Efficacy of Shugan Jieyu Prescription in the Treatment of Insomnia with Mild-to-Moderate Depression and Its Effects on Sleep Quality,Negative Emotion,and Serum Inflammatory Factor Levels
Objective To investigate the clinical efficacy of Shugan Jieyu Prescription in the treatment of insomnia with mild-to-moderate depression differentiated as qi stagnation and phlegm obstruction type,and to observe its effects on sleep quality,negative emotion,and serum inflammatory factor levels.Methods Ninety-six insomnia patients with mild-to-moderate depression of qi stagnation and phlegm obstruction type were divided into the study group and the control group,with 48 patients in each group.The control group was treated with conventional western medicine,and the study group was treated with Shugan Jieyu Prescription on the basis of treatment for the control group,and both groups were treated for two continuous months.The changes of traditional Chinese medicine(TCM)syndrome score,Pittsburgh Sleep Quality Index(PSQI)score,Insomnia Severity Index(ISI)score,Self-Depression Scale(SDS)score,Hamilton Depression Scale(HAMD)score,cerebral blood flow parameters,and serum levels of neurotransmitters and inflammatory factors such as 5-hydroxytryptamine,tumor necrosis factor α(TNF-α),substance P(SP),and interleukin 6(IL-6)in the patients of the two groups before and after treatment were observed.After treatment,the clinical efficacy and incidence of adverse reactions of the two groups were compared.Results(1)After two months of treatment,the total effective rate of the study group was 91.67%(44/48),while that of the control group was 72.92%(35/48),and the intergroup comparison(by chi-square test)showed that the clinical efficacy of the study group was significantly superior to that of the control group(P＜0.05).(2)After treatment,the scores of TCM syndrome,PSQI,ISI,HAMD,and SDS of patients in the two groups were significantly decreased when compared with those before treatment(P＜0.05),and the decrease in the study group was significantly superior to that in the control group(P＜0.01).(3)After treatment,the mean flow velocity(Vm)and maximum peak flow velocity(Vs)of bilateral cerebral arterial blood flow in the two groups of patients were significantly increased(P＜0.05)and the resistance index(RI)of cerebral arteries was significantly decreased when compared with those before treatment(P＜0.05).The increase of Vm and Vs and the decrease of RI in the study group were significantly superior to those in the control group(P＜0.01).(4)After treatment,the levels of TNF-α,IL-6,and SP in the two groups of patients were significantly decreased(P＜0.05)and the serum 5-HT level was significantly increased when compared with those before treatment(P＜0.05),and the decrease of serum TNF-α,IL-6,and SP levels and the increase of serum 5-HT level in the study group were significantly superior to those in the control group(P＜0.05).(5)During the treatment,the incidence of adverse reactions in the study group was 10.42%(5/48)and that in the control group was 16.67%(8/48).The intergroup comparison showed that the difference was not statistically significant(P＞0.05).Conclusion Shugan Jieyu Prescription exerts certain efficacy in treating insomnia patients with mild-to-moderate depression of qi stagnation and phlegm obstruction type,which can effectively regulate the levels of neurotransmitters and inflammatory factors,improve the parameters of cerebral blood flow,and alleviate the clinical symptoms of insomnia and depression,with high safety.
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