目的 探讨刺五加脑灵液联合扎来普隆片治疗失眠症的临床疗效。方法 选择2018年2月-2019年2月在成都市第四人民医院诊治的失眠症患者86例，根据用药的差别分为对照组（43例）和治疗组（43例）。对照组睡前口服扎来普隆片，5 mg/次，1次/d；治疗组在对照组的基础上口服刺五加脑灵液，10 mL/次，2次/d。两组患者均经10 d治疗。观察两组患者临床疗效，同时比较治疗前后两组患者PSQI、AIS、PHQ-9、WEMWBS和QLQ-C30评分，睡眠质量以及血清血清5-羟色胺（5-HT）、脑源性神经营养因子（BDNF）、白细胞介素-1β（IL-1β）、食欲素A（Orexin-A）、肿瘤坏死因子-α（TNF-α）和IL-2水平。结果 治疗后，对照组临床有效率为81.40%，显著低于治疗组的97.67%，两组比较差异有统计学意义（P<0.05）。经治疗，两组患者PSQI评分、AIS评分和PHQ-9评分均显著降低（P<0.05），但WEMWBS评分和QLQ-C30评分均显著升高（P<0.05），且治疗组这些评分项目改善更明显（P<0.05）。经治疗，两组患者总睡眠时间、REM睡眠时间、睡眠效率均提高（P<0.05），而睡眠潜伏期、觉醒时间均显著缩短（P<0.05），且以治疗组改善最为明显（P<0.05）。经治疗，两组患者血清5-HT、BDNF水平均明显升高（P<0.05），但IL-1β、Orexin-A、TNF-α、IL-2水平均明显降低（P<0.05），且以治疗组改善最为明显（P<0.05）。结论 刺五加脑灵液联合扎来普隆片治疗失眠症可显著改善睡眠情况，提高生活质量，有利于焦虑抑郁状态和心理健康状态改善。

Objective To explore the clinical efficacy of Ciwujia Naoling Solution combined with zaleplon in treatment of insomnia. Methods Patients (86 cases) with insomnia in Chengdu Fourth People's Hospital from February 2018 to February 2019 were divided into control (43 cases) and treatment (43 cases) groups based on different treatments. Patients in the control group were po administered with Zaleplon Tablets, 5 mg/time, once daily. Patients in the treatment group were po administered with Ciwujia Naoling Solution on the basis of the control group, 10 mL/time, twice daily. Patients in two groups were treated for 10 d. After treatment, the clinical efficacy was evaluated, and the PSQI, AIS, PHQ-9, WEMWBS and QLQ-C30 scores, sleep quality, and serum levels of 5-HT, BDNF, IL-1β, Orexin-A, TNF-α and IL-2 in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 81.40%, which was significantly lower than 97.67% in the treatment group, and there were differences between two groups (P < 0.05). After treatment, the PSQI, AIS, and PHQ-9 scores in two groups were significantly decreased (P < 0.05), but WEMWBS and QLQ-C30 scores were significantly increased (P < 0.05), and these scores in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the total sleep time, sleep time of REM, and sleep efficiency in two groups were significantly increased (P < 0.05), but sleep latency and wake-up time were significantly decreased (P < 0.05), and these indexes in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the serum levels of 5-HT and BDNF in two groups were significantly increased (P < 0.05), but the IL-1β, Orexin-A, TNF-α and IL-2 levels were significantly decreased (P < 0.05), and these serological indexes in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion Ciwujia Naoling Solution combined with zaleplon in treatment of insomnia can significantly improve sleep, improve quality of life, anxiety, depression and mental health.

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