Clinical Efficacy And Mechanism Of Baihe Dihuang Decoction On Insomnia Of Yin Deficiency Combined With Mild And Moderate Depression

Objective:A case-control study was conducted to observe the clinical effect of Baihe Dihuang Decoction in the treatment of Yin deficiency and internal heat type insomnia combined with mild to moderate depression.Methods:A total of 62 patients who met the diagnostic criteria of Yin deficiency and internal heat type insomnia combined with mild to moderate depression but were intolerant to western antidepressants in the sleep medicine department of Shandong Provincial Hospital from November 2019 to January 2020 and from May 2020 to December 2020 were randomly divided into control group and treatment group.The control group was treated with Alprazolam alone and the treatment group was treated with Alprazolam combined with Baihe Dihuang Decoction.The treatment course was 4 weeks.Objective Sleep quality was monitored by cardiopulmonary coupling technique(CPC)before and after treatment in 2 groups,including the proportion of Sleep Latency(SL),Total Sleep Time(TST),Unstable Sleep,Stable Sleep and Rapid Eye Movement(REM).At the same time,the Pittsburgh Sleep Quality Index(PSQI)and 17 items of Hamilton Depression Scale(HAMD-17)before and after treatment were compared between the two groups.The clinical TCM syndromes table was used to compare the curative effect before and after treatment.SPSS26.0 software was used for statistical analysis of the two groups of data.Results:1.Before treatment,there were no statistical differences between the treatment group and the control group in terms of age,gender,sleep proportion,sleep latency,total sleep time,PSQI,HAMD-17 and TCM syndrome scores.2.Comparison of objective sleep monitoring results before and after treatments in the treatment group was shorter than before,the difference was statistically significant(P<0.05),while SL in the control group was not statistically significant before and after treatment.TST in the treatment group and the control group was longer than before,and the difference was statistically significant(P<0.05).In the treatment group,the proportion of stable sleep increased,while the proportion of unstable sleep and REM sleep decreased,with statistical significance(P < 0.05).There was no significantchange in sleep structure in the control group.3.Comparison of PSQI scoresbefore and after treatment :(16.31±2.25)and(10.55±1.99)in the treatment groupand(16.42±2.89)and(12.77±3.11)in thecontrol group,respectively.After treatment,PSQI scores in both groups were decreased,with statistical significance(P<0.01),and the effective rate of PSQI in the treatment group(89.7%)was significantly higher than that in the control group(45.2%),indicating that the treatment group had a better effect on the improvement of subjective sleep quality.4.Comparison of HAMD-17 scores before and after treatment :(18.03±3.31)and(11.76±2.98)in the treatment group and(17.13±4.18)and(14.19±4.07)in the control group,respectively.After treatment,the score of HAMD-17 in both groups decreased,with statistical significance(P<0.01),and the effective rate of HAMD in the treatment group(79.3%)was significantly higher than that in the control group(25.8%),indicating that the improvement of depressive symptoms in the treatment group was more significant.5.Comparison of TCM syndrome scores before and after treatment:(27.31±2.94)and(10.8±3.5)in the treatment group and(27.26±3.25)and(19.9±3.74)in the control group,respectively.After treatments,the TCM syndrome scores in both groups were decreased,withstatistical significance(P<0.01).The effective rate of TCM syndrome scores in the treatment group(93.1%)was significantly higher than that in the control group(23.6%),indicating that the treatment group was more effective in improving the syndrome of Yin deficiency and internal heat.6.There is no obvious discomfort symptoms occurred in the two groups during the treatment.Conclusion:1.The combination of Baihe Dihuang Decoction and Alprazolam can shorten the sleeplatency of patients,improve the proportion of stable sleep,and reduce the proportion of unstable sleep and REM sleep;The two groups had similar effects in terms of total sleep time.2.The combined treatment of Baihe Dihuang Decoction and Alprazolam can better improve insomnia,relieve depressive symptoms,and regulate the syndrome of Yin deficiency and internal heat.3.Clinical studies show that Baihe Dihuang Decoction is safe and effective in the treatment of Yin deficiency and internal heat type insomnia combined with mild to moderate depression.