| Objective:What we discuss in this article is an national natural science research which is based on traditional Chinese medical science-Liver Stores Blood and Blood Homes Soul, and this is a branch of the biological basis of insomnia.These years, the connection of liver disease and sleeping disturbance has been widely accepted by the Medical community, but the clinical feature and biomedical principles are still on research. So we should learn the clinical feature of different kinds of sleeping disturbance and its physiological and pathological changes under the guidance of the traditional Chinses medical science. In this article we only study the clinical features of the chronic hepatitis patients who also has problem with sleeping, and the effect of Wild Jujube Seed Decoction DecoctionResearch Methods:1. Study selected Chronic hepatitis B liver blood deficiency associated with sleep disorders were130cases, meet the standard of guiding principles of Traditional Chinese Drug treatment of insomnia in clinical trials, the Chinese Medical Association of Infectious Diseases and Institute of Parasitic Diseases Branch Institute of Liver Diseases Branch jointly revised diagnostic criteria of chronic hepatitis patients and TCM is the heart and liver blood deficiency. By professional Chinese medicine outpatient asked fill their sleep status of the investigation records, fill in the Pittsburgh Sleep Quality Index Scale (PSQI), anxiety, self-assessment Scale (SAS), depression self-rating scale screening meet the inclusion criteria ofcases. Relevant examination (catecholamines, epinephrine and then with the patient informed consent, to norepinephrine, dopamine, ABO blood type, etc.) to observe the clinical features of sleep disorders in patients with chronic hepatitis B (liver blood stasis type).2. Met the inclusion criteria were randomly divided into treatment group (Semen Soup treatment group), the western medicine group (estazolam treatment group) and65cases of the two treatment groups age, gender, disease duration, the Pittsburgh Sleep Quality Index Scale (PSQI), anxiety and self-assessment scale (SAS) score, self-rating depression scale (SDS) score, the score was no significant difference, the two groups were comparable (P>0.05). The two treatment groups were given Suanzaoren soup and estazolam treatment, require the patient during the regular follow, before and after treatment were observed and recorded the first clinical symptoms, the score of Pi ttsburgh Sleep Qual ity Index Index (PSQI), Self-Rating Anxiety Scale (SAS the) score, the score of the self-Rating Depression scale (SDS), and children tea neurotransmitter checks. Re-assessment after the end of treatment in patients with sleep disorders characteristics, and again checks were compared with those before treatment. 3. After4weeks of treatment, adverse reactions observed to make a safety evaluation. Observation and treatment after treatment withdrawal one week, two groups of patients after the discontinuation of the observed occurrence of rebound insomnia.Results:1.Clinical features of chronic hepatitis B (liver blood deficiency type) with a sleep disorderThe distribution of patients with chronic hepatitis B (liver blood deficiency type) associated with sleep disorders sleep differences, difficult to sleep type, and more and more dreams, waking type, a sleep interrupted night insomnia type is relatively small.130cases observed object, the more women than men, while the gender distribution in the different types of sleep disorders also different, more difficult to fall asleep and multi-dream type of women wake up early-type, intermittent type of sleep all night insomnia type more men than women. Each type of sleep disorder patients there are significant differences in the age composition of adolescent patients, it is difficult to fall asleep, more than a dream of the high incidence of middle-aged patients with difficult to fall asleep, more than a dream, the high incidence of night insomnia. Chronic hepatitis B (liver blood deficiency type) with s leep disorders in patients with ABO blood distribution differences between each type of sleep disorder, blood type0are mainly distributed in more than a dream type; Type A blood are mainly distributed in more than a dream-type and difficult to sleep type B blood type is mainly distributed in hard to sleep type; AB blood type is mainly distributed in the night insomnia type. Through the the PSQI points of different type of sleep disorder patients, SAS points SDS integral analysis, found that patients with each type of sleep disorder in PSQI points, SAS Points by SDS points were higher than night insomnia the PSQI points, SDS points are the other four types of sleep disorders; night insomnia type and difficult to fall asleep-SAS integral was significantly higher than the other three type of sleep disorder.2. Wild Jujube Seed Decoction Clinical observation:Clinical application of Wild Jujube Seed Decoction treatment of chronic hepatitis B (liver blood Stasis type) associated with sleep disorders, compared with western medicine Estazolam, after a course of treatment (4weeks) after treatment Wild Jujube Seed Decoction treatment group,65cases of complete remission Example6, effective in cases of17and25valid cases, invalid cases17, the total efficiency of73.83%; Estazolam treatment group complete remission cases8, effective in cases of11,21effective cases, invalid cases25, the total efficiency of61.54%. The two groups by statistical analysis Semen Soup group with Estazolam group, the total efficiency difference was statistically significant (P <0.05), indicating that Semen Treatment of Chronic Hepatitis B (liver blood Stasis type) associated with sleep disorders clinical The total effective than Estazolam.3. Clinical symptom score changesComparison shows that the ratings of the two treatment groups the PSQI various factors, the two drugs are the factors of sleep disorders has improved role in reducing sleep time, longer sleep time, sleep disorders and daytime function, and have a better effect. The two treatment groups compared to Western medicine pharmacodynamics of Estazolam than the traditional Chinese medicine Wild Jujube Seed Decoction rapid onset of action after a course of treatment (4weeks) after treatment, the Chinese Medicines Board in improving sleep efficiency, reduce hypnotic drug applications and to improve patients increasingly functions to improve than western medicine group is more significant, indicating that Chinese medicine efficacy better than Western medicine Estazolam. In addition, through the Self-Rating Depression Scale (SDS) scores on anxiety and Self-Assessment Acale (SAS) score before and after treatment, compared Wild Jujube Seed Decoction anxiolytic, antidepressant, was superior to Estazolam.4. Neurotransmitter changes before and after treatmentThis study showed that chronic hepatitis B (liver blood deficiency type) with sleep disorders in patients with pre-treatment serum catecholamine, norepinephrine, and dopamine were higher than normal control group, the difference was statistically significant (P<0.05), after a course of treatment (4weeks) after treatment, the treatment group (Semen soup group) and group B (estazolam group) in serum catecholamines, dopamine than before treatment decreased, but still higher than normal. Wild Jujube Seed Decoction group Estazolam group, the former decreased more obvious difference was statistically significant (P<0.05). No significant changes in epinephrine, norepinephrine before and after treatment.5.The safety, adverse reactions and rebound analysisAdverse drug reactions, the adverse effects of Wild Jujube Seed Decoction group was significantly less than the WM group (P<0.05). To observe changes in the withdrawal two weeks after the total score of PSQI scores medication rebound situation, the results showed that Wild Jujube Seed Decoction two cases of rebound insomnia, and its occurrence rate of3.08%; Estazolam group of eight cases rebound insomnia, the rate was12.31%. Two groups the differences were statistically significant (P<0.05).Conclusion:In this study,130cases of chronic hepatitis B (liver blood Stasis type) in patients with sleep disorders, clinical observations, age, gender, ABO blood group points of PSQI, SAS Points and SDS points in the distribution of the type of sleep disorder, there are differences.Wild Jujube Seed Decoction with sleep disorders in the treatment of chronic hepatitis B (liver blood Stasis type) total efficiency is superior to Estazolam, mainly to improve sleep efficiency, reduce the application of hypnotic drugs, and improve patients’daytime function. Another Wild Jujube Seed Decoction anxiolytic, antidepressant effects than Western medicine Estazolam.Wild Jujube Seed Decoction is mainly reflected the impact of catecholamines in patients with catecholamine in the serum of patients, decreased levels of dopamine, adrenaline, noradrenaline had no obvious effect. |
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