中国全科医学2026，Vol.29Issue(13)：1666-1672,7.DOI:10.12114/j.issn.1007-9572.2025.0271
柴胡加龙骨牡蛎汤联合失眠认知行为疗法治疗肝郁化火型急性失眠的临床疗效研究
Clinical Efficacy of Chaihu Longgu Muli Decoction Combined with Cognitive Behavioral Therapy in the Treatment of Acute Insomnia of Liver Qi Stagnation with Fire Transformation Type
摘要
Abstract
Background Acute insomnia with liver qi stagnation and fire transformation type originates from emotional imbalance,which disturbs the heart and causes sleeplessness.The treatment focuses on soothing the liver,relieving depression,clearing heat,purging fire,and calming the mind.Chaihu Longgu Muli Decoction has the effect of calming and soothing the mind,and Cognitive Behavioral Therapy for Insomnia(CBT-I)is recommended as the first choice for non-drug treatment of insomnia.At present,there are few studies on Chaihu Longgu Muli Decoction combined with CBT-I in the treatment of acute insomnia with liver qi stagnation and fire transformation type.Objective The purpose of this study is to systematically evaluate the clinical effect of Chaihu Longgu Muli Decoction combined with CBT-I on acute insomnia patients with liver qi stagnation and fire transformation type.Methods From March 2023 to September 2024,90 patients who met the diagnostic criteria of acute insomnia with liver qi stagnation and fire transformation type at the 901th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army were selected as the research objects.According to the table of random numbers method,patients were divided into control group(45 cases)and observation group(45 cases).The control group received CBT-I intervention,while the observation group was treated with Chaihu Longgu Muli Decoction on the basis of CBT-I.Both groups received intervention for 4 weeks.Research evaluation indicators include:(1)Clinical symptom improvement[traditional Chinese medicine(TCM)syndrome score];(2)Sleep quality parameters[Pittsburgh Sleep Quality Index(PSQI)score,photoplethysmography(PPG)monitoring indicators];(3)Mood state indicators[Hamilton Anxiety Scale(HAMA)score,Hamilton Depression Scale(HAMD)score];(4)Serum biomarker levels[Tumor Necrosis Factor-alpha(TNF-α),Interleukin-1beta(IL-1β),5-Hydroxytryptamine(5-HT)];(5)Clinical efficacy and safety.Results The clinical total effective rate of the observation group[88.89%(40/45)]was significantly better than that of the control group[66.67%(30/45),χ2=14.284,P<0.05].Intra-group comparison showed that compared with before treatment,the total sleep time,sleep efficiency and 5-HT level in the two groups were significantly increased(P<0.05),while the sleep latency,awakening times,PSQI score,HAMA score,HAMD score,TCM syndrome score and inflammatory factors(TNF-α,IL-1β)levels were significantly decreased(P<0.05).The comparison between groups showed that the above indexes in the observation group were significantly better than those in the control group(P<0.05).There was no significant difference in the incidence of adverse events between the two groups(χ2=0.511,P>0.05).Conclusion The combination of Chaihu Longgu Muli Decoction with CBT-I is safe and feasible for treating acute insomnia with liver qi stagnation and fire transformation type.It effectively improves patients'sleep quality,alleviates emotional disturbances,reduces TCM symptom scores,regulates neurotransmitter levels,and suppresses inflammatory responses.The therapeutic efficacy surpasses that of CBT-I alone.关键词
入睡和睡眠障碍/急性失眠/肝郁化火型/柴胡加龙骨牡蛎汤/失眠认知行为疗法Key words
Sleep initiation and maintenance disorders/Acute insomnia/Liver qi stagnation with fire transformation/Chaihu longgu muli decoction/Cognitive behavioral therapy分类
医药卫生引用本文复制引用
余学芳,朱敏,马清林,谭神朗,吴子幸,江伟..柴胡加龙骨牡蛎汤联合失眠认知行为疗法治疗肝郁化火型急性失眠的临床疗效研究[J].中国全科医学,2026,29(13):1666-1672,7.基金项目
安徽省重点研究与开发计划项目(202104j07020002) （202104j07020002）
安徽医科大学校科学基金项目(2022xkj251,2023xkj125) （2022xkj251,2023xkj125）
中国人民解放军联勤保障部队第九〇一医院院级项目(2023YGYB02) （2023YGYB02）
