| Objective:To study the treatment of insomnia with liver depression and spleen deficiency by integrated psychotherapy combined with Xiaoyao Powder,and to explore the feasibility and superiority of integrated psychotherapy combined with internal treatment of traditional Chinese medicine through the determination of various scales,so as to provide more theoretical and clinical basis for its treatment of insomnia with liver depression and spleen deficiency,thus providing new ideas and programs for clinical treatment of sleep disorders.Methods:From June 2022 to February 2023,90 insomniacs with liver depression and spleen deficiency in the outpatient department of the Third Affiliated Hospital of Beijing University of Chinese Medicine,aged between 18 and 70,were collected,with 30 cases in each group and randomly divided into three groups,namely,combined treatment group,traditional Chinese medicine control group and psychological control group.The Chinese medicine control group was treated with modified Xiaoyao Powder,the psychological control group was intervened by integrated psychotherapy,and the combined treatment group was combined with the two control groups.At the time of enrollment and the 6th week of treatment,the subjects were assessed by PSQI,the awakening degree and invasive cognition were assessed by HAS scale and Glasgow thinking content questionnaire,the emotional state was assessed by SAS and SDS,and the symptoms of TCM were collected for TCM syndrome score assessment.After 6 weeks of intervention,the main efficacy indicators(PSQI,TCM syndrome score)and secondary efficacy indicators(HAS,GCTI,SAS,SDS)were compared among the three groups.Summarize and statistically analyze the above data and materials.Results:1.Case completion:A total of 90 patients were included in this study,of which 84 were actually completed and 6 fell off,with a completion rate of 93.33%.In the combined treatment group,29 cases completed and 1 case fell off,with a completion rate of 96.67%.In the psychological control group,27 cases completed,3 cases fell off,the completion rate was 90.00%;In the traditional Chinese medicine control group,28 cases completed and 2 cases shed,with a completion rate of 93.33%.2.Comparison analysis:Before treatment,there was no significant difference in age,gender,course of disease and educational level among the three groups(P>0.05),indicating comparability;Before treatment,there was no significant difference in baseline data of all observation indicators among the three groups(P>0.05),indicating comparability.3.Efficacy evaluation:(1)Overall clinical efficacy evaluation:the effective rate of the combined treatment group was 96.55%;The effective rate of the control group was 89.92%.The effective rate of the psychological control group was 88.89%,and the total curative effect of the three groups was significantly different(P<0.05),and the difference between the combined treatment group and the psychological control group was statistically significant(P<0.01).The difference between the combined treatment group and the control group was statistically significant(P<0.05).There was no significant difference between psychological control group and traditional Chinese medicine control group(P>0.05).The total effective rate of the combined treatment group was higher than that of the psychological control group and the traditional Chinese medicine control group.(2)Pittsburgh Sleep Quality Index(PSQI)evaluation:From the aspect of PSQI total score analysis,before and after treatment,there were significant differences in the total score of PSQI between the three groups(P<0.01),after treatment,there were significant differences between the total score of PSQI between the three groups(P<0.01),and there were statistically significant differences between the combined treatment group and the psychological control group(P<0.01).The difference between the combined treatment group and the control group was statistically significant(P<0.01).There was no significant difference between the psychological control group and the traditional Chinese medicine control group(P>0.05).From the PSQI effect analysis,the effective rate of the combined treatment group was 96.6%;The effective rate of psychological control group was 92.6%;The effective rate of the traditional Chinese medicine control group was 89.3%,and the comparison of PSQI efficacy among the three groups showed significant difference(P<0.05),and the pairwise comparison difference among the groups was the result of PSQI total score comparison.From the aspect of PSQI score analysis,the mean of PSQI score of the three groups after treatment was decreased compared with that before treatment,and PSQI score of the three groups before and after treatment had significant differences(P<0.05).The comparison of the score of the three groups after treatment,the four items of sleep quality,sleep time,sleep efficiency and sleep disorder,There were significant differences in scores among the three groups after treatment(P<0.05),but there were no significant differences in scores of sleep time and daytime dysfunction among the three groups after treatment(P>0.05).①Sleep quality:the combined treatment group was better than the psychological control group in improving sleep quality;② Time to fall asleep:the combined treatment group was better than the control group in shortening the time to fall asleep;③Sleep efficiency:The combined treatment group was better than the control group in improving sleep efficiency;④Sleep disorders:the combined treatment group was better than the traditional Chinese medicine control group in relieving insomnia disorders.(3)TCM syndrome evaluation:From the aspect of TCM syndrome score analysis,before and after treatment,there were significant differences in TCM syndrome score among the three groups(P<0.01);after treatment,there were significant differences in TCM syndrome score among the three groups(P<0.01);there were statistically significant differences between the combined treatment group and the psychological control group(P<0.01);There was no significant difference between the combined treatment group and the control group(P>0.05).The difference between psychological control group and traditional Chinese medicine control group was statistically significant(P<0.01).From the analysis of the curative effect of TCM syndrome,the effective rate of the combined treatment group was 96.6%;The effective rate of the control group was 96.4%.The effective rate of psychological control group was 81.5%,and there was also significant difference in TCM syndrome efficacy among the three groups(P<0.05).The difference was compared with the TCM syndrome score.(4)Glasgow Thinking Content Questionnaire(GCTI)evaluation:before and after treatment,there were significant differences in GCTI scores between the three groups(P<0.01);after treatment,there were significant differences between the three groups(P<0.01);there was no significant difference between the combined treatment group and the psychological control group(P>0.05);The difference between the combined treatment group and the control group was statistically significant(P<0.05).The difference between psychological control group and traditional Chinese medicine control group was statistically significant(P<0.05).(5)Evaluation of Hyperarousal Scale(HAS):Before and after treatment,there were significant differences in HAS scores among the three groups(P<0.01);after treatment,there were significant differences in HAS scores among the three groups(P<0.01);there were no significant differences between the combined treatment group and the psychological control group(P>0.05);The difference between the combined treatment group and the control group was statistically significant(P<0.01).The difference between psychological control group and traditional Chinese medicine control group was statistically significant(P<0.01).(6)Self-rating Anxiety Scale(SAS)evaluation:Before and after treatment,there were significant differences in SAS scores among the three groups(P<0.01);after treatment,there were significant differences in SAS scores among the three groups(P<0.01);there were statistically significant differences between the combined treatment group and the psychological control group(P<0.01);There was no significant difference between the combined treatment group and the control group(P>0.05).The difference between psychological control group and traditional Chinese medicine control group was statistically significant(P<0.01).(7)Self-rating Depression Scale(SDS)evaluation:Before and after treatment,there were significant differences in SDS scores among the three groups(P<0.01),but no significant differences in SDS scores among the three groups after treatment(P>0.05).Conclusion:1.Integrated psychotherapy combined with Xiaoyao SAN addition and reduction,single application of Xiaoyao SAN addition and reduction,and single application of integrated psychotherapy can effectively treat insomnia of liver depression and spleen deficiency type,and can reduce PSQI total score,PSQI factor score,TCM syndrome score,Glasgow thinking content questionnaire score,HAS score,SAS score and SDS score.And good security.2.Improvement of sleep condition:in terms of total efficacy and PSQI score,the combined treatment group had significant advantages compared with the traditional Chinese medicine control group and the psychological control group;In PSQI scores,①sleep quality:the combined treatment group was better than the psychological control group in improving sleep quality;②Time to fall asleep:the combined treatment group was better than the control group in shortening the time to fall asleep;③Sleep efficiency:The combined treatment group was better than the control group in improving sleep efficiency;④Sleep disorders:the combined treatment group was better than the traditional Chinese medicine control group in relieving insomnia disorders.3.Improvement of TCM symptoms of liver depression and spleen deficiency:the combined treatment group and the traditional Chinese medicine control group had better effects on the improvement of TCM syndrome related to patients with liver depression and spleen deficiency type insomnia than the psychological control group,and the combined treatment group had the most significant effect.4.Improvement of mood:In terms of SAS score,the combined treatment group and the traditional Chinese medicine control group had better effect on the improvement of anxiety than the psychological control group;In terms of SDS score,there was no significant difference in the improvement of depressive mood among the three groups.5.Improvement in other aspects:in terms of GCTI score,the combined treatment group and the psychological control group were better than the traditional Chinese medicine control group in improving excessive invasive cognition and shortening sleep latency;In terms of HAS score,the combination treatment group and the psychological control group were better than the traditional Chinese medicine control group in improving the state of hyperarousal and the degree of cortical arousal. |
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