清热化痰法治疗急性脑梗死后睡眠障碍的临床研究

目的 探讨清热化痰法治疗痰热上扰型急性脑梗死后睡眠障碍患者的临床疗效及其多导睡眠图的特点。方法 将144例痰热上扰型急性脑梗死后睡眠障碍患者随机分为中药组和西药组，每组72例。中药组服用黄连温胆汤，西药组服用佐匹克隆，采用《急性脑梗死后睡眠障碍中医证候评定表》和《匹兹堡睡眠质量指数量表》对观察指标评定，并对因子进行分析，同时进行多导睡眠监测，在治疗前、治疗结束后各进行1次测评。结果 两组患者治疗后睡眠质量指数积分、中医证候积分、多导睡眠参数均较治疗前改善，差异有统计学意义（P<0.05），且中药组中医证候积分改善明显（P<0.01），提示中药组治疗效果优于西药组。结论 黄连温胆汤可显著改善痰热内扰型急性脑梗死后睡眠障碍患者睡眠质量，疗效确切，不良反应发生率低。

Clinical Study on Clearing Heat and Resolving Phlegm Method in the Treatment of Sleep Disorders after Acute Cerebral Infarction

Objective To explore the characteristics of polysomnography in patients with sleep disorder after acute cerebral infarction with phlegm heat disturbance treated by clearing heat and resolving phlegm method. Methods A total of 144 cases with sleep disorder after acute cerebral infarction with phlegm heat disturbance were randomly divided into a Chinese herbal medicine group and western medicine group, with 72 cases in each group. The Chinese herbal medicine group was assigned to the Huanglian Wendan Decoction, and the western medicine group was assigned to zopiclone. The observation index were evaluated by Assessment scale for traditional Chinese medicine (TCM) syndrome of sleep disorder after acute cerebral infarction and Pittsburgh sleep quality index (PSQI), and the factors were analyzed. Meanwhile, polysomnography (PSG) was performed for one time before and after treatment. Results The PSQI, TCM syndrome score and PSG of the 2 groups after treatment were improved than before treatment, with significant differences (P<0.05), and the TCM syndrome score in the Chinese herbal medicine group was improved significantly (P<0.01), suggesting that the treatment efficacy of the Chinese herbal medicine group was better than the western medicine group. Conclusion Huanglian Wendan Decoction can significantly improve the sleep quality of patients with sleep disorder after acute cerebral infarction with phlegm heat disturbance, with good therapeutic effect and few side-effects.