| Background of researchInsomnia is a common clinical disease,often affecting people’s normal work,life,learning and health,as the most common disorder in modern society,can cause depression,anxiety and other psychological states,and lead to a decline in the efficiency of mental activity and impede social function.The physique of traditional Chinese medicine is a comprehensive and relatively stable characteristic in the form of body structure,physiological function and psychological state on the basis of congenital inheritance and acquired acquired.Physique affects the pathogenesis,syndrome type,treatment and prognosis of insomnia.In recent years,Chinese medicine treatment of insomnia is widely used in clinical practice.This research applies the scientific method of clinical research of traditional Chinese medicine to further verify its clinical effect,to explore the physique characteristics of the TCM of phlegm heat internal disturbance type insomniacs,the correlation of sleep quality of insomniacs with physique and mental health,and to provide the basis for the clinical diagnosis and treatment of insomnia.ObjectiveThrough theoretical study and clinical investigation to explore the physique characteristics of the TCM syndrome of phlegm heat internal disturbance,the correlation between the sleep quality of the insomniacs and the physique of traditional Chinese medicine and mental health,and observe the clinical effect of adding and subtracting Wendan Decoction in the treatment of phlegm heat disturbance type insomnia patients.Method60 cases of phlegm and heat disturbance insomnia patients were included in the study,and the personal information questionnaire was filled in.The Pittsburgh sleep index scale(PSQI),Chinese Medical Constitution assessment scale,TCM Syndrome Scale,anxiety self rating scale(SAS),self rating Depression Scale(SDS),and polysomnography were used.The sleep quality,TCM Constitution and psychological state of insomniac patients were evaluated.A single blind randomized method was used to randomly assign 60 subjects who met the inclusion criteria to the Chinese medicine group,the western medicine group and the western medicine group,20 in each group.The traditional Chinese medicine group was given two bags of Wendan Decoction,two bags a day,and two times in the morning and evening.The western medicine group gave the sawpone oral administration,and the Chinese and Western medicine group gave and subtract Wendan Decoction(two bags daily and sawpic 7.5mg)orally.The course of treatment was 4 weeks,each time before treatment and second weeks after treatment,fourth weeks each filled out an observation table,and recorded the corresponding situation.After the end of treatment,self comparison was made before and after treatment.Meanwhile,adverse reactions and adverse events occurred during the period were recorded to evaluate their clinical safety.Result1.The sleep quality,time of sleep,sleep time,sleep efficiency,sleep disturbance,hypnotic drugs and daytime dysfunction of the patients with phlegm heat internal disturbance were significantly different from those of the normal group,and there were significant differences in the P<0.05.2.0f the patients with phlegm heat internal disturbance type insomnia were evaluated by TCM Constitution,and it was found that the assessment scores of phlegm dampness constitution and humid heat constitution were more than 40 points,which accords with the standard of standard phlegm dampness,damp heat and physique.3.The correlation coefficient of sleep quality and anxiety score of the patients with phlegm heat internal disturbance type P is less than 0.05,and the correlation coefficient of depression score P is greater than 0.05,and there is no correlation.4.After the analysis of polysomnography,the difference of P<0.05 in the total sleep time,sleep efficiency,sleep latency and awakening time was statistically significant compared with the normal population.5.Pittsburgh sleep index scale:after 2 weeks of treatment,the clinical control rate of the Chinese medicine group was 1 cases,5 cases were markedly effective,?cases were effective,?cases were ineffective,the total effective rate was 65%.The clinical control rate of Western medicine group was 2 cases,8 cases were markedly effective,4 cases were effective,6 cases were ineffective,the total effective rate was 70%.The clinical control rate of the Chinese and Western medicine group was 2 cases,9 cases were markedly effective,5 cases were effective,4 cases were ineffective,the total effective rate was 80%.There was no statistical difference between the three groups.There was a significant difference in the PSQI scale scores between the three groups before and after 2 weeks of treatment.After 4 weeks of treatment,the clinical control rate of the Chinese medicine group was 3 cases,9 cases were markedly effective,6 cases were effective,2 cases were ineffective,the total effective rate was 90%.The clinical control rate of Western medicine group was 2 cases,8 cases were markedly effective,6 cases were effective,4 cases were ineffective,the total effective rate was 80%.The clinical control rate of the Chinese and Western medicine group was 3 cases,9 cases were markedly effective,5 cases were effective,3 cases were ineffective,the total effective rate was 85%.There was no significant difference between the three groups in the treatment of insomnia.There was a significant difference in the PSQI scale scores between the three groups before and after 4 weeks of treatment.6.Comparison of TCM syndrome score:after 2 weeks of oral medicine treatment,the clinical control rate of the Chinese medicine group was 4 cases,the effective 7 cases,the effective 6 cases,and the invalid 3 cases,the total effective rate was 85%.The clinical control rate of Western medicine group was 0 cases,1 cases were markedly effective,3 cases were effective,16 cases were ineffective,the total effective rate was 20%.The clinical control rate of the Chinese and Western medicine group was 3 cases,8 cases were markedly effective,4 cases were effective,5 cases were ineffective,the total effective rate was 75%.There was significant difference between the three groups,P<0.05 was statistically significant.Compared with the total score before and after treatment,there was statistical difference between the Chinese medicine group and the western medicine group.The P value of Western medicine group was greater than 0.05,and there was no statistical significance.After 4 weeks of oral medication,the clinical control rate of the Chinese medicine group was 6 cases,8 cases were markedly effective,4 cases were effective,2 cases were ineffective,the total effective rate was 90%.The clinical control rate of Western medicine group was 0 cases,1 cases were markedly effective,3 cases were effective,16 cases were ineffective,the total effective rate was 20%.The clinical control rate of the Chinese and Western medicine group was 5 cases,8 cases were markedly effective,4 cases were effective,3 cases were ineffective,the total effective rate was 85%.Comparison between the three groups,P<0.05 three groups for improving the effect of TCM syndromes were significantly different,statistically significant.Compared with the total score before and after treatment,there was statistical difference between the Chinese medicine group and the western medicine group.The P value of Western medicine group was greater than 0.05,and there was no statistical significance.7.Anxiety Scale score comparison:2 weeks after treatment and 4 weeks after the treatment,the three groups of patients were paired t test respectively,the Chinese medicine group and the Chinese and Western medicine group P were less than 0.05,with significant difference in the western medicine group P value greater than 0.05,no significant difference before and after treatment,no statistical significance.Conclusion1.The patients with insomnia due to phlegm heat disturbance conformed to the constitution type of phlegm dampness and dampness heat.Their sleep quality decreased and often accompanied with anxiety.2.Addition and subtraction of Wendan Decoction can improve the quality of sleep in the patients with insomnia,and can obviously improve the symptoms of Chinese medicine,such as pain,phlegm,chest tightness and irritability,and can improve the anxiety of the patients with phlegm heat disturbance. |
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