Analysis Of Pathogenesis Change Of Phlegm Heat Insomnia And Clinical Research Of Clearing Phlegm And Nourishing Yin On Insomnia Of Phlegm Heat With Yin Deficiency Type

Part ?:Analysis of Pathogenesis Change of Phlegm Heat InsomniaObjective:To preliminarily discuss the pathogenesis change of phlegm heat insomnia and guide clinical medication.Methods:According to literature and experience of clinical treatment for many insomnia patients,we find that most insomnia patients accompany with phlegm heat syndrome,which indicates that phlegm heat easily disturbs mind and damages blood and viscera.As a result,insomnia is hard to cure.But simple phlegm heat syndrome is clinically rare,insomnia is usually with intermingled deficiency and excess and relatively complicated.The object of study come from insomnia patients of Nanjing Hospital of traditional Chinese Medicine.We select 250 cases of insomnia patients with phlegm heat syndrome and analyze and summarize the primary and secondary syndrome.By statistics,we summarize the distribution of common syndromes of phlegm heat insomnia.At last,we preliminarily discuss the pathogenesis change of phlegm heat insomnia and further guide clinical medication.Results:(1)Sex Distribution:There are78 males and 172 females.The ratio of male to female is 1:2.21.(2)Age Distribution:There are 60 cases of young people(under 45 years old),accounting for 24%;131 cases of middle aged group(more than 45 years old and less than 60 years old),accounting for 52.4%;59cases of the elderly group(over 60 years old),accounting for 23.6%.Their average age is 51.62± 11.02 years old.(3)Among the 250 cases of insomnia patients with phlegm heat syndrome,there are only 3 cases of simple phlegm heat syndrome,accounting for 1.2%,93 cases of phlegm heat with yin deficiency type,accounting for 37.2%,28 cases of phlegm heat with qi deficiency of heart and gallbladder type,accounting for 11.2%,56 cases of phlegm heat with heart and spleen deficiency type,accounting for 22.4%,5 cases of phlegm heat with hyperactivity of heart-liver fire type,accounting for 2%,47 cases of phlegm heat with up-stirring of wind fire type,accounting for 18.8%,6 cases of phlegm heat with phlegm-blood stasis type,accounting for 2.4%.Conclusion:(1)Insomnia is more common in female patients.(2)Insomnia is more common in middle-aged people.(3)Simple phlegm heat insomnia is rare.Based on phlegm heat,many complicated syndromes appear with the onset and changes of pathogenesis.And insomnia of phlegm heat with yin deficiency type is the most common in clinic.Part II:Clinical Research of Clearing Phlegm and Nourishing Yin on Insomnia of Phlegm Heat with Yin Deficiency TypeObjective:To observe the clinical effect of clearing phlegm and nourishing yin on insomnia of phlegm heat with yin deficiency type.Methods:In this study,we select 90 cases of insomnia patients of phlegm heat with yin deficiency type from the diagnostic efficacy of standard TCM and western medicine.The 90 cases are randomly divided into 60 cases of treatment group(Huanglian Wendan prescription and Tianwang Buxintang with Estazolam Tablets)and 30 cases of control group(Bailemian Capsules with Estazolam Tablets).With the change of syndrome,the treatment group adjust the therapy on clearing phlegm and nourishing yin prescription.The courses of the two groups are both one month.Comparing PSQI scale and TCM syndrome score changes before and after treatment of each group,we also carry on comparison between the two groups after treatment.Results:(1)PSQI:The treatment group and the control group both can improve the sleep quality scores of the patients.Compared with the control group,the treatment group is better in improving sleep efficiency,day function and reducing sleep time and sleep disorders.There are significant differences between the two groups(p<0.05)and the treatment group is better than the control group.(2)TCM syndrome:The treatment group can significantly improves insomnia patients on restless sleep,vexation and irritability,chest tightness,dreaminess,waked easier,red tongue and yellow greasy fur(p<0.05).(3)Sleep quality effect:During the treatment group:3 cases(5.1%)are cured,10 cases(16.9%)are significantly effective,40 cases(67.8%)are effective and 6 cases(10.2%)are invalid,with a total effective rate of 89.8%.As to the control group,the dates are 0(0),1(3.3%),22(73.3%),7(23.3%)respectively,and the total cure rate is 76.7%.About comprehensive efficacy,there are significant differences between the two groups(p<0.05)and the treatment group is better than the control group.(4)TCM syndrome effect:During the treatment group:18 cases(30.5%)are cured,34 cases(57.6%)are significantly effective,3 cases(5.1%)are effective and 4 cases(6.8%)are invalid,with a total effective rate of 93.2%.As to the control group,the dates are 0(0),1(3.3%),18(60.0%),11(36.7%)respectively,and the total cure rate is 63.3%.About comprehensive efficacy,there are significant differences between the two groups(p<0.05)and the treatment group is better than the control group.Conclusion:Clearing phlegm and nourishing yin can effectively improve sleep quality of insomnia patients of phlegm heat with yin deficiency type,which is worthy of clinical application.