CN111759921B - Traditional Chinese medicine decoction for treating insomnia - Google Patents

Traditional Chinese medicine decoction for treating insomnia Download PDF

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CN111759921B
CN111759921B CN202010874928.8A CN202010874928A CN111759921B CN 111759921 B CN111759921 B CN 111759921B CN 202010874928 A CN202010874928 A CN 202010874928A CN 111759921 B CN111759921 B CN 111759921B
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insomnia
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赵艳
段浩博
王艳艳
段素社
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Abstract

A traditional Chinese medicine decoction for treating insomnia belongs to the field of traditional Chinese medicine preparations for treating insomnia, and comprises the following raw materials in parts by weight: 30 parts of nacre, 30 parts of magnetite, 30 parts of oyster, 40 parts of spina date seed, 15 parts of caulis polygoni multiflori, 10 parts of cortex albiziae, 10 parts of lucid ganoderma, 10 parts of valerian and 10 parts of rhizoma corydalis. The traditional Chinese medicine decoction disclosed by the invention has the effects of suppressing yang, nourishing blood and soothing nerves, one dose of the decoction is decocted into 2 bags, and 1 bag is respectively used after supper and before sleep, so that the decoction generally takes effect on the same day.

Description

Traditional Chinese medicine decoction for treating insomnia
Technical Field
The invention belongs to the field of traditional Chinese medicine preparations for treating insomnia, and relates to a traditional Chinese medicine decoction for treating insomnia, which has the effects of suppressing yang hyperactivity, nourishing blood and soothing nerves.
Background
The survey results published by the Chinese sleep research society in 2013 show that the incidence of insomnia in Chinese adults is 38.2%. The 2002 people are investigated by the social investigation center of the Chinese youth newspaper company, and the shallow sleep (45.8%), early morning wake-up (28.5%) and difficulty in falling asleep (28.1%) are three sleep problems which are most troubling to the interviewees. Insomnia is often accompanied by various psychological problems, the most common of which are anxiety, depression. The relationships of anxiety, depression and insomnia have been studied to prove causal, promotive and coexistent with each other.
Western medicine treatment for insomnia mainly comprises sedative and tranquilizer, which have great side effects and are easy to generate dependence, while traditional Chinese medicine treatment is complex in type and difficult to repeat in curative effect. In the "Insomnia Chinese medicine clinical practice guideline", the treatment of insomnia by differentiation of symptoms and signs is as follows:
1. excess syndrome
(1) Syndrome of liver depression transforming into fire
The main symptoms are: restlessness, inability to fall asleep, irritability, or dreaminess and convulsion after falling asleep.
The secondary symptoms are as follows: fullness and oppression in the chest and hypochondrium, frequent sighing, bitter taste in the mouth, dry throat, conjunctival congestion, yellow urine and constipation.
Tongue pulse: red tongue with yellow coating and wiry and rapid pulse.
Pathogenesis: liver failing to disperse and purge, stagnated for a long time and transforming into fire.
Therapeutic method: to soothe the liver, relieve depression, clear heat and transform fire.
Recommending prescription drugs: longdan Xiegan Tang (Yingbao Jian)
The medicine comprises the following components: radix Gentianae, fructus Gardeniae, Scutellariae radix, bupleuri radix processed with vinegar, radix rehmanniae, semen plantaginis (bag decocting), Alismatis rhizoma, medulla Junci, rhizoma Dioscoreae, Magnetitum preparata, radix Angelicae sinensis, Glycyrrhrizae radix, Ginseng radix, radix asparagi, Coptidis rhizoma, rhizoma anemarrhenae, etc.
(2) Syndrome of internal disturbance of phlegm-heat
The main symptoms are: insomnia, nightmare, vomiting, dispute 32429, easy fright and easy waking up.
The secondary symptoms are as follows: dizziness, epigastric fullness and oppression, bitter taste in the mouth, restlessness, poor appetite, sticky mouth and profuse sputum.
Tongue pulse: a red tongue with a yellow and greasy coating or a slippery and greasy coating, and a slippery and rapid pulse.
Pathogenesis: excessive phlegm-heat disturbing the heart-mind.
Therapeutic method: resolve phlegm, clear heat, harmonize the middle warmer and induce tranquilization.
Recommending prescription drugs: modified Wendan Tang (Beiji Qianjin prescription)
The medicine comprises the following components: caulis Bambusae in Taenia, fructus Aurantii Immaturus, pericarpium Citri Tangerinae, purified pinellia Tuber, Poria, rhizoma Zingiberis recens, fructus Jujubae, semen Arecae Preparatum, and Glycyrrhrizae radix.
(3) Syndrome of fire hyperactivity due to yin deficiency
The main symptoms are: restlessness, insomnia, difficulty in falling asleep, insomnia at night, and even insomnia at night.
The secondary symptoms are as follows: feverish sensation in the palms and soles, night sweats, dry mouth with little body fluid, amnesia, tinnitus, soreness of the waist, nocturnal emission, palpitation, and restlessness.
Tongue pulse: red tongue with little coating and thready and rapid pulse.
Pathogenesis: deficiency of yin essence and hyperactivity of deficient fire.
Therapeutic method: to nourish yin to reduce pathogenic fire, clear heat and induce tranquilization.
Recommending prescription drugs: modified coptis and donkey-hide gelatin decoction (treatise on exogenous febrile disease) consists of the following medicines: coptidis rhizoma, colla Corii Asini, ovum gallus Domesticus flavus, radix Paeoniae alba, rhizoma Zingiberis recens, fructus Jujubae, cortex moutan, cortex Lycii, and Scutellariae radix.
(4) Syndrome of disharmony of stomach qi
The main symptoms are: insomnia usually occurs after eating, and the stomach and abdomen are stuffy.
The secondary symptoms are as follows: indigestion, eructation, foul smell, foul stool, anorexia and poor appetite.
Tongue pulse: a thick and greasy pulse with a wiry or slippery and rapid pulse.
Pathogenesis: qi movement obstruction, stomach disharmony.
Therapeutic method: promote digestion, remove food stagnation, harmonize stomach and check adverse flow of qi.
Recommending prescription drugs: bolus for protecting health (Danxi Xin Fa)
The medicine comprises the following components: medicated leaven, charred hawthorn, poria, rhizoma pinelliae preparata, dried orange peel, radish seed, wrinkled gianthyssop, eupatorium, fructus forsythiae, perilla leaf, magnolia officinalis and liquorice.
(5) Syndrome of internal obstruction of blood stasis
The main symptoms are: insomnia, restlessness, chest stuffiness, heavy chest, dreaminess, inability to sleep at night, and insomnia.
The secondary symptoms are as follows: the facial color is bluish yellow, or the facial color spots, chest pain and headache are not cured for a long time, the pain is localized as needling, or hiccup is not cured for a long time, or the patient is choked by drinking water, vomitus, or internal heat is dull, or palpitation is severe, or irritability is aggravated, or the patient feels hectic fever at twitter.
Tongue pulse: a dark red tongue with petechia on the tongue surface, a dark lip or dark eyes, and a dry or wiry and tense pulse.
Pathogenesis: qi stagnation and blood stasis, and obstruction of the meridians.
Therapeutic method: promoting blood circulation, removing blood stasis, dredging meridian passage.
Recommending prescription drugs: xuefu Zhuyu Tang (correction of doctor Lin)
The medicine comprises the following components: angelica, radix rehmanniae, peach kernel, safflower, rhizoma ligustici wallichii, radix bupleuri, platycodon grandiflorum, medicinal cyathula root, immature bitter orange, red paeony root, liquorice, tree peony bark and rhizoma cyperi.
(6) Syndrome of exuberant heart fire
The main symptoms are: restlessness and insomnia, feverish sensation in the palms, soles and chest.
The secondary symptoms are as follows: dizziness, tinnitus, sores in the mouth and tongue, dry mouth, soreness of waist, nocturnal emission and spermatorrhea.
Tongue pulse: a red tongue with dry coating and a thready and rapid pulse.
Pathogenesis: the excessive fire-heat disturbs the heart-mind.
Therapeutic method: clear heart fire, nourish blood and induce tranquilization.
Recommending prescription drugs: chi Tang (Children's direct formula of drug for syndrome of infantile diseases) and JIE TAI WAN (Korean medical science and technology) added with herbs
The medicine comprises the following components: radix rehmanniae, caulis Akebiae, Coptidis rhizoma, cortex Cinnamomi, Poria, caulis Polygoni Multiflori, flos Chrysanthemi, and radix Angelicae Dahuricae.
2. Deficiency syndrome
(1) Heart-spleen deficiency syndrome/pattern
The main symptoms are: sleepiness is caused by the head covering, the head is not practical, the sleep is easy to wake, and the sleep is difficult after waking.
The secondary symptoms are as follows: palpitation, amnesia, mental fatigue, poor appetite, sallow complexion, tastelessness and distension after eating.
Tongue pulse: the tongue is pale with white coating and the pulse is thready and weak.
Pathogenesis: heart-blood deficiency, spleen-qi deficiency.
Therapeutic method: to replenish qi, invigorate the spleen, nourish the heart and induce tranquilization.
Recommending prescription drugs: the ginseng spleen-invigorating decoction (Zhengshenyindu Tang) comprises the following components: ginseng, largehead atractylodes rhizome, astragalus, Chinese angelica, polygala root, spina date seed, poria with hostwood, costustoot, arillus longan, ginger, Chinese date and liquorice.
(2) Heart and gallbladder Qi deficiency pattern
The main symptoms are: palpitations, timidity, difficulty in falling asleep, and easy convulsion after sleep.
The secondary symptoms are as follows: when it is attacked by convulsion, shortness of breath and lassitude.
Tongue pulse: the tongue is pale with white coating and the pulse is wiry and thready.
Pathogenesis: deficient heart blood and weak gallbladder qi.
Therapeutic method: tonify qi, nourish heart, calm and induce tranquilization.
Recommending prescription drugs: pill for tranquilization and tranquilization (medical comprehension)
The prescription is as follows: ginseng radix, Poria, semen Platycladi, cortex et radix Polygalae, radix Angelicae sinensis, semen Ziziphi Spinosae, rhizoma Acori Graminei, Olibanum, and Succinum powder.
For insomnia due to deficiency of body constitution and impairment of body fluids by sweating after illness, the modified Zizyphi Spinosae semen decoction (jin Kui Yao L ü e) can be used: spina date seed, ligusticum wallichii, rhizoma anemarrhenae, honey-fried licorice root, poria cocos and rush charcoal.
(3) Syndrome of disharmony between heart and kidney
The main symptoms are: insomnia in the night, or even insomnia all over the night.
The secondary symptoms are as follows: restlessness, dizziness, tinnitus, tidal fever, night sweat, nocturnal emission, impotence, menoxenia, amnesia, aphtha of the mouth and tongue, dry stool.
Tongue pulse: the tip of the tongue is red with little coating and the pulse is thready.
Pathogenesis: yin-fluid deficiency and hyperactivity of yang-qi can lead to the coordination of the disorder.
Therapeutic method: to harmonize heart and kidney, nourish blood and induce tranquilization.
Recommending prescription drugs: JIE TAI WAN (Collection of medical prescriptions) TIAN WANG BUXIN DAN (secret section of life)
The medicine comprises the following components: radix rehmanniae, radix scrophulariae, radix Salviae Miltiorrhizae, radix Ginseng, Poria, radix Polygalae, fructus Schisandrae chinensis, radix Platycodonis, semen Platycladi, rhizoma Coptidis, cortex Cinnamomi, and plumula Nelumbinis.
Therefore, the insomnia with the plurality of syndrome types inevitably generates kernel-seeing symptoms and intelligence-seeing symptoms clinically, and in the face of a patient with the insomnia, the efficacy cannot be guaranteed.
Disclosure of Invention
The invention aims to solve the problem of complicated typing and provides decoction for treating insomnia. The basic pathogenesis of insomnia, namely yang failing to exchange yin, is searched, basic medication is determined according to the basic pathogenesis, and the traditional Chinese medicine mode mainly based on disease differentiation is the premise of solving the existing complicated and puzzled typing. Aiming at the key point of insomnia caused by 'yang not crossing yin', the invention adopts a yang-subduing yin-entering method to carry out accurate treatment.
The technical scheme adopted by the invention for realizing the purpose is as follows:
a traditional Chinese medicine decoction for treating insomnia comprises the following raw materials in parts by weight: 30 parts of nacre, 30 parts of magnetite, 30 parts of oyster, 40 parts of spina date seed, 15 parts of caulis polygoni multiflori, 10 parts of cortex albiziae, 10 parts of lucid ganoderma, 10 parts of valerian and 10 parts of rhizoma corydalis. One dose is decocted into 2 bags, 1 bag is respectively used after supper and before sleep, and the effect is generally achieved on the same day.
The decoction is prepared by the following method:
(1) preparing raw materials: 30g of mother-of-pearl, 30g of magnetite, 30g of oyster, 40g of spina date seed, 15g of caulis polygoni multiflori, 10g of cortex albiziae, 10g of lucid ganoderma, 10g of valerian and 10g of rhizoma corydalis;
(2) soaking the raw materials in tap water for one hour, wherein the amount of water is 2cm higher than the raw materials, starting timing from the boiling of water, decocting with slow fire for 30 minutes, collecting 150ml of decoction, adding water, decocting for two times, adding water to a level 1 cm higher than the raw materials, decocting for 20 minutes, collecting 150ml of decoction, and mixing the two decoctions.
The invention has the beneficial effects that:
the invention finds out the main contradiction and basic pathogenesis of insomnia, and the selected medicines have the main functions of suppressing yang from entering yin, nourishing blood and soothing nerves, so that yang qi which is over the exterior can be suppressed, and the latent yang can be suppressed by nourishing yin and tonifying blood, thereby treating insomnia.
The invention determines that the yang-subduing and yin-subduing principle is a major method for treating insomnia according to the principle of 'establishing evidence (namely disease mechanism) and combining the formula with the method', because the yang-subduing and yin-subduing principle is the establishment aiming at 'yang-not-crossing-yin' which is the basic pathogenesis of insomnia, and can be said to be of central importance. The invention selects mother-of-pearl and Ling-Magnetitum as the main drugs, both of which have the effects of subduing yang and soothing the nerves, and Ling-Magnetitum also has the effect of protecting and curing true yin. For yang-subduing herbs, abalone shell is selected first, and cinnabar is selected first for herbs with action of tranquilizing mind, why are nacre and magnetite? This is because abalone shell has no action of tranquilizing the mind, and cinnabar has no action of suppressing yang, and contains mercury, which is toxic. Yang failing to cross yin and being caused by hyperactivity of heart fire; for tranquilizing the mind, it is necessary to ensure that the latent yang qi can be well collected in treatment, because of the factors of yin deficiency and yin failing to collect yang. Concha Ostreae with effects of suppressing yang, nourishing yin and tranquilizing; the spina date seed and the tuber fleeceflower stem are used as assistant drugs for nourishing heart and blood and calming the heart and the spirit, and the three auxiliary drugs are used for astringing latent yang qi to ensure that yang is crossed with yin. The spirit is dominated by the heart, insomnia occurs when the spirit is not kept, the heart pertains to fire, wood generates fire, liver qi is vigorous, heart fire is hyperactivity, and the mind is restless. The patients with insomnia are mostly caused by liver depression, and the insomnia inevitably affects the mood of the people to make the liver lose and loose the flow of qi, so that the cortex albiziae is used as an adjuvant drug for relieving the liver depression and soothing the heart and nerves. The yang-qi failing to meet yin is the main contradiction and the basic pathogenesis of insomnia, but long-term insomnia easily causes fatigue manifestations such as mental fatigue and fatigue, and qi and blood are inevitably weak, often show disturbance of vegetative nerve functions, and present the symptoms of sub-health, and the symptoms are various. The lucid ganoderma and the valerian have the effects of tonifying qi and soothing the nerves, regulating qi, promoting blood circulation and relieving pain, are assistant and guiding medicaments for treating insomnia and other symptoms. It is worth mentioning that the formula rule of traditional Chinese medicine can not be explained by the rhizoma corydalis in the prescription, because the use of rhizoma corydalis is completely based on the modern pharmacological research. Rhizoma corydalis contains corydalis B, has effects of relieving pain, hypnotizing, tranquilizing, and has a certain hypnotic and sedative effects similar to those of A and Pharbitidis.
Through clinical statistical analysis and clinical treatment, the total effective rate of the invention is 93.3%, which is obviously higher than 70% of the total effective rate of the western medicine estazolam.
Detailed Description
The present invention will be further described with reference to the following specific examples.
Detailed description of the preferred embodiments
Example 1
A traditional Chinese medicine decoction for treating insomnia, 30g of nacre, 30g of magnetite, 30g of oyster, 40g of spina date seed, 15g of caulis polygoni multiflori, 10g of cortex albiziae, 10g of lucid ganoderma, 10g of valerian and 10g of rhizoma corydalis.
The decoction is prepared by the following method: soaking the raw materials in tap water for one hour, wherein the amount of water is 2cm higher than the raw materials, starting timing from the boiling of water, decocting with slow fire for 30 minutes, collecting 150ml of decoction, adding water, decocting for two times, adding water to a level 1 cm higher than the raw materials, decocting for 20 minutes, collecting 150ml of decoction, and mixing the two decoctions. The composition is administered in 2 parts, one after supper and one before sleep.
Second, clinical trial
1. Clinical data
All cases in the study are from the department of medicine outpatient service in the traditional Chinese and western medicine combined hospital in the great wall of Shijiazhuang, and 120 cases of insomnia patients who were treated in 8 months to 2020 and 3 months in 2017 are divided into a treatment group and a control group by using a random digital table method. Treatment groups 60, 26 men and 34 women; the age is 21-63 years, the average age is 50.13 years, and the course of the disease is 2 months to 18 years. The control group comprises 60 cases, 24 cases for men and 36 cases for women, the age is 21-65 years, the average age is 50.8 years, and the course of disease is 2-16 years. The general data comparison of two groups of cases is statistically processed, and the difference is not significant (P > 0.05) and is comparable.
2 diagnostic criteria
Adopts the diagnosis standard of Western medicine insomnia and traditional Chinese medicine insomnia.
The Western diagnosis standard is made based on the classification and diagnosis standard of Chinese mental disorder. The patients mainly complain of insomnia, and the specific symptoms comprise: difficulty in falling asleep; the total sleep time is reduced; the user is easy to wake up after falling asleep, and the user is difficult to fall asleep again after waking up; dreaminess. The above symptoms appear more frequently than 3 times per week for more than 4 weeks, and are considered to be insomnia.
The diagnostic standard of traditional Chinese medicine is made based on the diagnostic standard of insomnia in the new century (2 nd edition) of internal science of traditional Chinese medicine. (1) The main symptoms are that the patient is difficult to fall asleep, easy to wake or dreaminess after falling asleep, and serious patients can not fall asleep all night for more than 3 weeks; (2) accompanied with symptoms of lassitude, lack of attention, palpitation, dizziness, etc.; (3) the patients have the medical history of big diseases, body weakness, excessive fatigue, worry, anxiety, improper diet and the like.
3. Inclusion criteria
(1) The compound preparation meets the diagnosis standards of western medicine and traditional Chinese medicine and is diagnosed as a patient with insomnia; (2) study-related medications were not taken within 2 weeks prior to treatment; (3) primary insomnia, insomnia caused by non-anxiety, postsomatic diseases and the like; (4) clear consciousness, normal spirit, and known informed consent.
4. Exclusion criteria
(1) Patients with serious primary diseases such as cardiovascular disease, liver disease and kidney disease; (2) psychotic patients; (3) systemic diseases such as pain, operation, etc., and insomnia caused by external factor interference; and (4) poor compliance and incomplete data.
5. Method of treatment
The treatment group adopts the traditional Chinese medicine decoction of the invention, namely the decoction of the embodiment 1, one dose is taken every day after dinner and before sleep at night, and little water is drunk before sleep.
The control group was orally administered with 1mg of estazolam 30 minutes before bedtime every night. (manufacturer: Huazhong pharmaceutical products company, product batch: 20200102). Two groups are treated for 4 weeks, and thick tea and coffee are prohibited during administration.
6. Observation index
Clinical symptom improvement condition, total sleep time, sleep efficiency and adverse reaction occurrence condition.
7. Standard of therapeutic effect
The standard is established according to the clinical research guiding principle of new Traditional Chinese Medicine (TCM) 3. (1) The recovery is that after the treatment, the sleep time is prolonged to more than 6 hours, the conditions of dreaminess, awakening and the like do not exist, and the sleep quality is high; (2) has obvious effects that after treatment, the sleep time is increased to some extent, the increase time is longer than 3 hours, dreams are rarely produced after falling asleep, the awakening is not easy to occur, and the sleep quality is higher; (3) effective, after the treatment, the sleep time is increased, the increase time is less than 3h, and the dreaminess and the awakening condition are slightly improved; (4) the treatment is ineffective, the sleep time is not obviously increased after the treatment, and the conditions such as dreaminess, awakening and the like are not improved or aggravated.
8. Therapeutic results
TABLE 1 comparison of clinical efficacy
Figure BDA0002652344420000091
As can be seen from the above table, the treatment group cured 35 cases, and the control group cured 11 cases; the total effective rate of the treatment group is 93.3 percent, and the total effective rate of the control group is 70 percent. The clinical curative effect of the treatment group is obviously better than that of the control group. (P < 0.05).

Claims (2)

1. The traditional Chinese medicine decoction for treating insomnia is characterized by being prepared from the following raw materials in parts by weight: 30 parts of nacre, 30 parts of magnetite, 30 parts of oyster, 40 parts of spina date seed, 15 parts of caulis polygoni multiflori, 10 parts of cortex albiziae, 10 parts of lucid ganoderma, 10 parts of valerian and 10 parts of rhizoma corydalis.
2. The traditional Chinese medicine decoction for treating insomnia according to claim 1, which is prepared by the following method:
(1) preparing raw materials: 30g of mother-of-pearl, 30g of magnetite, 30g of oyster, 40g of spina date seed, 15g of caulis polygoni multiflori, 10g of cortex albiziae, 10g of lucid ganoderma, 10g of valerian and 10g of rhizoma corydalis;
(2) soaking the raw materials in tap water for one hour, wherein the amount of water is 2cm higher than the raw materials, starting timing from the boiling of water, decocting with slow fire for 30 minutes, collecting 150ml of decoction, adding water, decocting for two times, adding water to a level 1 cm higher than the raw materials, decocting for 20 minutes, collecting 150ml of decoction, and mixing the two decoctions.
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