Clinical Study On The Insomnia With The Fire Derived From Stagnation Of Liver-QI Type By Danzhixiaoyao San Combined With Repetitive Transcranial Magnetic Stimulation

ObjectiveTo observation the effects of therapy of Danzhixiaoyao san and rTMS on insomnia with the fire derived from stagnation of liver-QI and explore the mechanism of combined treatment on insomnia,to provide objective basis for the clinical optimization of insomnia treatment.MethodChoosing 70 cases of inpatient between March 2016 and October 2017 in The People's Hospital Affiliated Fujian University of TCM,according to random number table method,are divided into the rTMS group and the combined group.Each group is 35 cases.1.rTMS group:The rTMS group was treated with rTMS for 14 days in total.lt was treated once a day,five days at each week.two days for rest.The stimulation site was the left lateral prefrontal cortex.The frequency of stimulation was lHz.The stimulus intensity was 80%MT.The stimulation time was 5 seconds;Number of stimuli was 50;Intermittent time was 35 seconds;Number of repetitions was 22.Single treatment time was 15 minutes.2.combined group:The combined group was treated with rTMS and Danzhixiaoyao san for 14 days.Danzhixiaoyao san:One agent of the powder was fried into 2 bags,150mL per bag,and 1 bag after breakfast and dinner.rTMS:The usage of rTMS was same as the rTMS group.By observing the Pittsburgh sleep quality index(PSQI),insomnia severity index(ISI),the change of TCM syndrome integral quantization tables,5-hydroxytryptamine(5-HT),dopamine(DA)and norepinephrine(NE)levels,we compared score changes of PSQI,ISI,TCM syndrome integral quantitative table,and the plasma level of 5-HT,DA,NE between two groups before and after treatment.Results1.Comparison of PSQI,ISI and TCM syndromes in the same group was statistically significant(P<0.05).Plasma 5-HT,DA and NE levels were compared before and after treatment,and the difference was statistically significant(P<0.05).2.The scores of PSQI,ISI and TCM syndromes in the two groups were all decreased(P<0.05),and the reduction of the combined group was larger than that of the rTMS group,with statistical significance(P<0.05).3.The plasma 5-HT level was increased in the two groups after treatment,and the increase in the combined group was larger than that in the rTMS group,and the difference was statistically significant(P<0.05).The plasma DA and NE levels in the two groups were both decreased,and the reduction in the combined group was greater than that in the rTMS group,and the difference was statistically significant(P<0.05).4.The total clinical efficacy of rTMS group was 71.85%,the total effective rate of the combined group was 88,24%,and the difference between the two groups was statistically significant(P<0.05).Conclusions1.Danzhixiaoyao san combined with rTMS can significantly improve the subjective feelings of patients with liver depression,the sleep quality of patients with liver depression,and improve TCM syndromes,curative effect is better than rTMS alone.2.Danzhixiaoyao san combined with rTMS may improve the liver depression type of sleep by reducing plasma DA,NE and improving 5-ht level.