Article(id=1322927067779703287, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926985957221241, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.11.043, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793339991754, onlineDateStr=2026-10-30, pubDate=1762704000000, pubDateStr=2025-11-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339991754, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339991754, creator=13701087609, updateTime=1793339991754, updator=13701087609, issue=Issue{id=1322926985957221241, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='11', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1762704000000', pubDateStr='2025-11-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793339972247, creator='13701087609', updateTime=1793340743335, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322930220201804556, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926985957221241, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322930220201804557, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926985957221241, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=213, endPage=216, ext={EN=ArticleExt(id=1322927068085887480, articleId=1322927067779703287, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Clinical Observation of Anshen Jiaotai Yizhi Decoction(安神交泰益智汤)in Treatment of Parkinson's Disease with Sleep Disorders and Its Effect on Hcy and IL-1β Levels in Patients, columnId=1256183365644968140, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Platform of Provincial Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To study the clinical effect of Anshen Jiaotai Yizhi Decoction(安神交泰益智汤)in the treatment of Parkinson's disease with sleep disorders and its effect on the levels of homocysteine(Hcy)and interleukin-1β(IL-1β)in patients.

Methods

110 patients with Parkinson's disease and sleep disorders were selected and divided into two groups,55 patients in the control group were treated with western medicine,and 55 patients in the observation group were treated with western medicine combined with Anshen Jiaotai Yizhi Decoction. After 2 weeks of treatment,the clinical efficacy,sleep quality,sleep structure index,related factor levels and adverse reactions were compared.

Results

The total effective rate of the observation group(96.36%,53/55)was higher than that(83.64%,46/55)of the control group(P<0.05). The Epworth sleepiness scale(ESS)scores after 2 weeks of treatment of the observation group was(7.92±1.83)points,and that of the control group was(9.14±2.11)points(P<0.05). The sleep efficiency of the two groups increased,the sleep latency shortened,the number of awakenings decreased,the apnea hypopnea index(AHI)decreased,and the minimum oxygen saturation increased. The indexes of the observation group were significantly better than those of the control group[(78.89±6.20)%,(23.10±4.08)min,(1.97±0.56)times,(9.08±1.03),(89.15±5.80)% vs(73.39±6.14)%,(27.82±5.26)min,(2.75±0.67)times,(11.71±1.34),(86.30±5.52)%](P<0.05). The levels of serum Hcy and IL-1βin the two groups decreased,and the levels of the observation group were significantly lower than those in the control group[(1.01±0.06)mg/L,(8.90±1.85)pg/mL vs(1.20±0.06)mg/L,(10.13±1.91)pg/mL](P<0.05). The incidence of adverse reactions of the two groups had no significance(14.55%,8/55 vs 10.91%,6/55)(P>0.05).

Conclusion

Anshen Jiaotai Yizhi Decoction has a better clinical effect in the treatment of Parkinson's disease with sleep disorders. It can significantly improve sleep status and regulate the neuroimmune inflammatory response in the brain. It is a safe and effective treatment plan and is worthy of application.

, authors=Lidan PU, Yawei ZHAO, Lihong CAO, Haolei YANG, Ziwei YUAN, Lijing YANG, authorsList=Lidan PU, Yawei ZHAO, Lihong CAO, Haolei YANG, Ziwei YUAN, Lijing YANG, authorCompany=null, correspAuthors=null, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322927069239321087, articleId=1322927067779703287, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=安神交泰益智汤治疗帕金森病睡眠障碍临床效果及对患者同型半胱氨酸、白细胞介素-1β水平影响, columnId=1256183369033965799, journalTitle=中华中医药学刊, columnName=省级项目平台, runingTitle=null, highlight=null, articleAbstract=
目的

研究安神交泰益智汤治疗帕金森病睡眠障碍临床效果及对患者同型半胱氨酸(Homocysteine,Hcy)、白细胞介素-1β(Interleukin—1β,IL-1β)水平影响。

方法

选取帕金森病合并睡眠障碍患者110例,按照随机数字表法均分为两组。对照组55例进行西医治疗,观察组55例采用西医联合安神交泰益智汤治疗,治疗2周后比较两组患者的临床疗效、睡眠质量、睡眠结构指标、相关因子水平及不良反应。

结果

观察组总有效率96.36%(53/55),高于对照组的83.64%(46/55)(P<0.05)。爱泼沃斯嗜睡量表(Epworth sleepiness scale,ESS)评分:治疗2周后观察组(7.92±1.83)分显著低于对照组(9.14±2.11)分(P<0.05)。治疗前两组睡眠结构各指标差异均无统计学意义(P>0.05),治疗2周后观察组睡眠效率、睡眠潜伏期、觉醒次数、呼吸暂停低通气指数(Apnea-hypopnea index,AHI)、最低氧饱和度显著优于对照组[(78.89±6.20)%、(23.10±4.08)min、(1.97±0.56)次、(9.08±1.03)、(89.15±5.80)% vs(73.39±6.14)%、(27.82±5.26)min、(2.75±0.67)次、(11.71±1.34)、(86.30±5.52)%](P<0.05)。治疗前两组血清Hcy、IL-1β可比(P>0.05),治疗2周后观察组低于对照组[(1.01±0.06)mg/L、(8.90±1.85)pg/mL vs(1.20±0.06)mg/L、(10.13±1.91)pg/mL](P<0.05)。观察组、对照组不良反应发生率分别为14.55%(8/55)、10.91%(6/55),差异无统计学意义(P>0.05)。

结论

安神交泰益智汤治疗帕金森病睡眠障碍临床效果更佳,能够显著改善睡眠状态、调节脑内神经免疫炎症反应,是安全有效的治疗方案,值得应用。

, authors=蒲俪丹, 赵亚伟, 曹利红, 杨浩雷, 袁子薇, 杨丽静, authorsList=蒲俪丹, 赵亚伟, 曹利红, 杨浩雷, 袁子薇, 杨丽静, authorCompany=null, correspAuthors=null, authorNote=

蒲俪丹(1988-),女,河北无极人,主治医师,硕士,研究方向:中西医结合脑病、呼吸睡眠疾病的治疗。

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蒲俪丹(1988-),女,河北无极人,主治医师,硕士,研究方向:中西医结合脑病、呼吸睡眠疾病的治疗。

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组别例数性别/(例)年龄/(岁)病程/(年)
男性女性
对照组55322353.40±6.283.96±1.17
观察组55302552.92±6.104.05±1.26
χ2/t值0.1480.4070.388
P值0.7000.6850.699
), ArticleFig(id=1322927073731420718, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927067779703287, language=CN, label=表1, caption=

两组帕金森病合并睡眠障碍患者一般资料比较

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组别例数性别/(例)年龄/(岁)病程/(年)
男性女性
对照组55322353.40±6.283.96±1.17
观察组55302552.92±6.104.05±1.26
χ2/t值0.1480.4070.388
P值0.7000.6850.699
), ArticleFig(id=1322927073815306799, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927067779703287, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治愈好转无效总有效
观察组5529(52.73)24(43.64)2(3.64)53(96.36)
对照组5524(43.64)22(40.00)9(16.36)46(83.64)
χ2值4.950
P值0.026
), ArticleFig(id=1322927073957913136, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927067779703287, language=CN, label=表2, caption=

两组帕金森病合并睡眠障碍患者临床疗效比较

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组别例数治愈好转无效总有效
观察组5529(52.73)24(43.64)2(3.64)53(96.36)
对照组5524(43.64)22(40.00)9(16.36)46(83.64)
χ2值4.950
P值0.026
), ArticleFig(id=1322927074045993521, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927067779703287, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗前治疗2周后t值P值
观察组5513.85±3.107.92±1.8312.217<0.001
对照组5514.01±2.969.14±2.119.936<0.001
t值0.2773.239--
P值0.7820.002--
), ArticleFig(id=1322927074129879602, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927067779703287, language=CN, label=表3, caption=

两组帕金森病合并睡眠障碍患者ESS评分比较(±s)

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组别例数治疗前治疗2周后t值P值
观察组5513.85±3.107.92±1.8312.217<0.001
对照组5514.01±2.969.14±2.119.936<0.001
t值0.2773.239--
P值0.7820.002--
), ArticleFig(id=1322927074230542899, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927067779703287, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数测定时间睡眠效率/(%)睡眠潜伏期/(min)觉醒次数/(次)AHI最低血氧饱和度/(%)
观察组55治疗前63.70±5.4442.51±9.464.06±0.9514.85±3.2182.40±4.74
治疗2周后78.89±6.2023.10±4.081.97±0.569.08±1.0389.15±5.80
t1值13.65713.97214.05512.6936.683
P1值<0.001<0.001<0.001<0.001<0.001
对照组55治疗前64.02±5.7042.33±9.214.11±0.8414.98±3.4682.18±4.92
55治疗2周后73.39±6.1427.82±5.262.75±0.6711.71±1.3486.30±5.52
t2值8.29410.1469.3876.3564.132
P2值<0.001<0.001<0.001<0.001<0.001
两组治疗前比较t3值0.3010.1010.2920.2040.239
P3值0.7640.9200.7710.8390.812
两组治疗2周后比较t4值4.6755.2586.62511.5402.640
P4值<0.001<0.001<0.001<0.0010.010
), ArticleFig(id=1322927074322817588, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927067779703287, language=CN, label=表4, caption=

两组帕金森病合并睡眠障碍患者睡眠结构各指标比较(±s)

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组别例数测定时间睡眠效率/(%)睡眠潜伏期/(min)觉醒次数/(次)AHI最低血氧饱和度/(%)
观察组55治疗前63.70±5.4442.51±9.464.06±0.9514.85±3.2182.40±4.74
治疗2周后78.89±6.2023.10±4.081.97±0.569.08±1.0389.15±5.80
t1值13.65713.97214.05512.6936.683
P1值<0.001<0.001<0.001<0.001<0.001
对照组55治疗前64.02±5.7042.33±9.214.11±0.8414.98±3.4682.18±4.92
55治疗2周后73.39±6.1427.82±5.262.75±0.6711.71±1.3486.30±5.52
t2值8.29410.1469.3876.3564.132
P2值<0.001<0.001<0.001<0.001<0.001
两组治疗前比较t3值0.3010.1010.2920.2040.239
P3值0.7640.9200.7710.8390.812
两组治疗2周后比较t4值4.6755.2586.62511.5402.640
P4值<0.001<0.001<0.001<0.0010.010
), ArticleFig(id=1322927075992150581, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927067779703287, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数测定时间Hcy/(mg/L)IL-1β/(pg/mL)
观察组55治疗前1.37±0.1314.96±3.12
治疗后1.01±0.068.90±1.85
t1值18.64712.390
P1值<0.001<0.001
对照组55治疗前1.39±0.1015.04±3.04
治疗后1.20±0.0610.13±1.91
t2值12.08310.142
P2值<0.001<0.001
两组治疗前比较t3值0.9040.136
P3值0.3680.892
两组治疗后比较t4值16.6063.431
P4值<0.0010.001
), ArticleFig(id=1322927076071842358, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927067779703287, language=CN, label=表5, caption=

两组帕金森病合并睡眠障碍患者血清Hcy及IL-1β水平比较(±s)

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数测定时间Hcy/(mg/L)IL-1β/(pg/mL)
观察组55治疗前1.37±0.1314.96±3.12
治疗后1.01±0.068.90±1.85
t1值18.64712.390
P1值<0.001<0.001
对照组55治疗前1.39±0.1015.04±3.04
治疗后1.20±0.0610.13±1.91
t2值12.08310.142
P2值<0.001<0.001
两组治疗前比较t3值0.9040.136
P3值0.3680.892
两组治疗后比较t4值16.6063.431
P4值<0.0010.001
), ArticleFig(id=1322927076164117047, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927067779703287, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数厌食恶心合计
观察组555(9.09)3(5.45)8(14.55)
对照组552(3.64)4(7.27)6(10.91)
χ2值0.327
P值0.567
), ArticleFig(id=1322927076268974648, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927067779703287, language=CN, label=表6, caption=

两组帕金森病合并睡眠障碍患者不良反应情况比较

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组别例数厌食恶心合计
观察组555(9.09)3(5.45)8(14.55)
对照组552(3.64)4(7.27)6(10.91)
χ2值0.327
P值0.567
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安神交泰益智汤治疗帕金森病睡眠障碍临床效果及对患者同型半胱氨酸、白细胞介素-1β水平影响
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蒲俪丹 , 赵亚伟 , 曹利红 , 杨浩雷 , 袁子薇 , 杨丽静
中华中医药学刊 | 省级项目平台 2025,43(11): 213-216
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中华中医药学刊 |省级项目平台 2025 , 43 (11) : 213 -216
安神交泰益智汤治疗帕金森病睡眠障碍临床效果及对患者同型半胱氨酸、白细胞介素-1β水平影响
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蒲俪丹, 赵亚伟, 曹利红, 杨浩雷, 袁子薇, 杨丽静
作者信息
  • 河北省中医院,河北 石家庄 050000
作者简介:

蒲俪丹(1988-),女,河北无极人,主治医师,硕士,研究方向:中西医结合脑病、呼吸睡眠疾病的治疗。

Clinical Observation of Anshen Jiaotai Yizhi Decoction(安神交泰益智汤)in Treatment of Parkinson's Disease with Sleep Disorders and Its Effect on Hcy and IL-1β Levels in Patients
Lidan PU, Yawei ZHAO, Lihong CAO, Haolei YANG, Ziwei YUAN, Lijing YANG
Affiliations
  • Hebei Traditional Chinese Medicine Hospital,Shijiazhuang 050000,Hebei,China
出版时间: 2025-11-10 doi: 10.13193/j.issn.1673-7717.2025.11.043
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目的

研究安神交泰益智汤治疗帕金森病睡眠障碍临床效果及对患者同型半胱氨酸(Homocysteine,Hcy)、白细胞介素-1β(Interleukin—1β,IL-1β)水平影响。

方法

选取帕金森病合并睡眠障碍患者110例,按照随机数字表法均分为两组。对照组55例进行西医治疗,观察组55例采用西医联合安神交泰益智汤治疗,治疗2周后比较两组患者的临床疗效、睡眠质量、睡眠结构指标、相关因子水平及不良反应。

结果

观察组总有效率96.36%(53/55),高于对照组的83.64%(46/55)(P<0.05)。爱泼沃斯嗜睡量表(Epworth sleepiness scale,ESS)评分:治疗2周后观察组(7.92±1.83)分显著低于对照组(9.14±2.11)分(P<0.05)。治疗前两组睡眠结构各指标差异均无统计学意义(P>0.05),治疗2周后观察组睡眠效率、睡眠潜伏期、觉醒次数、呼吸暂停低通气指数(Apnea-hypopnea index,AHI)、最低氧饱和度显著优于对照组[(78.89±6.20)%、(23.10±4.08)min、(1.97±0.56)次、(9.08±1.03)、(89.15±5.80)% vs(73.39±6.14)%、(27.82±5.26)min、(2.75±0.67)次、(11.71±1.34)、(86.30±5.52)%](P<0.05)。治疗前两组血清Hcy、IL-1β可比(P>0.05),治疗2周后观察组低于对照组[(1.01±0.06)mg/L、(8.90±1.85)pg/mL vs(1.20±0.06)mg/L、(10.13±1.91)pg/mL](P<0.05)。观察组、对照组不良反应发生率分别为14.55%(8/55)、10.91%(6/55),差异无统计学意义(P>0.05)。

结论

安神交泰益智汤治疗帕金森病睡眠障碍临床效果更佳,能够显著改善睡眠状态、调节脑内神经免疫炎症反应,是安全有效的治疗方案,值得应用。

帕金森病  /  睡眠障碍  /  安神交泰益智汤  /  同型半胱氨酸  /  白细胞介素-1β  /  多导睡眠监测
Objective

To study the clinical effect of Anshen Jiaotai Yizhi Decoction(安神交泰益智汤)in the treatment of Parkinson's disease with sleep disorders and its effect on the levels of homocysteine(Hcy)and interleukin-1β(IL-1β)in patients.

Methods

110 patients with Parkinson's disease and sleep disorders were selected and divided into two groups,55 patients in the control group were treated with western medicine,and 55 patients in the observation group were treated with western medicine combined with Anshen Jiaotai Yizhi Decoction. After 2 weeks of treatment,the clinical efficacy,sleep quality,sleep structure index,related factor levels and adverse reactions were compared.

Results

The total effective rate of the observation group(96.36%,53/55)was higher than that(83.64%,46/55)of the control group(P<0.05). The Epworth sleepiness scale(ESS)scores after 2 weeks of treatment of the observation group was(7.92±1.83)points,and that of the control group was(9.14±2.11)points(P<0.05). The sleep efficiency of the two groups increased,the sleep latency shortened,the number of awakenings decreased,the apnea hypopnea index(AHI)decreased,and the minimum oxygen saturation increased. The indexes of the observation group were significantly better than those of the control group[(78.89±6.20)%,(23.10±4.08)min,(1.97±0.56)times,(9.08±1.03),(89.15±5.80)% vs(73.39±6.14)%,(27.82±5.26)min,(2.75±0.67)times,(11.71±1.34),(86.30±5.52)%](P<0.05). The levels of serum Hcy and IL-1βin the two groups decreased,and the levels of the observation group were significantly lower than those in the control group[(1.01±0.06)mg/L,(8.90±1.85)pg/mL vs(1.20±0.06)mg/L,(10.13±1.91)pg/mL](P<0.05). The incidence of adverse reactions of the two groups had no significance(14.55%,8/55 vs 10.91%,6/55)(P>0.05).

Conclusion

Anshen Jiaotai Yizhi Decoction has a better clinical effect in the treatment of Parkinson's disease with sleep disorders. It can significantly improve sleep status and regulate the neuroimmune inflammatory response in the brain. It is a safe and effective treatment plan and is worthy of application.

Parkinson's disease  /  sleep disorders  /  Anshen Jiaotai Yizhi Decoction(安神交泰益智汤)  /  homocysteine  /  interleukin-1β  /  polysomnography monitoring
蒲俪丹, 赵亚伟, 曹利红, 杨浩雷, 袁子薇, 杨丽静. 安神交泰益智汤治疗帕金森病睡眠障碍临床效果及对患者同型半胱氨酸、白细胞介素-1β水平影响. 中华中医药学刊, 2025 , 43 (11) : 213 -216 . DOI: 10.13193/j.issn.1673-7717.2025.11.043
Lidan PU, Yawei ZHAO, Lihong CAO, Haolei YANG, Ziwei YUAN, Lijing YANG. Clinical Observation of Anshen Jiaotai Yizhi Decoction(安神交泰益智汤)in Treatment of Parkinson's Disease with Sleep Disorders and Its Effect on Hcy and IL-1β Levels in Patients[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (11) : 213 -216 . DOI: 10.13193/j.issn.1673-7717.2025.11.043
帕金森病是一种退行性神经系统疾病,在中老年人群高发,有运动症状和非运动症状,其中睡眠障碍是最常见的非运动症状,长期睡眠障碍会导致帕金森病症状加重,使得患者生活质量严重下降[1]。帕金森睡眠障碍药物治疗多采用去甲肾上腺素再摄取抑制剂类、短效苯二氮卓类等药物,长期用药会出现药效减退及依赖性、不良反应增多等弊端[2-3]。近年来中医以其独到的优势成为帕金森病睡眠障碍治疗的新契机,有研究提示中西药联合治疗在减轻帕金森病症状方面比单药治疗更有效,大多能达到增效减毒的效果[4-5]。睡眠障碍乃属中医“不寐”病之类、亦有称“不能眠”“不得卧”“目不蹊”等,早在《难经》中即有记载,归纳不寐病总的病理表现为阴虚阳盛,阳不交阴,阴阳不相顺接,神不内守,神志欠安。现代医家则基于古代研究理论,结合现代生活方式特点,从各自治疗经验入手,强调不寐从脏腑论治,重视情志致病,从肝论治,并根据生理解剖特点,中西医结合论治不寐[6-7]。本研究分析安神交泰益智汤在帕金森病睡眠障碍治疗中的应用效果,报道如下。
选取河北省中医院2021年1月—2022年12月治疗的帕金森病合并睡眠障碍患者110例,均符合英国帕金森病协会(United kingdom parkinson disease society,UKPDS)诊断标准,并排除以下情况:帕金森综合征、帕金森叠加综合征;其他神经系统疾病、精神疾病以及服用镇静催眠药史患者;其他疾病导致的认知、意识障碍不能配合检查者;精神疾病患者。随机数字表法将患者均分为两组,每组55例,两组一般资料差异无统计学意义(P>0.05),见表1。患者签署知情同意书,医院医学伦理委员会审核批准研究进行。
对照组患者进行西医治疗,主要包括盐酸普拉克索、多巴丝肼片参照说明应用。观察组患者在对照组基础上联合安神交泰益智汤治疗,药物组成如下:桂枝10 g,龙骨20 g,牡蛎20 g,醋龟板15 g,丹参15 g,九节菖蒲12 g,郁金10 g,白芍20 g,甘草9 g等加减组成,水煎服,1剂/d,共取汁200 mL,分2次服用。两组患者均治疗2周。
(1)临床疗效:依据帕金森病睡眠量表(Parkinson's disease sleep scale,PDSS)[8]减分率评定治疗前后失眠改善情况,共15个问题,得分越高表明严重程度越低。PDSS减分率90%~100%为治愈;10% ~89%为好转;0~9%为无效。总有效=治愈+好转。(2)治疗前及治疗2周后睡眠质量:采用爱泼沃斯嗜睡量表(Epworth sleepiness scale,ESS)[9]评估,包括8种生活场景下的嗜睡情况,根据患者情况每个项目0到3分,分值越高提示嗜睡倾向越明显。(3)睡眠结构分析:分别在治疗前及治疗2周后观察并记录两组患者多导睡眠图(Polysomnography,PSG),包括睡眠效率、睡眠潜伏期、觉醒次数、呼吸暂停低通气指数(Apnea-Hypopnea index,AHI)、最低血氧饱和度。睡眠效率:总体睡眠时间与卧床时间比值;睡眠潜伏期:关灯至出现第一个非快速动眼期(Non-rapid eye movement,NREM)睡眠Ⅰ期开始的时间(至少持续3 min);觉醒次数:NREM睡眠过程中持续3 s以上的脑电图频率改变次数,包括θ波、α波和(或)频率>16 Hz的脑电波(但不包括纺锤波);AHI:呼吸暂停指数和低通气指数之和。(4)相关因子水平:分别在治疗前及治疗2周后取患者晨起空腹静脉血5 mL,采用酶联免疫试剂法检测血清同型半胱氨酸(Homocysteine,Hcy)、白细胞介素-1β(Interleukin-1β,IL-1β)水平。(5)定期观察并记录患者不良反应发生情况。
应用SPSS 21.0统计软件包,计数资料行χ2检验,计量资料行t检验,P<0.05为差异有统计学意义。
总有效率观察组显著高于对照组(P<0.05)。见表2。
治疗前两组ESS评分差异无统计学意义(P>0.05),两组治疗2周后ESS评分降低,观察组低于对照组(P<0.05)。见表3。
治疗前两组睡眠结构各指标比较差异均无统计学意义(P>0.05),治疗2周后,两组患者睡眠效率升高、睡眠潜伏期缩短、觉醒次数减少、AHI降低、最低血氧饱和度升高,观察组以上各项指标显著优于对照组(P<0.05)。见表4。
两组血清Hcy、IL-1β水平治疗2周后降低,观察组低于对照组(P<0.05)。见表5。
观察组、对照组不良反应发生率分别为14.55%、10.91%(P>0.05)。见表6。两组不良反应症状均较轻微,能够自行缓解。
帕金森病睡眠障碍中医学属“颤证”与“不寐”并病。颤证轻者头摇动或手足微颤,重者头部震摇,肢体颤动不止,甚则肢节拘急、失去生活自理能力,其病在筋脉,与肝、肾、脾等脏关系密切,肝风内动、筋脉失养,本为气血阴阳亏虚,标为风、火、痰、瘀为患。不寐在《内经》称为“不得卧”“目不瞑”。研究提示,帕金森病患者多年迈,且病后心虚胆怯,禀赋不足等导致心神不安,因心神失养而睡眠障碍[10-12]。
本研究中观察组增加安神交泰益智汤治疗帕金森病睡眠障碍,治疗总有效率达96.36%,而且显著改善了患者睡眠状况。安神交泰益智汤根据君臣佐,方中龟板滋阴潜阳、益肾强骨为君药;龙骨、牡蛎镇静安神为臣药;郁金行气解郁,丹参活血化瘀、清心安神,白芍滋养肝血,菖蒲开窍宁神共为佐药,甘草调和诸药为使药,诸药合用,共奏熄风潜阳,安神益智之效。桂枝发汗解肌,温通经脉,助阳化气,平冲降气,安神定心。现代药理研究表明桂枝具有抗炎、抗过敏作用[13-14]。龙骨味甘涩平,归经入心、肝、肾经;《千金要方》中治好忘,久服聪明益智。赵霞等的研究表明龙骨有镇静安神、抗抑郁等作用[15]。张乃文等的基础实验研究提示龙骨可使大鼠入睡时间得以缩短、觉醒时间减少、自由活动得到延长 [16]。牡蛎可敛阴、潜阳,实验证明其连续性给药可发挥显著的镇静作用,有助于睡眠[17]。醋龟板:味咸、甘,性微寒,归经,归肝、肾、心经,功效:滋阴潜阳,益肾强骨,养血补心,《丹溪心法》:治降阴火、补肾水;《圣济总录》:治心矢志善忘。丹参主入心经,养神定志,《本草崇原》中论其:“少阴君火之气,而下交于地,使上下相交”,本方之中取其能够活血化瘀,除烦安神。九节菖蒲化痰开窍,醒脾安神,《药性解》中有云:“菖蒲通神明,宜入心经;能通九窍,益心智,除健忘”。白芍,味苦、酸,可平抑肝阳、柔肝止痛。郁金入心肝二经,能够凉心,散郁,行气解郁安神,与菖蒲同用,有清心开窍,除烦安神的功能,上药共为佐药,一方面加强镇肝安神之效,同时对痰疲等病理产物的清除也有所兼顾。
有研究提示近年来炎症在帕金森病发生发展过程中的作用已成为研究热点,MAPKs信号通路的活化以及该通路活化所诱导的炎症反应,NLRP3炎症小体在小胶质细胞中表达异常等导致的神经炎症促发了疾病[18-20]。血清Hcy水平异常升高加强了神经炎症反应,使得神经元DNA被破坏,国内外均有研究表明高血清Hcy水平可导致巨噬细胞反应、脂肪在血管壁堆积,损伤细胞结构,损害大脑血管[21-22]。神经元损伤和脑细胞组织损伤与帕金森睡眠障碍发生有关[23]。IL-1β是一种调节细胞,有研究表明其表达水平与帕金严重程度呈正相关[24]。本研究结果显示观察组增加安神交泰益智汤治疗帕金森病睡眠障碍更好地改善了患者血清Hcy、IL-1β水平,考虑与安神交泰益智汤中部分药物组分调节脑内神经免疫炎症反应的作用有关,如现代药理研究证实白芍具有抗炎、脑及神经保护作用,芍药内酯苷可通过血脑屏障,具有明确神经保护作用,且进一步发现芍药苷作用机制与抗神经细胞氧化、抗自由基损伤,平衡离子通道、抑制细胞内钙超载,抗神经毒性、促进神经生长等有关,对慢性动脉性脑缺血、脑缺血-再灌注损伤和阿尔茨海默病、帕金森等疾病等的体内和体外实验研究有效[25-27]。
综合上述内容可见,安神交泰益智汤治疗帕金森病睡眠障碍临床效果更佳,能够显著改善睡眠状态、调节脑内神经免疫炎症反应,是安全有效的治疗方案,值得应用。
  • 河北省中医药管理局科研计划项目(2021050)
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2025年第43卷第11期
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doi: 10.13193/j.issn.1673-7717.2025.11.043
  • 首发时间:2026-10-30
  • 出版时间:2025-11-10
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河北省中医药管理局科研计划项目(2021050)
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    河北省中医院,河北 石家庄 050000
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2种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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