目的 探討烏靈膠囊聯(lián)合奧沙西泮治療慢性失眠的臨床療效。方法 選取2021年1月—2023年2月上海市精神衛(wèi)生中心收治的118例慢性失眠患者，隨機(jī)分為對照組（59例）和治療組（59例）。對照組睡前口服奧沙西泮片，15 mg/次，1次/d。在對照組基礎(chǔ)上，治療組口服烏靈膠囊，3粒/次，3次/d。兩組服藥21 d。觀察兩組患者臨床療效，比較治療前后兩組患者癥狀好轉(zhuǎn)時間，覺醒次數(shù)與總睡眠時間，匹茲堡睡眠質(zhì)量指數(shù)（PSQI）和過度覺醒量表（HAS）評分，白細(xì)胞介素1β（IL-1β）、5-羥色胺（5-HT）、γ-氨基丁酸（GABA）、腫瘤壞死因子-α（TNF-α）、腦源性神經(jīng)營養(yǎng)因子（BDNF）、S100鈣結(jié)合蛋白（S100B）、神經(jīng)生長因子（NGF）和膠質(zhì)源性神經(jīng)營養(yǎng)因子（GDNF）水平。結(jié)果 治療后，治療組臨床有效率為98.31%，明顯高于對照組（86.44%，P＜0.05）。治療后，治療組癥狀好轉(zhuǎn)時間均明顯早于對照組（P＜0.05）。治療后，兩組每日的覺醒次數(shù)明顯下降，而總睡眠時間明顯延長（P＜0.05），且治療組每日的覺醒次數(shù)、總睡眠時間明顯優(yōu)于對照組（P＜0.05）。治療后，兩組患者PSQI評分和HAS評分明顯降低（P＜0.05），且治療組PSQI評分和HAS評分降低更明顯（P＜0.05）。治療后，兩組患者TNF-α、IL-1β和S100B水平均明顯低于治療前，而GABA、5-HT、BDNF、NGF和GDNF水平明顯高于治療前（P＜0.05），且治療組這些指標(biāo)均明顯好于對照組（P＜0.05）。結(jié)論 奧沙西泮聯(lián)合烏靈膠囊治療慢性失眠效果確切，能有效改善臨床癥狀，明顯緩解過度覺醒狀態(tài)，增強(qiáng)神經(jīng)遞質(zhì)的能力，減弱神經(jīng)炎性反應(yīng)，充分調(diào)節(jié)神經(jīng)細(xì)胞因子水平。

Objective To explore the effects of Wuling Capsules combined with oxazepam in treatment of chronic insomnia. Methods Patients (118 cases) with chronic insomnia in Shanghai Mental Health Center from January 2021 to February 2023 were randomly divided into control (59 cases) and treatment (59 cases) group. Patients in the control group were po administered with Oxazepam Tablets, 15 mg/time, once daily. Patients in the treatment group were po administered with Wuling Capsules on the basis of the control group, 3 grains/time, three times daily. Patients in two groups were treated for 21 d. After treatment, the clinical evaluation was evaluated, and the improvement time of symptom, awakening frequency, sleep time, the scores of PSQI and HAS, the levels of TNF-α, IL-1β, GABA, 5-HT, S100B, BDNF, NGF and GDNF in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 98.31%, which was significantly higher than that of the control group (86.44%, P < 0.05). After treatment, the improvement time of symptom in the treatment group was significantly earlier than that in the control group (P < 0.05). After treatment, the daily awakening times of the two groups were significantly decreased, while the total sleep time was significantly prolonged (P< 0.05), and the daily awakening times and total sleep time in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the PSQI and HAS scores in two groups were significantly decreased, and which in the treatment group decreased more significantly (P < 0.05). After treatment, the levels of TNF-α, IL-1β and S100B in two groups were significantly lower than those before treatment, while the levels of GABA, 5-HT, BDNF, NGF and GDNF were significantly higher than those before treatment (P < 0.05), and the indexes in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion Oxazepam combined with Wuling Capsules is effective in treatment of chronic insomnia, which can effectively improve clinical symptoms, relieve excessive awakening, enhance the ability of neurotransmitters, weaken neuroinflammatory response and fully regulate the level of neurocytokines.

R971

上海市科學(xué)技術(shù)委員會項(xiàng)目(12401906200)