目的 探討歸脾丸與唑吡坦聯(lián)合治療心脾兩虛型失眠癥的臨床療效。方法 回顧性選取河南中醫(yī)藥大學(xué)第三附屬醫(yī)院2022年4月—2024年5月收治的126例失眠癥（心脾兩虛型），按照使用藥物治療方案的不同分為對(duì)照組（63例）和治療組（63例）。對(duì)照組口服酒石酸唑吡坦片，10 mg/次，1次/d。在對(duì)照組基礎(chǔ)上，治療組口服歸脾丸，8～10丸/次，3次/d；兩組治療15 d。觀察兩組患者的療效，比較治療前后兩組患者癥狀緩解時(shí)間，斯匹格失眠量表（SPIEGEL）評(píng)分和匹茲堡睡眠指數(shù)（PSQI）評(píng)分，及5-羥色胺（5-HT）、γ-氨基丁酸（GABA）、腦源性神經(jīng)營(yíng)養(yǎng)因子（BDNF）和多巴胺（DA）水平。結(jié)果 治療后，治療組總有效率（96.83%）明顯高于對(duì)照組（85.71%，P＜0.05）。治療后，與對(duì)照組對(duì)比，治療組易醒、乏力、入睡困難、體力下降好轉(zhuǎn)時(shí)間均較短（P＜0.05）。治療后，兩組患者SPIEGEL評(píng)分和PSQI評(píng)分明顯下降（P＜0.05），且治療后治療組SPIEGEL評(píng)分和PSQI評(píng)分均明顯低于對(duì)照組（P＜0.05）。治療后，兩組患者5-HT、GABA和BDNF水平明顯升高，而DA水平明顯降低（P＜0.05），且治療后，與對(duì)照組比較，治療組5-HT、GABA和BDNF水平高于對(duì)照組，而DA水平低于對(duì)照組（P＜0.05）。結(jié)論 歸脾丸與唑吡坦協(xié)同治療，能使失眠癥患者癥狀緩解時(shí)間加快，對(duì)患者睡眠質(zhì)量改善明顯。

Objective To explore the clinical effect of Guipi Pills combined with zolpidem in treatment of heart spleen deficiency type. Methods The clinical data of patients (126 cases) with heart spleen deficiency type in the Third Affiliated Hospital of Henan University of Traditional Chinese Medicine from April 2022 to May 2024 were analyzed retrospectively. They were divided into control (63 cases) and treatment (63 cases) group based on different treatments. Patients in the control group were po administered with Zolpidem Tartrate Tablets, 10 mg/time, once daily. Patients in the treatment group were po administered with Guipi Pills on the basis of the control group, 8 — 10 pills/time, three times daily. Patients in two groups were treated for 15 d. After treatment, the clinical evaluations were evaluated, the symptom relief time, the scores of SPIEGEL and PSQI, the levels of 5-HT, GABA, BDNF and DA in two groups before and after treatment were compared. Results After treatment, the total effective rate of the treatment group (96.83%) was significantly higher than that of the control group (85.71%, P < 0.05). After treatment, compared with the control group, the treatment group was easy to wake up, fatigue, difficulty falling asleep, and the improvement time of physical decline were shorter (P < 0.05). After treatment, SPIEGEL score and PSQI score of two groups were significantly decreased (P < 0.05), and after treatment, SPIEGEL score and PSQI score of the treatment group were significantly lower than that of the control group (P < 0.05). After treatment, the levels of 5-HT, GABA and BDNF in both groups were significantly increased, while the levels of DA were significantly decreased (P < 0.05). After treatment, compared with the control group, the levels of 5-HT, GABA and BDNF in the treatment group were higher than those in the control group, while the levels of DA were lower than those in the control group (P< 0.05). Conclusion The synergistic treatment of Guipi Pills combined with zolpidem can accelerate the recovery of insomnia patients, significantly improve their sleep quality.

R971