Clinical Efficacy Observation Of Jianzhong Zhihan Decoction Combined With CPAP In Treatment Of Obesity-type OSA Patients With Phlegm And Blood Stasis Syndrome

Objective:This study was conducted to observe the clinical efficacy of Jianzhong Zhihan Decoction combined with CPAP in the treatment of obesity-type obstructive sleep apnea（OSA）patients with phlegm and blood stasis syndrome.To explore the clinical significance of the treatment of obese OSA patients with phlegm and blood stasis syndrome from the perspective of integrated traditional Chinese and western medicine and to promote its application.Methods:In this study,a randomized case-control design was adopted.A total of90 obese patients OSA patients who were diagnosed with Gansu Sleep Medicine Center from January 2020 to January 2021,and were dialectically diagnosed as phlegm and blood stasis mutual syndrome by Chinese medicine.they were randomly divided into test group and control group with 45 patients in each group.The control group was given continuous positive airway pressure（CPAP）combined with basic treatment（diet management,exercise education）,and the test group took the Jian zhong Zhihan granules on the basis of the treatment method of the control group.To observe the two groups of patients before and after treatment with obesity indicators（body weight,BMI,waist circumference）,PSG parameters[the lowest oxygen saturation（LSaO₂）,apnea hypoventilation index（AHI）,micro-arousal index（MAI）and oxygen reduction index（ODI）],lipid metabolism index（TC,TG,HDL-C,HDL-C）,ESS sleepiness scale scores and the change of TCM syndrome integral.Results:Obesity indicators:The obesity indicators in both groups were significantly decreased before and after treatment,and the obesity indicators in the test group were more decreased than those in the control group,the differences were statistically significant（P<0.05）.（2）PSG parameters:intra-group comparison of PSG parameters between two groups before and after treatment showed that the AHI,OAI and MAI were significantly decreased,while LSp O₂was significantly increased,the differences were statistically significant（P<0.01）.Compared with the control group,AHI and OAI in the test group decreased to a greater extent and LSp O₂increased to a higher degree（P<0.05）,while there was no statistical significance in MAI（P>0.05）.（3）Blood lipid metabolism indexs:Comparing the blood lipid metabolism index of the two groups of patients before and after treatment,TC,TG,LDL-C were significantly decreased,while HDL-C were significantly increased,the differences were statistically significant（P<0.01）.The TC and TG in the test group down degree is more obvious compared with control group,and HDL-C increased higher（P<0.05）,there was no statistically significant difference of LDL-C（P>0.05）.（4）ESS score:The ESS score was significantly lower in both groups before and after treatment（P<0.01）,while the decrease in the test group was significantly higher than that in the control group（P<0.01）.（5）Total TCM syndrome score:Comparing the total TCM syndrome scores of the two groups of patients before and after treatment,the total TCM syndrome scores were significantly reduced（P<0.01）,and the total TCM syndrome scores of the patients in the test group decreased more significantly（P<0.05）.（6）Single-item TCM syndrome scores:Comparison of single item TCM syndrome scores in the control group showed no statistically significant difference in stuffy feeling in chest scores（P>0.05）,the other single TCM syndrome scores were statistically significant（P<0.01）.The scores of TCM syndromes of each single item in the test group were statistically significant（P<0.01）.Comparison between the two groups after treatmen,there was no statistically significant difference in the scores of snoring and holding back in sleep between the two groups（P>0.05）,and the other single TCM syndrome scores were statistically significant（P<0.05）.（7）The total effective rate of control group（71.11%）was significantly lower than that of test group（88.89%）,and the difference was statistically significant（P<0.05）.（8）In this study,no obvious adverse reactions occurred,and it is safe and reliable.Conclusion:The Jianzhong Zhihan Decoction combined with CPAP can improve obesity indicators（weight,BMI,waist circumference）,PSG parameters（LSaO₂,AHI,MAI and ODI）,lipid metabolism index（TC,TG,HDL-C,HDL-C）,ESS scores and TCM syndrome integral scores in obese OSA patients with phlegm and blood stasis syndrome is better than that in control group,and safe,no adverse side effects,can improve the patient’s quality of life,is worth popularization in clinical.