加味酸枣仁汤治疗卒中后认知障碍伴失眠对患者HPA轴功能、睡眠质量及认知功能的影响(1)
[摘要] 目的 探討加味酸枣仁汤治疗卒中后认知障碍伴失眠对患者下丘脑-垂体-肾上腺轴(HPA轴)功能、睡眠质量及认知功能的影响。 方法 选取2018年1月～2020年3月我院神经内科收治的100例脑卒中患者，基于随机数字表简单随机分为研究组与对照组，每组各50例，对照组行常规用药治疗，观察组在对照组基础上另给予酸枣仁汤加减治疗，比较两组临床资料、HPA功能指标皮质醇(Cor)、促肾上腺皮质激素(ACTH)变化以及睡眠质量与认知功能变化。 结果 两组的性别、年龄及分布、BMI、疾病类型、基础病、吸烟史与饮酒史、Cor、ACTH比较，差异无统计学意义(P>0.05)。时点(治疗1个疗程、2个疗程、3个疗程、4个疗程)上，研究组Cor减少量、ACTH减少量均明显高于对照组(P<0.05)。根据PSQI评分、Mo CA评分、NIHSS评分，治疗前两组比较，差异无统计学意义(P>0.05)，治疗4个疗程，研究组Mo CA评分明显高于对照组，PSQI评分、NIHSS评分均明显低于对照组(P<0.05)。结论 加味酸枣仁汤辅助治疗卒中后认知障碍伴失眠效果显著，可显著提高患者HPA轴功能，有效改善其睡眠质量，并提升认知功能。
[关键词] 卒中;认知障碍;失眠;加味酸枣仁汤;HPA轴功能;睡眠质量;认知功能
[中图分类号] R338.63 [文献标识码] A [文章编号] 1673-9701(2020)30-0014-04
The effect of modified Suanzaoren Decoction on the patients' HPA axis function， sleep quality and cognitive function while treating post-stroke cognitive impairment combined with insomnia
SUI Shuyan1 ZHU Mingjin2 ZHANG Zhenzhong1
1.Department of Neurology， Tongde Hospital of Zhejiang Province， Hangzhou 310012， China; 2.Department of Rehabilitation， Tongde Hospital of Zhejiang Province， Hangzhou 310012， China
[Abstract] Objective To explore the effect of modified Suanzaoren Decoction on the patients' hypothalamic-pituitary-adrenal(HPA) axis function， sleep quality and cognitive function while treating post-stroke cognitive impairment combined with insomnia. Methods From January 2018 to March 2020， a total of 100 patients with cerebral stroke admitted to and treated in Department of Neurology of our hospital were selected and simply and randomly divided into the study group and the control group based on random number table， with 50 patients in each group. The control group was treated with conventional medication， while the observation group was treated with the modified Suanzaoren Decoction on the basis of the control group. The changes of clinical data， HPA function indexes cortisol(Cor) and adrenocorticotropic hormone(ACTH) and the changes of sleep quality and cognitive function were compared between the two groups. Results There were no significant differences between the two groups in gender， age and distribution， BMI， disease types， underlying diseases， smoking and drinking history， Cor and ACTH(P>0.05). At the time points(1 course， 2 courses， 3 courses and 4 courses of treatment)， the decrease of Cor and ACTH in the study group was significantly more than that in the control group(P<0.05). In terms of PSQI， Mo CA and NIHSS scores， there were no significant differences between the two groups before treatment(P>0.05)， but after 4 courses of treatment， the Mo CA scores of the study group were significantly higher than those of the control group， and the PSQI scores and NIHSS scores were significantly lower than those of the control group(P<0.05). Conclusion Modified Suanzaoren Decoction is effective in adjuvant treatment of post-stroke cognitive impairment combined with insomnia. It can significantly improve the patients' HPA axis function， effectively ameliorate the sleep quality and enhance the cognitive function., 百拇医药(眭淑彦 朱明锦 张震中)
[关键词] 卒中;认知障碍;失眠;加味酸枣仁汤;HPA轴功能;睡眠质量;认知功能
[中图分类号] R338.63 [文献标识码] A [文章编号] 1673-9701(2020)30-0014-04
The effect of modified Suanzaoren Decoction on the patients' HPA axis function， sleep quality and cognitive function while treating post-stroke cognitive impairment combined with insomnia
SUI Shuyan1 ZHU Mingjin2 ZHANG Zhenzhong1
1.Department of Neurology， Tongde Hospital of Zhejiang Province， Hangzhou 310012， China; 2.Department of Rehabilitation， Tongde Hospital of Zhejiang Province， Hangzhou 310012， China
[Abstract] Objective To explore the effect of modified Suanzaoren Decoction on the patients' hypothalamic-pituitary-adrenal(HPA) axis function， sleep quality and cognitive function while treating post-stroke cognitive impairment combined with insomnia. Methods From January 2018 to March 2020， a total of 100 patients with cerebral stroke admitted to and treated in Department of Neurology of our hospital were selected and simply and randomly divided into the study group and the control group based on random number table， with 50 patients in each group. The control group was treated with conventional medication， while the observation group was treated with the modified Suanzaoren Decoction on the basis of the control group. The changes of clinical data， HPA function indexes cortisol(Cor) and adrenocorticotropic hormone(ACTH) and the changes of sleep quality and cognitive function were compared between the two groups. Results There were no significant differences between the two groups in gender， age and distribution， BMI， disease types， underlying diseases， smoking and drinking history， Cor and ACTH(P>0.05). At the time points(1 course， 2 courses， 3 courses and 4 courses of treatment)， the decrease of Cor and ACTH in the study group was significantly more than that in the control group(P<0.05). In terms of PSQI， Mo CA and NIHSS scores， there were no significant differences between the two groups before treatment(P>0.05)， but after 4 courses of treatment， the Mo CA scores of the study group were significantly higher than those of the control group， and the PSQI scores and NIHSS scores were significantly lower than those of the control group(P<0.05). Conclusion Modified Suanzaoren Decoction is effective in adjuvant treatment of post-stroke cognitive impairment combined with insomnia. It can significantly improve the patients' HPA axis function， effectively ameliorate the sleep quality and enhance the cognitive function., 百拇医药(眭淑彦 朱明锦 张震中)