Department of Emergency, Wuhan Traditional Chinese Medicine Hospital, Wuhan, Hubei, China.
Department of Encephalopathy, Wuhan Traditional Chinese Medicine Hospital, Wuhan, Hubei, China.
Medicine (Baltimore). 2024 Nov 1;103(44):e40160. doi: 10.1097/MD.0000000000040160.
This study investigates the clinical efficacy of Tiaoshu Anshen Decoction in treating insomnia characterized by spleen and stomach Qi dysfunction. According to the differences of previous treatment, 94 patients were divided into treatment group and control group. The treatment group was treated with Tiaoshu Anshen Decoction, and the control group was treated with oral esazolam for 2 weeks. We compared serum levels of 5-hydroxyindoleacetic acid (5-HIAA), 5-hydroxytryptamine (5-HT), norepinephrine (NE), dopamine (DA), DASS-21, and HAMD scores before and after treatment. We also evaluated gastrointestinal function, traditional Chinese medicine syndrome scores, quality of life, and adverse reactions, with statistical analysis conducted using SPSS 25.0. The overall efficacy and clinical outcomes were comparable between the 2 groups. Both groups showed increased serum factor levels and decreased Pittsburgh Sleep Quality Index (PSQI), HAMD, and DASS-21 scores post-treatment. Notably, the treatment group exhibited significant improvement in stool consistency, digestive symptoms, DOB < 4 and DOB ≥ 4 distribution, and TCM syndrome scores, outperforming the control group. No adverse reactions were reported in either group. This study suggests that spleen and stomach Qi dysfunction significantly contribute to insomnia, affecting its occurrence, type, and severity. Tiaoshu Anshen Decoction effectively enhances 5-HIAA, 5-HT, NE, and DA levels, reduces inflammatory factors, and improves sleep quality, gastrointestinal function, and overall quality of life. The decoction may exert its effects by regulating Qi dynamics and gastrointestinal function, indicating the gastrointestinal system as a potential key target in treating sleep disorders.
本研究探讨了调枢安神汤治疗以脾胃气机失调为特征的失眠症的临床疗效。根据既往治疗的差异，将 94 例患者分为治疗组和对照组。治疗组采用调枢安神汤治疗，对照组采用口服艾司唑仑治疗，疗程为 2 周。我们比较了治疗前后两组患者血清 5-羟吲哚乙酸（5-HIAA）、5-羟色胺（5-HT）、去甲肾上腺素（NE）、多巴胺（DA）、DASS-21 和 HAMD 评分的变化，同时评估了胃肠功能、中医证候评分、生活质量和不良反应，并采用 SPSS 25.0 进行统计分析。两组患者的整体疗效和临床结局相当。两组患者治疗后血清因子水平均升高，匹兹堡睡眠质量指数（PSQI）、HAMD 和 DASS-21 评分均降低。值得注意的是，治疗组在粪便稠度、消化症状、DOB＜4 和 DOB≥4 分布以及中医证候评分方面的改善明显优于对照组。两组均未发生不良反应。本研究表明，脾胃气机失调与失眠密切相关，影响其发生、类型和严重程度。调枢安神汤能有效提高 5-HIAA、5-HT、NE 和 DA 水平，降低炎症因子水平，改善睡眠质量、胃肠功能和整体生活质量。该方剂可能通过调节气机和胃肠功能发挥作用，提示胃肠系统可能是治疗睡眠障碍的一个潜在关键靶点。
