目的 探讨枣仁安神颗粒联合右佐匹克隆片治疗老年原发性失眠的临床疗效。方法 选取2020年4月—2021年4月在武汉市第一医院神经内科睡眠与心理门诊就诊的96例老年原发性失眠症患者，根据随机数字表法将所有患者分为对照组和治疗组，每组48例。对照组睡前口服右佐匹克隆片，2 mg/次，1次/d。治疗组在对照组基础上睡前口服枣仁安神颗粒，1袋/次，1次/d。两组患者连续治疗4周。观察两组的临床疗效，比较两组的睡眠质量、睡眠指标以及血清中脑源性神经营养因子（BDNF）、神经肽Y（NPY）、肿瘤坏死因子-α（TNF-α）水平。结果 治疗后，治疗组患者的总有效率为89.58%，对照组的总有效率为72.92%，两组比较有明显差异（P<0.05）。治疗后，两组的匹兹堡睡眠质量指数（PSQI）量表评分均低于治疗前（P<0.05）；治疗后，治疗组的PSQI评分低于对照组（P<0.05）。治疗后，两组的慢波睡眠（SWS）、睡眠效率（SE）高于治疗前，觉醒时间（AT）低于治疗前（P<0.05）；治疗后，治疗组患者的SWS、SE高于对照组，AT低于对照组（P<0.05）。治疗后，两组的血清BDNF、NPY水平高于治疗前，血清TNF-α水平低于治疗前（P<0.05）；治疗后治疗组的BDNF、NPY水平高于对照组，TNF-α低于对照组（P<0.05）。结论 枣仁安神颗粒联合右佐匹克隆片治疗老年失眠症疗效确切，能改善睡眠质量，调节SWS、SE、AT，升高BDNF、NPY水平，降低TNF-α水平，安全性较好。

ObjectiveTo investigate the curative effect of Zaoren Anshen Granules combined with Dexzopiclone Tablets in treatment of senile primary insomnia Methods Patients (96 cases) with senile primary insomnia in Wuhan First Hospital from April 2020 to April 2021 were randomly divided into control and treatment groups, and each group had 48 cases. Patients in the control group were po administered with Dexzopiclone Tablets, 2 mg/time, once daily. Patients in the treatment group were po administered with Zaoren Anshen Granules on the basis of the control group, 1 bag/time, once daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacies were evaluated, and the sleep quality, sleep index, and the levels of BDNF, NPY, and TNF-α in two groups were compared. Results After treatment, the total effective rate was 89.58% in the treatment group and 72.92% in the control group, and there was significant difference between two groups (P < 0.05). After treatment, the PSQI scores of two groups were lower than those before treatment (P < 0.05). After treatment, the PSQI score of the treatment group was lower than that of the control group (P < 0.05). After treatment, the SWS and SE of two groups were higher than before treatment, but AT of two groups was lower than before treatment (P < 0.05). After treatment, the SWS and SE in the treatment group were higher than those in the control group, but AT in the treatment group was lower than those in the control group (P < 0.05). After treatment, the serum levels of BDNF and NPY in two groups were higher than those before treatment, but the serum level of TNF-α in two groups was lower than that before treatment (P < 0.05); After treatment, the BDNF and NPY in the treatment group were higher than those in the control group, but the serum level of TNF-α in the treatment group was lower than those in the control group (P < 0.05). Conclusion Zaoren Anshen Granules combined with Dexzopiclone Tablets is effective in treatment of senility primary insomnia, which can improve sleep quality, regulate SWS, SE, and AT, increase the levels of BDNF and NPY, and reduce the level of TNF-α, with good safety.

R971

武汉市医学科研项目（WX20B23）