【摘要】 目的 探讨基于《诸病源候论》的传统调理导引法对失眠症患者的临床效果。方法 选取2018年5月—2020年6月期间北京市朝阳区中医医院收治的失眠症患者104例作为研究对象，按随机数字表法分为对照组和观察组，每组各52例。对照组给予艾司唑仑片，观察组在对照组基础上给予基于《诸病源候论》的传统调理导引法。治疗4周后，观察比较两组患者临床疗效、不良反应发生率，治疗前后匹兹堡睡眠指数量表(Pittsburgh sleep quality index, PSQI)评分、抑郁自评量表(Self-rating depression scale, SDS)评分、焦虑自评量表(Self-rating anxiety scale, SAS)评分、5-羟色胺(5-hydroxytryptamine, 5-TH)及脑源性神经营养因子(Brain-derived neurotrophic factor, BDNF)水平。结果 治疗后观察组临床总有效率96.15%(50/52)高于对照组82.69%(43/52),差异有统计学意义(P<0.05)。治疗后两组患者PSQI评分均较治疗前降低，差异有统计学意义(P<0.05);且观察组PSQI评分明显低于对照组，差异有统计学意义(P<0.05)。治疗后两组患者SDS、SAS评分均较治疗前降低，差异有统计学意义(P<0.05);且观察组SDS、SAS评分明显低于对照组，差异有统计学意义(P<0.05)。治疗后两组患者血清BDNF、5-TH水平均较治疗前升高，差异有统计学意义(P<0.05);且观察组患者BDNF、5-TH水平明显高于对照组，差异有统计学意义(P<0.05)。治疗期间，两组患者腹泻、疲乏及口干等不良反应发生率比较，差异无统计学意义(P>0.05)。结论 基于《诸病源候论》的传统调理导引法治疗失眠症患者的疗效较好，可以有效缓解患者的负面情绪和调节血清BDNF、5-TH水平，安全性较好，值得借鉴及推广。更多还原

【Abstract】 Objective To explore the clinical effect of traditional conditioning guidance method based on the Treatise on the Origins and Manifestations of Various Diseases in the treatment of patients with insomnia.Method A total of 104 patients with insomnia admitted to Beijing Chaoyang District Hospital of Traditional Chinese Medicine from May 2018 to June 2020 were selected as the study objects.They were divided into control group and observation group by random number table method, with 52 cases in each group.The control group was treated with Estazolam tablets, and the observation group was treated with traditional conditioning guidance method based on the Treatise on the Origins and Manifestations of Various Diseases, in addition to Estazolam tablets.After 4 weeks of treatment, the clinical efficacy, incidence of adverse reactions, Pittsburgh sleep quality index(PSQI)scores, self-rating depression scale(SDS)scores, self-rating anxiety scale(SAS)scores, as well as the levels of 5-hydroxytryptamine(5-HT)and brain-derived neurotrophic factor(BDNF)before and after treatment were determined and compared between the two groups.Results After treatment, the total clinical effective rate of observation group was 96.15%(50/52),which was higher than the control group′s rate of 82.69%(43/52),and the difference was statistically significant(P<0.05).After treatment, both groups showed a significant decrease in PSQI scores compared to before treatment(P<0.05).The PSQI score of the observation group was lower than that of control group(P<0.05).After treatment, both groups exhibited a significant decrease in SDS and SAS scores compared to before treatment(P<0.05).Additionally, the SDS and SAS scores in the observation group were significantly lower than those in the control group(P<0.05).After treatment, the serum levels of BDNF and 5-TH in both groups were significantly higher than before treatment(P<0.05).Furthermore, the levels of BDNF and 5-HT in the observation group were significantly higher than those in the control group, with statistical significance(P<0.05).During the treatment period, there was no significant difference in the incidence of adverse reactions, such as diarrhea, fatigue and dry mouth, between the 2 groups(P>0.05).Conclusion The traditional conditioning guidance method based on the Treatise on the Origins and Manifestations of Various Diseases has promising curative effect in the treatment of patients with insomnia.It can effectively relieve the negative emotions of patients and regulate the levels of serum BDNF and 5-TH.This approach demonstrates good safety and is worthy of reference and promotion.更多还原