM group(P＜0.05),serum levels of DA was no significant difference in western medicine,integrated medicine and control group(P＞0.05).5-HIAA-~5-HIAA/5-HT:After 6 weeks of treatment,the serum 5-HT level and ratio of 5-HIAA/5-HT were decreased in the integrated medicine group(P＜0.05),The serum 5-HT level and ratio of 5-HIAA/5-HT were no significant difference in TCM,western medicine and control group(P＞0.05).6.Comparison between subjective and objective slee:Compared with the objective sleep latency and total sleep time,psychological stress insomniacs had significantly longer subjective sleep latency and lower total sleep time. 7.Correlation of PSQI and SRSS:PSQI and SRSS wers positive correlation obviously.ConclusionsType A behavior is a susceptible personality and behavior pattern to psychological stress insomnia.Time hurry and competition and hostility is obvious.Psychological stress insomniacs had obvious anxiety and depression and showed sleep state misperception,overestimating sleep latency and underestimating total sleep time.Jiawei Xiaoyao San can improve subjective sleep in psychological stress insomnias.The integrated medicine can significantly improve subjective sleep and anxiety,as well as increase SE. The integrated medicine can regulate HPAA and monoamine neurotransmitter to some extent.