The Effect Of Dyssomnia Via Shugan Jianpi Method Treated For Patients With Chronic Kidney Disease At Stage 3-4

Objective: To explore the effect of Dyssomnia after Shugan Jianpi method treated for Chronic Kidney Disease(CKD)at stage 3-4.Methods:A total of 60 patients from the outpatients or inpatients of the First Affiliated Hospital to Guangxi Traditional Chinese Medicine University from December 2017 to October 2018 accord with western medicine diagnostic standard of Dyssomnia and CKD at stage 3-4,and diagnosed with liver-depression and spleen-deficiency syndrome by Chinese differentiation,were chosen to be randomly divided into control group with 30 patients and treatment group with 30 patients by random number table.The control group was given the basic treatment of Western medicine plus Chinese patent medicine and estazolam,the treatment group was given Shugan Jianpi herbal medicine prescription on the basis of the basic treatment of Western medicine and Chinese patent medicine,the observation time was 4 weeks.All the information of patients were collected before entering the group,including the name,gender,age,primary chronic kidney disease,the course of Dyssomnia and other basic information.Instructing patients to fill in the Pittsburgh Sleep Quality Index(PSQI)and TCM Syndromes Lists(TSL),and comparing scores of before and after treatment.Collection and comparation of data before and after treatment of serum creatinine(Scr),urea nitrogen(BUN),glomerular filtration rate(eGFR).At the end of the study,the scores of PSQI and TSL,the changes of Scr,BUN and eGFR indexes before and after treatment were sorted out and analyzed statistically.And evaluate the efficacy of sleep quality,TCM syndrome and disease curative effect.Results:(1)Comparison of sleep quality: The treatment group and control group in the total score of PSQI,and the factor score of sleep quality,sleep duration,sleep latency,sleep efficiency,sleep disorder,daytime dysfunction,used sleep medication before and after treatment was significantly different(P<0.05),and the total effective rate of the treatment group is 90%,and 83.3% of control group(P>0.05).It shows that the corresponding treatment of the two groups can significantly improve the overall sleep situation and sleep quality,sleep duration,sleep latency,sleep efficiency,sleep disorder,daytime dysfunction,used sleep medication of the patients with CKD at stage 3-4 and liver-depression and spleen-deficiency symptoms.The two groups after treatment in the factor score of sleep efficiency and daytime dysfunction has significant difference(P<0.05),but the total score of PSQI and the others factor score were no significant difference between two groups(P>0.05).Indicating that the curative effect of the treatment group was better than that of the control group in improving sleep efficiency and daytime dysfunction of the patients with CKD at stage 3-4 and liver-depression and spleen-deficiency symptoms,and the corresponding treatment of the two groups had the same effect on improving the sleep problem of sleep quality,sleep duration,sleep latency,sleep disorder,used sleep medication.(2)Comparison of the curative effect of TCM Syndrome:There was no significant difference in TCM syndromes score before and after treatment in the control group(P>0.05),and there was statistical significance in TCM syndromes score before and after treatment in the treatment group(P<0.05).The two groups after treatment in TCM Syndrome has significant difference(P<0.05).The effective rates of the treatment group and the control group were 90.0% and 26.7% respectively,and the two groups were statistically significant(P<0.05).It shows that the method of Shugan Jianpi has a significant effect on improving syndromes of the patients with CKD at stage 3-4 and liver-depression and spleen-deficiency symptoms,while the method of treatment in the control group has no significant effect on improving TCM syndromes of the patients with CKD at stage 3-4 and liver-depression and spleen-deficiency symptoms.(3)Comparison of the curative effect of disease: There was no significant difference in Scr,BUN,eGFR before and after treatment in two groups(P>0.05),while the two groups were no significant difference after treatment(P>0.05).The effective rates of the treatment group and the control group were 30.0% and 16.7% respectively,and the two groups were no significant difference(P>0.05).The results showed that the corresponding treatments in 4 weeks of the two groups had no significant effect on Scr,eGFR and BUN of the patients with CKD at stage 3-4 and liver-depression and spleen-deficiency symptoms.Conclusion:1.The method of Shugan Jianpi treat for CKD at stage 3-4 with Dyssomnia can significantly improve the sleep quality,and its effect is similar to that of estazolam,and its curative effect is more effective than estazolam in the aspect of sleep disorder and daytime dysfunction;2.the method of Shugan Jianpi has a significant effect on symptoms of liver-depression and spleen-deficiency with the Dyssomnia and CKD at stage 3-4;3.Among the four-week treatment,The method of Shugan Jianpi treat for CKD at stage 3-4 with Dyssomnia had no significant effect on Scr,eGFR and BUN.