Clinical Study Of Rouganjiaoxin Recipe Combined With Cognitive Behavioral Therapy In The Treatment Of Insomnia

ObjectiveEvaluate the clinical efficacy of Rougan Jiaoxin formula combined with cognitive behavioral therapy,and to explore a comprehensive and effective clinical intervention plan for the treatment of insomnia.MethodsA total of 48 patients with insomnia of Xinganxuexu and Xinhuoshangrao type were selected from the outpatient department of Dongformula Hospital of Beijing University of Chinese Medicine from July 2019 to December 2020.The random number table was used to divide them into two groups,24 cases in the TCM group and 24 cases in the comprehensive treatment group.The TCM group was treated with Rougan Jiaoxin formula granules,and the comprehensive treatment group was treated with Rougan Jiaoxin formula+cognitive behavior therapy.All the subjects were followed up once a week.The dosage of Rougan Jiaoxin formula granules was distributed for 1 week each time,the cognitive behavioral therapy was performed once a week,and the two groups were both treated for 4 weeks continuously.At the time of enrollment and 4 weeks after treatment,the subjects were evaluated by the PSQI for sleep quality,and the HAMA and HAMD for anxiety and depression evaluation,and by collectting the TCM symptoms(main symptoms,concurrent symptoms,tongue conditions,and pulse conditions,etc.)for TCM syndrome score evaluation.After 4 weeks of intervention,the primary efficacy indexes(PSQI)and the secondary efficacy indexes(HAMA,HAMD,TCM syndrome scores)of the subjects within and between the two groups were compared.P<0.05 was considered statistically significant.Results(1)Sleep quality improvement:comparing within the group,after 4 weeks of treatment,the total score of PSQI and the scores of sleep quality,time to fall asleep,sleep time,sleep efficiency,sleep disorder and daytime dysfunction in TCM group were lower than those before treatment(P<0.05),and the score of hypnotic drugs were also lower than that before treatment,but the difference was not statistically significant(P>0.05);the total score of PSQI and the scores of sleep quality,time to fall asleep,sleep time,sleep efficiency,sleep disorder,hypnotic drugs and daytime dysfunction in the comprehensive treatment group were lower than those before treatment,and the differences were statistically significant(P<0.05).Comparing between groups,after 4 weeks of treatment,the sleep efficiency score of the comprehensive treatment group was significantly lower than that of the TCM group(P<0.05).In the total score of PSQI and other sub scores,the comprehensive treatment group was lower than the TCM group,but the differences were not statistically significant(P>0.05).The total effective rate of the TCM group was 81.8%,and the comprehensive treatment group was 90.5%,but there was no significant difference between the two groups(P>0.05);the PSQI score reduction rate of the comprehensive treatment group was significantly higher than that of the TCM group,and the difference was statistically significant(P<0.01);In patients with chronic insomnia,the PSQI score reduction rate of the comprehensive treatment group was significantly higher than that of the TCM group,and the difference was statistically significant(P<0.01).(2)Emotional state assessment:after 4 weeks of treatment,the scores of HAMA and HAMD in the TCM group and the comprehensive treatment group were both lower than those before treatment,and the differences were statistically significant(P<0.05).The scores of HAMA and HAMD in the comprehensive treatment group were lower than those in the TCM group,but there was no significant difference between the two groups(P>0.05).(3)TCM syndrome score:after 4 weeks of treatment,the total score of TCM syndromes,main symptom score,forgetfulness,irritability,thirst and drinking,bitter mouth,yellow urine and concurrent symptoms scores in the TCM group were both lower than those before treatment,the differences were statistically significant(P<0.05);the total score of TCM syndrome,main symptom score,forgetfulness,dizziness,irritability,thirst and drinking,bitter mouth,yellow urine and concurrent symptoms scores in the comprehensive treatment group were lower than before treatment,and the differences were statistically significant(P<0.05).There was no significant difference between the two groups in the total score of TCM syndrome and other scores(P>0.05).ConclusionRougan Jiaoxin formula can effectively improve the sleep conditions and related TCM symptoms of patients with Xinganxuexu Xinhuoshangrao type of insomnia.It also has a certain improvement effect on bad moods such as anxiety and depression,so it is worthy of clinical promotion;the comprehensive treatment plan combining Rougan Jiaoxin formula and cognitive behavior therapy has more obvious effect on improving the sleep condition of patients.Especially for chronic insomnia patients and in improving the sleep efficiency,the comprehensive treatment plan may be more suitable for promotion.