Clinical Research On The Effects Of Wenshibentun Decoction In Patients With Insomnia Due To Yang Deficiency

BackgroudInsomnia is a common clinical neurological and frequently disease, it's widespread complaint in patients with clinical subjects, it's also accompanied by many symptoms of a disease. Frequent insomnia makes direct effects on patients'emotions, mentality and working abilities next morning, which fully distress them. Chinese medicines with a long-history experience in curing insomnia starts from Yin Deficiency and Yang sufficiency at the present by ignoring Yang deficiency. Our professor has found that Yang Deficiency as a common type of insomnia, and the proportion with this type there is an increasing tendency. Ming Dynasty Peng Ziyi wrote《circular movement of the ancient Chinese medicine》, constructed a dynamic model of physiology and pathology in human, and discussed with one concept of word and human, for explaining the pathology of chronic intractable insomnia and guiding the clinical treatment, our professor has made great achievements by that. Based on clinical experience, tutor finds Yang deficiency insomnia turns out to be a type of common characteristics, which insomniacs are tending to be more and more. Peng ZiYi in Republic of China, in his book "Circular Movement of Ancient Chinese Medicine" constructing the dynamic model, combining the personal physiology and pathology, explains the pathology of chronic intractable insomnia and guides clinical treatment with remarkable effects. Object iveThis paper, based on the formation of《verification and optimization of Chinese medicine experts in nsomnia treatment program》by Guangdong Provincial Hospital of Traditional Chinese Medicine of special scientific and technological research from tutor, is aimed to observe the experience decotion for treatment of Wenshibentun Decotion in insomnia with Yang Deficiency. Explored the use of the Wenshibentun Decotion for treatment of insomnia to adapt topopulation characteristics., Secondary purpose is to compare effective insomniacs cured by the experience with the subject of another expert in the Tonganside---Sini Powder Plus Cassia Twig and Dragon Bone Combination adapt to population characteristics of insomnia t by Yang Deficiency.(Case observation data is offered by from other members of the research group responsible for the collection, its the same procedure of the program to implemen in the study, it does not repeat discussing in this article), by combining and analysing data about curative effects in Yang deficiency insomniacs by Wenshibentun Decotion and Sini Powder Plus Cassia Twig and Dragon Bone Combination. Designed to provide clinical objective basis for individualized medicine. MethodsThis study is an observational study of cases. This study is an observational study of cases without control group. We collected the 30 samples that meet the inclusion criteria since January 2010 to March 2011, in professor Yang Zhimin s outpatient clinic,which locates in Guangdong Provincial TCM Hospital. And carried out a survey, these mainly contain Demographic characteristics, History characteristics, Four diagnostic information, Pittsburgh Sleep Quality Index(PSQI), Insomnia severity Index(ISI), for sleep evaluation, Self-rating Anxiety Scale(SAS) and Self-rating Depression scale(SDS), for emotional evaluation. Primary endpoint including the reduction rate of PSQI total score, PSQI(with Total valuation of PSQI 7 scores)and ISI before and afer treatment. Based on the study of TCM diagnosis, it is to compare analytically curative insomniacs by Wenshibentun Decoction and those by Sini Powder Plus Cassia Twig and Dragon Bone Combination in terms of clinical characteristic.Result1. Patients with the longest duration was 360 months,a minimum of 6 monhts in the study population, with a median of 60 months, average (82.13+87.59) months, in which more than 6 months incidence of the majority, accounting for 93.3%. By Insomnia Severity Index score to distinguish between the severity of insomnia, in which 6.7% subclinical insomnia,63.3% a considerable degree of insomnia,30.0%severe insomnia. Through solo-factor deplorable analysis, it is to compare the difference between effective cases and ineffective cased(including four diagnostic information, medical history characteristics and the scale score)by adopting Fisher precise probability with (P<0.05) as standard mould, comparing effective cases and ineffective ones.The percentage regarding fearing coldness and coolness, forgetfulness is higher than ineffective cases, which difference leads to statistical meaning (P< 0.05). This points out that insomniacs who is effectively cured by Wenshibentun decotion feature in fear of coldness and coolness, forgetfulness.2. Pittsburg Sleep Quality Index(PSQI) compared with Total valuation of PSQI 7 scores, patients of Yang deficiency are highly scored. Compared with pre-interference, one-month interference and one-month medicine withdrawal make total PSQI and 7 elements both decreased, which presents statistical meaning (P<0.01).Sleep quality obviously improved, but still not meet the normal level at large. Patients'sleep (time of falling asleep, sleeping, efficiency, sleep-disorder, hypnosis medicines) and subjective sleep quality both better. Compared with one-month post-interference, after one-month medicine withdrawal, patients'total PSQI and 7 elements valuation has no statistical meaning (P>0.05), by presenting that curative effects do not decrease when medicine-withdraws. Chinese medicine efficacy might be relatively stable. Compared with pre-interference, one month after interference and medicine withdrawal, ISI valuation all degraded makes statistical meaning (P<0.01).It proves patients performance is improved in great pace. Compared with one-month interference, one-month medicine withdrawal makes lower ISI, which variation shows statistical meaning (P< 0.01).Pre-interference continues curative effects, which might be related to that Chinese medicine is effective cumulatively.3. In Self-rating Anxiety Scale(SAS) and Self-rating Depression scale(SDS), this study interferes 60% Yang deficient insomniacs who has slight and moderate anxiety,40% slight and moderate depression. Compared with before-interfered, after one-month interference and medicine withdrawal, patients'SAS and SDS get lower in valuation, which variation is statistically meaningful (P< 0.01). Compared with after-interference in one month, after medicine withdrawal, valuation of SAS and SDS is decreased with statistical meaning (P< 0.01), showing curative effects continue.4. Comparing effective insomnia of Yang Defficiency by Wenshibentun Decoction with that Sini Powder Plus Cassia Twig and Dragon Bone Combination (P<0.05) the former is high in percentage featured by western medicines history, ineffectiveness in Chinese medicines. Moreover, anxiety symptoms is lower in percentage than Sini Powder Plus Cassia Twig and Dragon Bone Combination. Comparing different insomniacs by above two treatments in before-interference PSQI and 7 elements, the insomniacs cured by Wenshibentun Decotion is higher in sleep disorder index than those by Sini Powder Plus Cassia Twig and Dragon Bone Combination (P<0.05)Conclusion1. The treatment of chronic insomnia by Wenshibentun Decotion might mainly aims at stubborn chronic or recurring insomnia. By adopting this treatment for insomnia, clinic references can be identified in the fear of coldness and forgetfulness.2. After insomniacs of Yang deficiency takes Wenshibentun modified decoction, they can be observed their sleep course (Falling asleep, sleeping time, sleeping efficiency) and sujective sleeping quality, daytime performance,3. After insomniacs of Yang deficiency takes Wenshibentun modified decoction, all which can be improved greatly including their anxiety and depression.4. By comparing with Wenshibentun Decotion, Sini Powder Plus Cassia Twig and Dragon Bone Combination is an more effective treatment for kidney deficiency failure, the insufficient b. f turn axis. The symptoms in Yang deficiency insomnia during cure by Wenshibentun Decotion is much more prominent, but cure by Sini Powder Plus Cassia Twig and Dragon Bone Combination features in excessive Yang insomnia obviously. Treatment of insomnia disorders are probably more serious by comparing with Sini Powder Plus Cassia Twig and Dragon Bone Combination.Treatment of insomnia disorders are probably more serious by comparing with Sini Powder Plus Cassia Twig and Dragon Bone Combination.