| 陈曦,杨晓明.化湿醒鼾汤治疗痰湿内阻证OSAHS临床疗效及对炎症反应、氧化应激的影响[J].浙江中西医结合杂志,2022,32(3): |
| 化湿醒鼾汤治疗痰湿内阻证OSAHS临床疗效及对炎症反应、氧化应激的影响 |
| Clinical efficacy of Huashixinghan Decoction in the treatment of OSAHS with internal obstruction of phlegm and dampness and its influence on inflammation and oxidative stress |
| 投稿时间：2021-05-14 修订日期：2021-12-28 |
| DOI： |
| 中文关键词: 化湿醒鼾汤 阻塞性睡眠呼吸暂停低通气综合征 临床疗效 炎症反应 氧化应激 |
| 英文关键词:Huashixinghan Decoction Obstructive Sleep Apnea-Hypopnea Syndrome Clinical Curative Effect Inflammatory Reaction Oxidative Stress. |
| 基金项目:浙江省中医药科技计划项目；编号：2019ZQ046 |
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| 中文摘要: |
| 目的 探讨化湿醒鼾汤治疗痰湿内阻证阻塞性睡眠呼吸暂停低通气综合征(OSAHS)临床疗效及对炎症反应、氧化应激的影响。方法 将浙江省丽水市中医院于2018年9月~2020年9月收治的94例痰湿内阻证OSAHS患者按随机数字表法分入对照组(47例)与观察组(47例),对照组给予常规综合治疗,观察组在对照组的基础上联合化湿醒鼾汤治疗。分析2组治疗前后炎症反应[白介素-6(IL-6)、肿瘤坏死因子ɑ(TNF-ɑ)]及氧化应激[血清超氧化物歧化酶(SOD)、丙二醛(MDA)]指标、Epworth嗜睡量表(ESS)、蒙特利尔认知评估(MoCA)评分、血氧饱和度、呼吸暂停低通气指数(AHI)及血液流变学变化,观察2组临床疗效及不良反应发生情况。结果 与对照组比较,观察组治疗有效率更高(97.87％vs 82.98％)(χ2=6.021,P=0.014)。两组治疗前氧化应激与炎症反应指标比较无明显差异(P>0.05),治疗后观察组SOD水平高于对照组,MDA、IL-6、TNF-ɑ水平低于对照组(P<0.05)。两组治疗前夜间最低血氧饱和度、AHI、ESS、MoCA评分比较无明显差异(P>0.05),治疗后观察组夜间最低血氧饱和度、MoCA评分高于对照组,AHI、ESS值低于对照组(P<0.05)。两组治疗前各血液流变学指标比较比较无明显差异(P>0.05),治疗后观察组各血液流变学指标均低于对照组(P<0.05)；观察组不良反应发生率与对照组比较(4.26％vs 6.38％)无明显差异(P=0.211,χ2=0.646)。结论 化湿醒鼾汤治疗痰湿内阻证OSAHS能获得较好的临床疗效,可有效调理患者痰湿体质和血液循环,减轻临床症状,改善睡眠障碍和氧化应激反应,降低炎症反应,不良反应少,值得推广。 |
| 英文摘要: |
| Objective: To investigate the clinical efficacy of Huashixinghan Decoction in the treatment of OSAHS with internal obstruction of phlegm and dampness and its influence on inflammation and oxidative stress. Methods: Ninety-four patients with OSAHS with phlegm-dampness internal obstruction syndrome admitted to Lishui City Hospital of Zhejiang Province from September 2018 to September 2020 were divided into the control group (47 cases) and the observation group (47 cases) according to the random number table method. The group was given conventional comprehensive treatment, and the observation group was treated with Huashixinghan Decoction on the basis of the control group. The inflammatory response [interleukin-6 (IL-6), tumor necrosis factor ɑ (TNF-ɑ)] and oxidative stress [serum superoxide dismutase (SOD), malondialdehyde (MDA)] indicators before and after treatment in the two groups were compared, and Epworth Sleepiness Scale (ESS), Montreal Cognitive Assessment (MoCA) score, blood oxygen saturation, apnea-hypopnea index (AHI) and hemorheological changes were analyzed, and the clinical efficacy and adverse reactions were analyzed. Results: Compared with the control group, the treatment efficiency of observation group was higher (97.87% vs 82.98%) (χ2=6.021, P=0.014). The oxidative stress and inflammatory response indexes between the two groups before treatment was no significant difference(P>0.05). After treatment, compared with the control group, the SOD level of the observation group was higher, and the levels of MDA, IL-6 and TNF-ɑ were lower(P<0.05). The minimum blood oxygen saturation, AHI, ESS, and MoCA scores between the two groups before treatment was no significant difference(P>0.05). After treatment, compared with the control group, the minimum blood oxygen saturation and MoCA scores in the observation group at night were higher, and the AHI and ESS values were lower(P<0.05). The hemorheological indexes before treatment was no significant difference between the two groups(P>0.05). After treatment, compared with the control group, the whole blood viscosity high-cut and whole blood viscosity low-cut, fibrinogen and plasma viscosity in observation group were all lower(P<0.05). The rate of adverse reactions between the observation group and the control group (4.26% vs 6.38%) was no significant difference(P=0.211, χ2=0.646). Conclusion: Huashixinghan Decoction can achieve good clinical effects in treating OSAHS with internal obstruction of phlegm and dampness. It can effectively regulate the physique and blood circulation of patients with phlegm and dampness, relieve clinical symptoms, improve sleep disorders and oxidative stress, and reduce inflammation with less adverse reactions. It is worthy of promotion. |
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