The Clinical Effect Of "The 1^st Snoring Prescription" On OSAHS With Qi Deficiency And Phlegm And Blood Stasis Syndrome And Its Effect On MIF And IL-18

Objective:To treat patients with obstructive sleep apnea hypopnea syndrome with Qi deficiency and phlegm and blood stasis syndrome by using Chinese medicine“1^stt snoring prescription（1^stt SP）”,by studying its effect on patients’AHI,LSpO₂,BMI,TCM syndrome score,comprehensive efficacy,and serum MIF and serum IL-18 levels,to verify the clinical efficacy of the side and explore its mechanism of action,provide a theoretical basis for clinical promotion.Methods:Sixty-eight patients who met the inclusion criteria were divided into a treatment group and a control group according to the principle of randomized control,with 34 cases in each group.The control group was given general treatment（cognitive intervention,diet,exercise guidance,smoking cessation,and side sleep as much as possible）,and the treatment group was given 1^stt SP combined with general treatment.After 12 weeks of treatment,the differences in the AHI,LSpO₂,BMI,TCM syndrome scores,serum MIF,and serum IL-18before and after treatment were compared between the two groups,and the correlation between the levels of MIF and IL-18 and AHI and LSpO₂ was analyzed.Results:（1）Comparison of the general data between the two groups of patients before treatment:gender,age,BMI,AHI,LSpO₂,TCM syndrome score,MIF,IL-18 were not statistically significant（P>0.05）.The two groups were comparable.（2）Apnea-hypopnea index（AHI）:There was no statistically significant difference in the control group before and after treatment（P>0.05）;There was a statistically significant difference in the treatment group before and after treatment（P<0.05）;The difference between the two groups before and after treatment,the treatment group improved significantly compared with the control group,the difference was statistically significant（P<0.05）.（3）lowest nocturnal oxygen saturation（LSpO₂）:There was no significant difference in the control group before and after treatment（P>0.05）;There was a statistically significant difference in the treatment group before and after treatment（P<0.05）;The difference between the two groups before and after treatment,the treatment group improved significantly compared with the control group,the difference was statistically significant（P<0.05）.（4）Body mass index（BMI）:There was no significant difference in the control group before and after treatment（P>0.05）;There was a statistically significant difference in the treatment group before and after treatment（P<0.05）;The difference between the two groups before and after treatment,the treatment group improved significantly compared with the control group,the difference was statistically significant（P<0.05）.（5）TCM syndrome score:There was no significant difference in the control group before and after treatment（P>0.05）;There was a significant difference in the treatment group before and after treatment（P<0.05）;The difference between the two groups before and after treatment,the treatment group improved significantly compared with the control group,the difference was statistically significant（P<0.05）.（6）Comprehensive evaluation of the efficacy of OSAHS:0 cases were cured in the control group,0 cases were markedly effective,5 cases were effective,29 cases were ineffective,the total effective rate was 14.71%;0 cases were cured in the treatment group,5cases were markedly effective,18 cases were effective,and 11 cases were ineffective,The total effective rate was 67.65%,the effective rate of the treatment group was higher than that of the control group,and the difference between the two groups was statistically significant（P<0.05）.（7）Macrophage migration inhibitory factor（MIF）:There was no significant difference in the control group before and after treatment（P>0.05）;There was a significant difference in the treatment group before and after treatment（P<0.05）;The difference between the two groups before and after treatment,the treatment group improved significantly compared with the control group,the difference was statistically significant（P<0.05）.（8）Interleukin-18（IL-18）:There was no significant difference in the control group before and after treatment（P>0.05）;There was a significant difference in the treatment group before and after treatment（P<0.05）;The difference between the two groups before and after treatment,the treatment group improved significantly compared with the control group,the difference was statistically significant（P<0.05）.（9）Correlation analysis:Serum MIF was positively correlated with AHI（r=0.643,P=0.000）,and was negatively correlated with LSpO₂（r=-0.541,P=0.000）;serum IL-18 was positively correlated with AHI（r=0.557,P=0.000）,and was negatively correlated with LSpO₂（r=-0.579,P=0.000）;serum MIF was positively correlated with IL-18（r=0.413,P=0.000）.Conclusion:（1）The 1^stt snoring prescription has a positive effect on improving polysomnography indexes（AHI,LSpO₂）,BMI,and TCM syndrome scores in patients with OSAHS syndrome of qi deficiency and phlegm and blood stasis.（2）The 1^stt snoring prescription can reduce the serum MIF and serum IL-18 levels in patients with OSAHS syndrome of qi deficiency and phlegm and blood stasis,which may be related to the improvement of inflammation caused by OSAHS.