| Objective:To explore the efficacy of Chinese medicine in the clinical treatment of chronic insomnia in the elderly(kidney deficiency and blood stasis type)by observing the changes in Chinese medicine symptoms,Pittsburgh Sleep Quality Index(PSQI)scores and Fatigue Scale(FAS)scores,and the effects on patients’ serum TNF-a,IL-6and 5-HT levels based on the method of tonifying the kidney and invigorating blood,with a view to providing new ideas for the clinical treatment of chronic insomnia in the elderly.Methods: A total of 60 elderly patients with chronic insomnia of the kidney deficiency and blood stasis type were collected from the outpatient clinic of the Department of Encephalopathy of our hospital,and were divided into a treatment group and a control group by the simple ranking randomization method.30 patients were included in each group.The treatment group was given the formula of tonifying the kidney and invigorating blood twice in the morning and twice in the evening,while the control group was given the western drug eszopiclone for 6 weeks.The changes in TCM symptoms,PSQI score and FAS score of the subjects in both groups were observed and recorded before and after treatment and during treatment,and the changes in serum TNF-a,IL-6 and 5-HT levels were detected.Statistical and analysis of the differences in efficacy between the two groups.Results:1.Comparison of basic information: statistical tests were conducted on the gender,age and duration of disease of the patients included in the study.The result showed no difference in the basic information of the three groups of patients(P>0.05),which was comparable.2.Clinical efficacy comparison: The overall effective rate of the treatment group was 96.67% and that of the control group was 82.76%,with a statistical difference between the two groups(P < 0.05),suggesting that the efficacy of the treatment group was better than that of the control group.3.PSQI,FAS and total TCM syndrome score comparison: PSQI,FAS score and TCM syndrome score improved in both groups after the third week and sixth week of treatment compared to the pre-treatment period(P < 0.05);the treatment group was better than the control group in terms of TCM syndrome score at the third week of treatment(P < 0.05),but there was no difference in PSQI and FAS score(P > 0.05);and at the sixth week of treatment The treatment group outperformed the control group in terms of improvement in PSQI,FAS scores and TCM symptom score scores(P < 0.05).4.The comparison of inflammatory factors and 5-HT: The serum TNF-a and IL-6levels decreased and 5-HT levels increased in both groups after the third and sixth weeks of treatment(P<0.05);the treatment group was better than the control group in reducing TNF-a and IL-6 levels and increasing 5-HT levels in the third and sixth weeks of treatment(P<0.05).5.Evaluation of safety: During the treatment period,no adverse reactions such as liver and kidney damage occurred in both groups,and no abnormalities were found in the three major routine tests such as blood,urine,faeces and electrocardiogram.Conclusion:1.the formula of tonifying the kidney and invigorating blood reduced the TCM symptoms and PSQI and FAS scores of elderly patients with chronic insomnia(kidney deficiency and blood stasis type),and improved the sleep and quality of life of elderly patients,with significant clinical efficacy.2.Nourishing the kidney and invigorating the blood can reduce both serum TNF-a and IL-6 levels and increase 5-HT levels,and its mechanism of action in treating insomnia may be related to the intervention of inflammatory factors and 5-HT in elderly patients with insomnia(kidney deficiency and blood stasis type).3.The clinical treatment of elderly patients with insomnia(kidney deficiency and blood stasis)with the formula of tonifying the kidney and invigorating the blood did not cause any adverse effects,which is safe and reliable for clinical use and worthy of further promotion and application. |
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