Exploring the Therapeutic Mechanism of Longdan Xiegan Tang wax Mud Moxibustion on Insomnia with Depression based on the HPA axis
Objective To explore the therapeutic mechanism of Longdan Xiegan Tang wax mud moxibustion on in-somnia with depression based on the HPA axis.Methods 150 patients with insomnia and depression admitted to Panyu District Traditional Chinese Medicine Hospital in Guangzhou from January 2023 to January 2024 were selected as the research subjects.They were randomly divided into a control group(50 cases,excluding 4 cases),a traditional Chi-nese medicine group(50 cases,excluding 2 cases),and a Chinese and Western medicine group(50 cases,excluding 2 cases)using a random number table method.The control group was treated with Zopiclone tablets,the traditional Chinese medicine group was treated with Longdan Xiegan Tang wax mud moxibustion,and the Chinese and Western medicine group was treated with Zopiclone tablets and Longdan Xiegan Tang wax mud moxibustion.Observe the scores of two main traditional Chinese medicine symptoms,sleep quality(evaluated using the Pittsburgh Sleep Quality Index(PSQI)scale),depression status(evaluated using the Hamilton Depression Rating Scale(HAMD)),laboratory in-dicators(cortisol(Cor),adrenocorticotropic hormone releasing hormone(ACTH)and diurnal slope,neurotransmit-ter indicators(5-hydroxytryptamine(5-HT),neuropeptide Y(NPY)),to evaluate the safety of medication.Results After treatment,the scores of traditional Chinese medicine symptoms,PSQI and HAMD scores,Cor and ACTH(08:00 and 20:00)levels in the three groups were significantly lower than before treatment in the same group,while the diurnal slope of Cor and ACTH,5-HT and NPY levels were higher than before treatment in the same group,with sig-nificant differences within the group(P<0.05);There was no statistically significant difference in traditional Chinese medicine symptom scores,PSQI and HAMD scores,Cor and ACTH(08:00 and 20:00)levels,Cor and ACTH day night slopes,5-HT and NPY levels between the control group and the traditional Chinese medicine group(P>0.05);The traditional Chinese medicine symptom score,PSQI and HAMD scores,Cor and ACTH(08:00 and 20:00)lev-els in the Chinese and Western medicine group were lower than those in the control group and the traditional Chinese medicine group at the same time(P<0.05),while the diurnal slope of Cor and ACTH,5-HT and NPY levels were higher than those in the control group and the traditional Chinese medicine group at the same time(P<0.05).Com-parison of total adverse reaction rates among the three groups during treatment(P>0.05).Conclusion Longdan Xiegan Tang wax mud moxibustion is safe and effective in treating insomnia with depression.Combined with zopiclone tablets,it can significantly improve patients'sleep and depression symptoms,its mechanism may be related to regulating HPA axis related hormones and restoring neurotransmitter balance.
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