中医药干预肺癌相关性失眠临床疗效观察

Traditional Chinese medicine in treatment to lung cancer related insomnia

  • 摘要: 目的 评估养阴益气安神法治疗气阴两虚型非小细胞肺癌(non-small cell lung cancer,NSCLC)相关性失眠的疗效。 方法 选择2015年11月-2016年12月就诊于海军总医院的90例气阴两虚型NSCLC失眠患者,随机分为治疗组(予以百合固金汤联合黄连阿胶汤化裁)和对照组(予以唑吡坦),治疗2周。于治疗前1 d、治疗后7 d和14 d、停药后14 d用匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)量表及Actiwatch睡眠活动记录仪评估睡眠状况及疗效。 结果 共85例完成此试验,治疗14 d时,中药组与西药组相比,总有效率(69.8% vs 69%)、PSQI(中位数8 vs 7.5)、睡眠时长(中位数7.1 h vs 6.6 h)差异无统计学意义,但中药组入睡潜伏期高于西药组(中位数38 min vs 29 min,P< 0.05)。停药14 d后,中药组失眠治疗总有效率降至55.8%,西药组总有效率降至26.2%,两组差异有统计学意义(P< 0.05)。中药组PSQI评分显著低于西药组(中位数9 vs 10.5,P< 0.05)、睡眠时长显著高于西药组(中位数6.4 h vs 5.8 h,P< 0.05);两组入睡潜伏期差异无统计学意义。 结论 使用养阴益气安神法,运用百合固金汤联合黄连阿胶汤治疗NSCLC失眠有效,其疗效与唑吡坦在改善睡眠时长上相当,虽然中药在降低入睡潜伏期上弱于唑吡坦,但中药的持续疗效优于唑吡坦。

     

    Abstract: Objective To evaluate the effect of the method of yang yin yi qi an shen among the qi yin liang xu non-small cell lung cancer(NSCLC) insomniacs. Methods We selected 90 qi yin liang xu NSCLC insomniacs from Navy General Hospital from November 2015 to December 2016, and they were randomly divided into two groups: the traditional Chinese medicine (TCM) group in which patients were treated with Bai He Gu Jin Tang combined with Huang Lian E Jiao Tang for two weeks, and the western medicine (WM) group in which patients were treated with zolpidem for two weeks.Pittsburgh sleep quality index (PSQI) was recorded and sleep quality was monitored by Actiwatch before the treatment, at day 7 and day 14 during treatment, at day 14 after treatment. Results In total 85 patients completed our study.On the 14th day of treatment, the effective rate (TCM Group: 69.8% vs WT Group: 69%), PSQI score(TCM Group: 8 vs WT Group: 7.5), sleep duration (TCM Group: 7.1 h vs WT Group: 6.6 h) between the two groups had no statistically signi ficant difference.But patients in traditional medicine group had signi ficantly greater onset latency than those in western medicine group (38 min vs 29 min, P< 0.05).On the 14th day after drug withdraw, the effective rate in traditional medicine group decreased to 55.8%, while that in western medicine group decreased to 26.2% (P< 0.05).Besides, patients in traditional medicine group had signi ficantly lower PSQI score (9 vs 10.5, P< 0.05) and longer sleep duration (6.4 h vs 5.8 h, P< 0.05).The length of onset latency between the two groups showed no signi ficant difference. Conlusion It's effective to treat insomnia with the method of yang yin yi qi anshen by using Bai He Gu Jin Tang combined with Huang Lian E Jiao Tang among NSCLC patients.Bai He Gu Jin Tang combined with Huang Lian E Jiao Tang can lengthen the sleep duration, which is also showed by zolpidem.Bai He Gu Jin Tang combined with Huang Lian E Jiao Tang is less effective than zolpidem in reducing the time of onset latency, however, its effect lasts longer than zolpidem.

     

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