目的 探討精烏膠囊聯(lián)合艾司唑侖治療心腎不交型失眠癥的臨床療效。方法 選取2021年9月—2023年9月在武漢市中醫(yī)醫(yī)院診治的128例心腎不交型失眠患者，按隨機(jī)數(shù)字法分為對照組（64例）和治療組（64例）。對照組患者睡前口服艾司唑侖片，1 mg/次，1次/d。在對照組的基礎(chǔ)上，治療組口服精烏膠囊，6粒/次，3次/d。兩組連服藥30 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，匹茲堡睡眠質(zhì)量指數(shù)（PSQI）評分，血清因子白細(xì)胞介素-1β（IL-1β）、前列腺素D₂（PGD₂）、5-羥色胺（5-HT）和腫瘤壞死因子-α（TNF-α）水平，及不良反應(yīng)。結(jié)果 治療后，治療組總有效率為98.43%，明顯高于對照組（84.38%，P＜0.05）。治療后，治療組入睡困難、睡眠較淺、容易驚醒、醒后難以入睡好轉(zhuǎn)時間均明顯短于對照組（P＜0.05）。治療后，兩組患者PSQI評分明顯降低（P＜0.05），且治療組患者PSQI評分明顯低于對照組（P＜0.05）。治療后，兩組患者血清因子IL-1β和TNF-α明顯降低，而PGD₂和5-HT水平明顯升高（P＜0.05），且治療組這些血清因子水平均明顯好于對照組（P＜0.05）。藥物期間，對照組不良反應(yīng)發(fā)生率為12.57%，明顯高于治療組（4.69%，P＜0.05）。結(jié)論 艾司唑侖與精烏膠囊協(xié)同治療，可有效改善臨床失眠癥狀，有效減弱失眠相關(guān)因子水平，明顯提升睡眠質(zhì)量。

Objective To explore the clinical effect of Jingwu Capsules combined with eszolam in treatment of insomnia of incompatibility between heart and kidney. Methods Patients (128 cases) with incompatibility between heart and kidney in Wuhan Hospital of Traditional Chinese Medicine from September 2021 to September 2023 were divided into control (64 cases) and treatment (64 cases) group by random numbers. Patients in the control group were po administered with Estazolam Tablets, 1 mg/time, once daily. Patients in the treatment group were po administered with Jingwu Capsules on the basis of the control group, 6 grains/time, three times daily. Patients in two groups were treated for 30 d. After treatment, the clinical evaluations was evaluated, the symptom relief time, PSQI scores, the levels of serological IL-1β, TNF-α, PGD2 and 5-HT, and adverse reaction in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 98.43%, which was significantly higher than that of the control group (84.38%, P < 0.05). After treatment, the improvement time of difficulty falling asleep, shallow sleep, easy to wake up and difficulty falling asleep after waking in the treatment group was significantly shorter than that in the control group (P < 0.05).. After treatment, the PSQI score in two groups was significantly decreased (P < 0.05), and the PSQI score of the treatment group was significantly lower than that of the control group (P < 0.05). After treatment, the serum levels of IL-1β and TNF-α were significantly decreased, while the levels of PGD₂ and 5-HT were significantly increased in two groups (P < 0.05), and the levels of these serum factors in the treatment group were significantly better than those in the control group (P < 0.05). During the treatment, the incidence of adverse reactions in the control group was 12.57%, which was significantly higher than that in the treatment group (4.69%, P < 0.05). Conclusion The synergistic treatment of eszolam and Jingwu Capsules is effective in improving clinical insomnia symptoms, and which effectively reduce the level of insomnia-related factors and significantly improve sleep quality.

R971

國家重點研發(fā)計劃項目（2018YFC1705602）；武漢市衛(wèi)生計生科研基金資助項目（WZ21C55）