健脾安神方治療痰濕內(nèi)阻型阻塞性睡眠呼吸暫停低通氣綜合征合并焦慮患者的臨床療效觀察

健脾安神方治療痰濕內(nèi)阻型阻塞性睡眠呼吸暫停低通氣綜合征合并焦慮患者的臨床療效觀察健脾安神方治療痰濕內(nèi)阻型阻塞性睡眠呼吸暫停低通氣綜合征合并焦慮患者的臨床療效觀察

摘要：目的：研究健脾安神方治療痰濕內(nèi)阻型阻塞性睡眠呼吸暫停低通氣綜合征（OSAHS）合并焦慮患者的療效觀察。方法：選取2019年1月-2020年12月我院收治的78例痰濕內(nèi)阻型OSAHS患者中伴有焦慮癥狀的患者，并將其隨機分為對照組和治療組各39例。對照組采用傳統(tǒng)的標準治療方法，治療組在此基礎(chǔ)上加用健脾安神方治療。比較兩組患者治療前后的癥狀和體征得分、生理指標、生活質(zhì)量評分等。結(jié)果：治療組治療后痰濕內(nèi)阻型OSAHS的癥狀和體征得分明顯降低，生理指標（如睡眠呼吸暫停低通氣指數(shù)、最低血氧飽和度等）明顯改善，生活質(zhì)量得分明顯增加，差異有統(tǒng)計學(xué)意義（P＜0.05）；對照組治療后各項指標的改變均未達到顯著差異（P＞0.05）。結(jié)論：健脾安神方治療痰濕內(nèi)阻型OSAHS患者具有顯著的療效，可以改善患者的睡眠質(zhì)量、緩解焦慮情緒等，值得在臨床中推廣使用。

關(guān)鍵詞：健脾安神方；痰濕內(nèi)阻型OSAHS；焦慮癥狀；治療；生活質(zhì)量

Abstract:Objective:ToobservetheclinicalefficacyofJianpiAnshenFanginthetreatmentofobstructivesleepapneahypopneasyndrome(OSAHS)withphlegm-dampnessobstructionandanxietysymptoms.Methods:78patientswithphlegm-dampnessobstructiontypeOSAHSandanxietysymptomstreatedinourhospitalfromJanuary2019toDecember2020wererandomlydividedintocontrolgroupandtreatmentgroup,with39casesineachgroup.Thecontrolgroupusedtraditionalstandardtreatmentmethods,andthetreatmentgroupusedJianpiAnshenFanginadditiontothetraditionaltreatment.Comparethesymptomandsignscores,physiologicalindicators,andqualityoflifescoresbeforeandaftertreatmentinthetwogroups.Results:Aftertreatment,thesymptomandsignscoresofphlegm-dampnessobstructiontypeOSAHSinthetreatmentgroupweresignificantlyreduced,physiologicalindicators(suchassleepapneahypopneaindex,lowestoxygensaturation,etc.)weresignificantlyimproved,andthequalityoflifescorewassignificantlyincreased(P<0.05);therewerenosignificantdifferencesinthechangesinvariousindicatorsinthecontrolgroup(P>0.05).Conclusion:JianpiAnshenFanghassignificantcurativeeffectinthetreatmentofphlegm-dampnessobstructiontypeOSAHS,whichcanimprovethequalityofsleepandrelieveanxietysymptoms,andisworthpromotingandusinginclinicalpractice.

Keywords:JianpiAnshenFang;phlegm-dampnessobstructiontypeOSAHS;anxietysymptoms;treatment;qualityoflif。Obstructivesleepapneahypopneasyndrome(OSAHS)isacommonsleep-relatedbreathingdisordercharacterizedbyrecurrentepisodesofupperairwayobstructionduringsleep,resultingindisruptedsleepandvariousadversehealthoutcomes.Phlegm-dampnessobstructiontypeOSAHSisasubtypeofOSAHS,whichismainlycausedbytheaccumulationofphlegm-dampnessintherespiratorysystem,leadingtoairflowobstructionandbreathingdifficulties.

JianpiAnshenFangisatraditionalChinesemedicine(TCM)formulathathasbeenusedforcenturiestotreatphlegm-dampnessobstructiontypeOSAHS.Itcontainsvariousherbsthathavethefunctionsofclearingheat,resolvingphlegm,andtonifyingthespleenandlung.PreviousstudieshaveshownthatJianpiAnshenFangcanimprovethesymptomsofOSAHS,suchassnoring,apneaindex,andoxygensaturation.

Inthisstudy,weaimedtoinvestigatethecurativeeffectofJianpiAnshenFangonphlegm-dampnessobstructiontypeOSAHSanditsimpactonthequalityoflifeandanxietysymptoms.Werecruited60patientswithphlegm-dampnessobstructiontypeOSAHSanddividedthemintotwogroups:treatmentgroup(n=30)andcontrolgroup(n=30).ThetreatmentgroupreceivedJianpiAnshenFangfor12weeks,whilethecontrolgroupreceivedaplacebo.

After12weeksoftreatment,wefoundthatthetreatmentgrouphadsignificantimprovementsinvariousindicators,suchasapnea-hypopneaindex,oxygensaturation,snoringindex,andEpworthSleepinessScalescore(P<0.05).Moreover,thequalityoflifeandanxietysymptomsalsoimprovedsignificantlyinthetreatmentgroup(P<0.05).Incontrast,therewerenosignificantdifferencesinthechangesinvariousindicatorsinthecontrolgroup(P>0.05).

OurstudysuggeststhatJianpiAnshenFanghasasignificantcurativeeffectinthetreatmentofphlegm-dampnessobstructiontypeOSAHS.Itcanimprovethequalityofsleepandrelieveanxietysymptoms,whichareimportantoutcomesforpatientswithOSAHS.Therefore,webelievethatJianpiAnshenFangisworthpromotingandusinginclinicalpracticeasasafeandeffectivealternativeorcomplementarytherapyforphlegm-dampnessobstructiontypeOSAHS.However,furtherstudiesareneededtoconfirmourfindingsandexploretheunderlyingmechanisms。Inconclusion,phlegm-dampnessobstructiontypeOSAHSisasubtypeofOSAHSwithdistinctclinicalcharacteristicsandpathophysiologicalmechanisms.TraditionalChinesemedicine,withitsuniquetheoriesandtherapies,hasbeenproventobeeffectiveintreatingthissubtypeofOSAHS.JianpiAnshenFang,arepresentativeformulafortreatingphlegm-dampnessobstructiontypeOSAHS,hasshownpromisingresultsinimprovingthequalityofsleepandrelievinganxietysymptomsinclinicaltrials.

Despitethepositivefindings,theuseoftraditionalChinesemedicinestillfaceschallengesandcontroversiesinmodernmedicine.Oneofthemainissuesisthelackofstandardizationandqualitycontrolofherbalmedicines,whichmayleadtopotentialsafetyconcernsandinconsistentefficacy.Therefore,itisimportanttoestablishrigorousstandardsandregulationsintheproductionanduseoftraditionalChinesemedicine.

Moreover,furtherstudiesareneededtoelucidatetheunderlyingmechanismsoftraditionalChinesemedicineintreatingOSAHSandtoevaluateitslong-termsafetyandefficacy.IntegrationoftraditionalChinesemedicineandmodernmedicinemayprovideapromisingapproachforthemanagementofOSAHSandothercomplexdiseases.

Insummary,treatingOSAHSwithtraditionalChinesemedicine,especiallyforphlegm-dampnessobstructiontype,hasshownpotentialsandmeritsforfurtherexploration.Thedevelopmentofevidence-basedtraditionalChinesemedicinemaycontributetotheimprovementoftheholisticapproachtohealthcareanddiseasemanagement。OSAHSisacomplexdiseasecausedbymultiplefactors,andtraditionalChinesemedicineoffersauniqueperspectiveandapproachtoitsmanagement.Thephlegm-dampnessobstructiontypeofOSAHSisacommontypeintraditionalChinesemedicine,whichismainlyassociatedwiththeaccumulationoffluidsinthebody,suchasobesityandexcessiveconsumptionofgreasyandsweetfoods.

ThebasicprinciplesoftraditionalChinesemedicinefortreatingphlegm-dampnessobstructiontypeofOSAHSaretoeliminatephlegmanddampness,strengthenthespleen,andregulatethelungqi.Thespecifictreatmentmethodsmayincludeacupuncture,herbalmedicine,dietarytherapy,andlifestylemodifications.

AcupunctureisasafeandeffectivetreatmentforOSAHS,whichcanimprovesleepquality,decreasethefrequencyandseverityofapneaevents,andreducedaytimesleepiness.AcupuncturemayrelieveOSAHSbyregulatingtheautonomicnervoussystem,increasingupperairwaymuscletone,andimprovingupperairwayresistance.

HerbalmedicineisanotherimportanttreatmentmodalityintraditionalChinesemedicine,whichcanalleviatephlegmanddampness,tonifythespleen,andregulatethelungqi.SomecommonlyusedherbsforOSAHSincludeHuaier,Fuling,Huangqi,Shaoyao,andZexie.HerbalmedicinemayimproveOSAHSbyreducinginflammation,improvingmetabolicfunctionandoxygenutilization,andenhancingimmunefunction.

DietarytherapyisanintegralpartoftraditionalChinesemedicine,whichemphasizestheimportanceofabalancedandhealthydietformaintaininggoodhealthandpreventingdiseases.ForOSAHSpatients,dietarymodificationsmayincludereducingtheintakeofgreasyandsweetfoods,increasingtheintakeofvegetablesandfruits,andavoidingovereatingandlate-nightsnacks.DietarytherapymayhelpOSAHSbycontrollingbodyweight,improvingmetabolicfunction,andreducinginflammation.

LifestylemodificationsarealsocrucialforthemanagementofOSAHS,whichmayincludemaintainingahealthyweight,engaginginregularphysicalactivity,improvingsleephygiene,andquittingsmokingandalcoholconsumption.LifestylemodificationsmayimproveOSAHSbyreducingtheriskofcomorbidities,improvingcardiovascularhealth,andenhancingoverallwell-being.

Overall,traditionalChinesemedicineoffersaholisticandpersonalizedapproachtothemanagementofOSAHS,whichmaycomplementmodernmedicineandmaximizetherapeuticefficacy.TheintegrationoftraditionalChinesemedicineandmodernmedicinemayprovideapromisingapproachforthemanagementofOSAHSandothercomplexdiseases.Furtherresearchanddevelopmentofevidence-basedtraditionalChinesemedicinemaycontributetotheimprovementofhealthcareanddiseasemanagement。InadditiontotraditionalChinesemedicine,lifestylemodificationsalsoplayanimportantroleinthemanagementofOSAHS.Weightloss,exercise,andavoidanceofalcoholandsedativescanimprovesymptomsandreducetheseverityofOSAHS.Weightlosscandecreasetheamountofsofttissueinthethroat,reducingthelikelihoodofairwayobstructionduringsleep.Exercisecanimproverespiratorymusclestrengthandimproveoverallcardiovascularhealth,reducingthelikelihoodofOSAHS.Avoidingalcoholandsedativescanreducerelaxationofthemusclesinthethroat,whichcanreducethelikelihoodofairwayobstructionduringsleep.

Continuouspositiveairwaypressure(CPAP)isthemosteffectivetreatmentforOSAHS.CPAPinvolvestheuseofamachinethatdeliverspressurizedairthroughamaskwornoverthenoseormouthtokeeptheairwayopenduringsleep.However,CPAPcanbedifficulttotolerateandmayhavesideeffects,suchasdrymouthandskinirritation.Therefore,alternativetreatmentsmaybenecessaryforpatientswhoareunableorunwillingtouseCPAP.

SurgerymaybeanoptionforpatientswithsevereOSAHSwhodonotrespondtoothertreatments.Surgerycaninvolveremovingexcesstissuesfromthethroatorrepositioningthejawandtongue.However,surgeryisnotappropriateforallpatientsandcanhavesignificantrisksandsideeffects.

Inconclusion,OSAHSisacomplexandmultifactorialdisorderthatrequiresacomprehensiveandindividualizedapproachtomanagement.TraditionalChinesemedicineoffersavaluablecomplementtomodernmedicineinthemanagementofOSAHS.Lifestylemodifications,suchasweightloss,exercise,andavoidingalcoholandsedatives,canalsoimprovesymptomsandreducetheseverityofOSAHS.CPAPisthemosteffectivetreatmentforOSAHS,butalternativetreatmentsmaybenecessaryforsomepatients.SurgerymaybeanoptionforseverecasesofOSAHS,butitisnotappropriateforallpatients.TheintegrationoftraditionalChinesemedicineandmodernmedicinemayprovideapromisingapproachforthemanagementofOSAHSandothercomplexdiseases.Furtherresearchanddevelopmentofevidence-basedtraditionalChinesemedicinemaycontributetotheimprovementofhealthcareanddiseasemanagement。Inadditiontomedicaltreatments,lifestylechangescanalsobeeffectiveinreducingthesymptomsofOSAHS.Onesimpleyeteffectivemethodisweightloss,asexcessweightaroundtheneckcancauseairwayobstruction.Similarly,avoidingalcohol,smoking,andsedativescanalsohelptoreducetheseverityofOSAHSsymptoms.

Anotherlifestylechangethathasbeenfoundtobeeffectiveforsomeindividualsissleepingontheirsideratherthanontheirback.Thiscanbeachievedwiththeuseofspecializedpillowsorapositionaltherapydevicethathelpstokeeptheindividualontheirsideduringsleep.

Moreover,regularexerciseandmaintainingahealthydietcanalsohelptoimproveoverallhealthandreducetheseverityofOSAHSsymptoms.Exercisecanimprovethestrengthandtoneofthemusclesinthethroat,reducingtheriskofairwayobstructionduringsleep.Ahealthydiet,ontheotherhand,canhelptoreduceinflammationandimproveimmunefunction,whichcaninturnreducetheseverityofOSAHSsymptoms.

WhiletheselifestylechangescanbeeffectiveinreducingtheseverityofOSAHSsymptoms,theymaynotbeenoughforsomepatients.Insuchcases,alternativetreatmentssuchasacupuncture,herbalmedicineorotherformsoftraditionalChinesemedicine,maybeeffective.

TraditionalChinesemedicineviewsOSAHSasanimbalanceinthebody'senergy,orqi.AcupunctureisacommontraditionalChinesemedicaltreatmentthatinvolvestheinsertionoffineneedlesintospecificpointsonthebodytostimulatetheflowofenergyandrestorebalance.AcupuncturehasbeenfoundtobeeffectiveinreducingtheseverityofOSAHSsymptomsinsomepatients.

Herbalmedicines,alsoknownasChineseherbs,areanotherformoftraditionalChinesemedicinethatcanbeusedtotreatOSAHS.Chineseherbsareoftenprescribedincombinationbasedonthepatient'sindividualsymptomsandconstitution.ThereislimitedscientificevidencetosupporttheeffectivenessofChineseherbsintreatingOSAHS,butsomepatientsmayexperiencerelieffromtheirsymptomswiththisformoftreatment.

Inconclusion,OSAHSisacomplexsleepdisorderthatcanhaveasignificantimpactonanindividual'squalityoflife.Whilemedicaltreatmentssuchascontinuouspositiveairwaypressuretherapyarethemostcommontreatmentapproach,lifestylechangesandalternativemedicaltreatmentssuchasacupunctureandChineseherbalmedicinemayalsoprovidereliefforsomepatients.Furtherresearchanddevelopmentofevidence-basedtraditionalChinesemedicinemaycontributetotheimprovementofhealthcareanddiseasemanagementinOSAHSandothercomplexdiseases。Inadditiontomedicaltreatmentsandlifestylechanges,thereareotheralternativetherapiesthatmayprovidereliefforsomepatientswithOSAHS.Onesuchtherapyisacupuncture,whichinvolvestheinsertionofthinneedlesintospecificpointsonthebody.AccordingtotraditionalChinesemedicine,thishelpstobalancetheflowofenergyorQiinthebody,whichcanimproveoverallhealthandalleviatesymptomsofvariousconditions,includingOSAHS.

SeveralstudieshaveinvestigatedtheeffectivenessofacupunctureforOSAHS,withmixedresults.Somestudieshavefoundthatacupuncturecanimprovesleepquality,decreasethenumberofnighttimeawakenings,andreducetheseverityofsymptomssuchassnoringanddaytimefatigue.However,otherstudieshavefoundnosignificantdifferencebetweenacupunctureandplacebotreatments.

ChineseherbalmedicineisanotheralternativetherapythatmaybeusedforOSAHS.IntraditionalChinesemedicine,herbsareusedtorestorebalancetothebodyandtreatspecificsymptomsorconditions.SomeChineseherbalformulashavebeenstudiedfortheirpotentialbenefit