Clinical Observation On Treatment Of Insomnia With Liver - Qi And Kidney Deficiency By Jieyu Anding Decoction Combined With

Background:The fast pace of modern life, the pressure to survive, easy to cause people emotional stress, coupled with irregular work and rest, resulting in primary insomnia increased gradually. Because poor emotional tone, liver-qi stagnation is a common clinical cause of insomnia. As time went by, liver-qi stagnation changed into the liver-fire. Heart and Liver’s fire gets over-powerful。 Excessive fire would damage yin, so the kidney-water is bad; over-powerful fire would hurt qi, so the kidney-qi is bad; after some time kidney-yang becomes deficiency; all these things bring about the syndrome of liver depression and kidney deficiency. Sources segment generated can be traced to specific factors, including past negative emotional stimuli, fatigue, irregular work and rest and so on. However, although many patients with insomnia associated with significant symptoms of insomnia, we have no way to know the reason. Summarize the reasons, which on the one hand may be due to the increasing influence of the long-term living environment or innate differences in personality disposition formed, on the other hand the patient may be reluctant to talk to the doctor why. For patients with insomnia can identify the specific reason for the formation of the reasons we can direct psychological counseling to relieve insomnia. But most insomnia can not be traced back to the apparent cause of insomnia patients with liver depression and kidney deficiency, we can often use traditional Chinese medicine dialectical theory of governance, and with anti-depressant drug treatment, to carry on combination treatment of Chinese and Western Medicine, achieved good results, in clinical diagnosis and treatment process.Objective:Insomnia symptoms with liver depression and kidney deficiency were dreamful sleep at night, waking up early, dizziness, headache, upset, depression, hypochondriac pain, soreness of the bone and joint, frequent urination or urine difficult to control, tinnitus, heel pain, dry throat with bitter taste, hectic fever, sweating, feverish sensation in the palms and soles. Tongue is red and dry, and pulse is thin and profound. According to my instructor long-term accumulation about the clinical experience of Traditional Chinese Medicine-Jieyu Anmian decoction, collocates with sertraline, for the treatment of liver depression and kidney deficiency insomnia to develop new ideas. The present study was designed to observe and evaluate the clinical efficacy of Jieyu Anmian decoction and it combined with sertraline treatment in the area of liver depression and kidney deficiency insomnia.Methods:By Dongzhimen hospital outpatients from October 2013 to December 2015, collecting insomnia patient information, screening stagnation of liver depression and kidney deficiency insomnia patients met the inclusion criteria test. Test group uses Jieyu Anmian decoction jointed by sertraline, and the control group was only treated with decoction. According to Randomized Controlled Study, we observe two groups, through the TCM symptom scores table, PSQI as evaluation criteria, and evaluate treatment efficacy. In this paper, data analysis is induced by SPSS21.0 software. If P<0.05, it is considered statistically significant.Results:28 days treatment course for insomnia patient with liver depression and kidney deficiency, the Traditional Chinese Medical group uses only traditional Chinese Medicine--Jieyu Anmian decoction, while joint medical group uses Jieyu Anmian decoction with sertraline. The results are folio wings:Adopting TCM integral table for symptom to evaluate the curative effect of Traditional Chinese Medicine: ① The total effective rate of TCM Syndromes:among the 40 cases, there are 1 cured,3 with excellent effect,23 with improvement, and 13 without effect that the total effective rate is 67.5%; while among the 36 cases of joint medical group, there are 2 cured,6 with excellent effect,23 with improvement, and 5 without effect that the total effective rate is 86.1%. ②Aggregate score:the aggregate scores of traditional Chinese symptom of both Traditional Chinese Medical group and joint medical group are decreased (P<0.05), and the decrease level of joint medical group is more significant (P< 0.05). ③ Primary symptom:the evaluation of all factors of primary symptom of the insomnia with liver depression and kidney deficiency of both Traditional Chinese Medical group and joint medical group have decreased (P<0.05), and the factors of gloomy mood, hypochondriac pain, frequent micturition or control-difficulty of urine symptoms of the patients of joint medical group have decreased more significantly than Traditional Chinese Medical group (P< 0.05).④ Accompanied symptom:the various evaluation of accompanied symptoms of the patients of Traditional Chinese Medical group have decreased more significantly (P< 0.05), while the evaluation of defecate dry and hard and stool loose factors of patients of joint medical group is without significant decrease (P> 0.05), and except stool irregularities, the evaluation of other accompanied symptom factors of joint medical group have decreased significantly (P>0.05); the evaluation of accompanied symptoms factors like painful distension and dizziness in the head and tidal fever and night sweating of Traditional Chinese Medical group have decreased more significantly than joint medical group (P< 0.05). Adopting PSQI table to conduct clinical evaluation of curative effect:①The clinical total effective rate:among the 40 cases of traditional medical group, there are 1 cured,14 with excellent effect,14 with improvement, and 11 without effect that the total effective rate is 72.5%; while among the 36 cases of joint medical group, there are 4 cured,9 with excellent effect,17 with effect, and 6 without effect that the total effective rate is 83.3%. ②he aggregate score and every factor in PSQI evaluation of Traditional Chinese Medical group and joint medical group have decreased comparatively than pre-treatments.Conclusions:①The Traditional Chinese Medical group and joint medical group have great effects to insomnia patient with liver depression and kidney deficiency, to the total evaluation of integral table for symptom of Traditional Chinese Medicine, and to the curing of factors of primary and accompanied symptoms. ② The curing effects of Traditional Chinese Medical group toward accompanied factor --defecate dry and hard or stool loose is better than joint medical group. ③ The curing effects of joint medical group toward the total evaluation of integral table for symptom of traditional Chinese medicine, factors of primary symptoms (gloomy mood, hypochondriac pain, frequent micturition or control-difficulty of urine), and accompanied symptoms (painful distension and dizziness in the head, tidal fever and night sweating) are better than traditional Chinese medical group’s. ④ The Traditional Chinese Medical group and joint medical group have comparatively effective toward curing insomnia patient with liver depression and kidney deficiency. ⑤Through comprehensive evaluation, the Jieyu Anmian decoction has been proved that it has good curative effect, and it, together with sertraline, has great effect in the clinical treatment that shall be promoted and widely applicated.