The Clinical Research Of Insomnia Treated By HuangLianEJiao Formula

There are more and more sleeping disorders with the increasing level of modernization, the quicken pace of life, more night life and the increasing psychological pressure. Insomnia is a common kind of sleeping disorder. Insonmia is a disease of which people can not get enough sleep as the normal one usually do and it means inadequeate or poor-quality sleep, which is characterized by insufficiency of sleep time and sleep depth in order to refresh from tiredness. It will disturb the normal life and work because of sleep insufficiency or poor-quanlity sleep. Therefore the clinical targets of treating insomnia are:(1)relieve symptoms:in order to shorten the sleep latency, decreasing the times of getting up, extending the sleeping time; (2)keep the normal sleep structure; (3)recover the social funtions and improve the quanlity of life. Based on the current research, the healing efficacy of treating insomnia by HuangLianEJiao formula will be evaluated objectively through studing literatures. A new idea will be supported for solving the complicated sleeping problem by the priority of TCM.Part one Literature Research1. This paper summarized the name, pathogenesis, treatment of insomnia in TCM and modern traditional Chinese medical physician's achievements of research on CHB in clinic. It alao summed up the domestic and foreign scholars's progress on the epidemiology, etio-logy, pathology, pathogenesis, diagnosis and treatment, and the research trend and direction of insomnia, in our country or abroad now. There are a lot of relevant factors which lead to insomnia. Suspectible factors such as personality, sexualtiy, age and genetic factor are one hand. The external special factors for example quanlity of life, human relationship, sleep environment and so on are the other hand.2. Through the theory of Seasonal Febrile Disease, we put forward the view of "thermalization in ShaoYin meridian". Replenishing the vital essence and removing heat is the main treatment for insomnia.Part two clinical and experimental research 1. Objective:1)Investigate the types of insomnia and the time distribution of sleep disorder.2)Compare the diurnal residual effects among four different syndrome types.3) The correlation between syndrome types and course of disease.4)Clinical study of treating insomnia by HuangLianEJiao Formula and to find out the change of subjective sleep quality.5)The correlations of course of insomnia and healing efficacy. Compared with the reductive ratio of PSQI after the same period of treatment in order to explore the correlations of course of disease and healing efficacy.2. Methods:112 patients who comply with a standard of CCMD-3 are collected. On the basis of the syndrome classification from the Chinese Internal Medicine, they have been divided in to 4 groups such as liver fire harassing the heart, hearts dis-turbed by phlegmy, insufficiency of heart and spleen, imbalance between heart-yang and kidney-yin. All patients are treated by HuangLianEJiao formula as a basic formula,4 weeks for a period of treatment,2 course of treatment as usual. Patients should be evaluated and reevaluated before, after 4 weeks'treatment and at the end of the course of treatment by PSQI.3. Results:1)There are 25 patients have problems of falling asleep and the proportion in all insomnia patients is 22.32%.61.61% insomnia patients have problems in maintenance stage and the rest of patients are in premature awake. It is showed that sleep disorder in maintenance stage has the higher proportion than the other two.2) Over 80% insomnia patients have doldrums and tiredness. Therefore doldrums and tiredness are the main symptoms of the diurnal residual effects(serious in the morning).3) The proportion of TCM syndrome type "imbalance between heart-yang and kidney-yin" is considered as the largest parts of insomnia patients. Patients in heart-kidney imbalance have the longest disease processes and the difference has statistical significance compared with other three syndrome types.4)The differences in sleep time and function of daytime have the statistical significance between syndrome type "imbalance between heart-yang and kidney-yin" and the other three.5)The points of PSQI have fallen and they have obvious difference before and after treatment separately. But we get the lowest effective rate in syndrome type "imbalance between heart-yang and kidney-yin".6)Patients in syndrome type "imbalance between heart-yang and kidney-yin" have longer sleep latency, lower sleep efficiency and shorter sleep time which have statisitcal significance compare with the other three syndrome types.4. Conclusion:1)There are highest proportion in sleep maintenance stage of insomnia. It's said that most patients have sleep maintenance difficults and they are related to diurnal residual effects (serious in the morning).2)The insomnia is most related to the TCM syndrome type "imbalance between heart-yang and kidney-yin". It's discovered that the course of disease in syndrome types liver fire harassing the heart, hearts dis-turbed by phlegmy, insufficiency of heart and spleen increase in file. And the course of disease in heart-kidney imbalance is the longest. Therefore, insomnia has a process which is sthenia transforming into asthenia. 3)Patients treated by HuangLianEJjiao formula as a basic one make progress in sleep quality but differentiate to some extent in effective rate. There are higher effective rate in treating insomnia in sthenic syndrome than in asthenia syndrome.