目的 探讨归脾丸与唑吡坦联合治疗心脾两虚型失眠症的临床疗效。方法 回顾性选取河南中医药大学第三附属医院2022年4月—2024年5月收治的126例失眠症（心脾两虚型），按照使用药物治疗方案的不同分为对照组（63例）和治疗组（63例）。对照组口服酒石酸唑吡坦片，10 mg/次，1次/d。在对照组基础上，治疗组口服归脾丸，8～10丸/次，3次/d；两组治疗15 d。观察两组患者的疗效，比较治疗前后两组患者症状缓解时间，斯匹格失眠量表（SPIEGEL）评分和匹兹堡睡眠指数（PSQI）评分，及5-羟色胺（5-HT）、γ-氨基丁酸（GABA）、脑源性神经营养因子（BDNF）和多巴胺（DA）水平。结果 治疗后，治疗组总有效率（96.83%）明显高于对照组（85.71%，P＜0.05）。治疗后，与对照组对比，治疗组易醒、乏力、入睡困难、体力下降好转时间均较短（P＜0.05）。治疗后，两组患者SPIEGEL评分和PSQI评分明显下降（P＜0.05），且治疗后治疗组SPIEGEL评分和PSQI评分均明显低于对照组（P＜0.05）。治疗后，两组患者5-HT、GABA和BDNF水平明显升高，而DA水平明显降低（P＜0.05），且治疗后，与对照组比较，治疗组5-HT、GABA和BDNF水平高于对照组，而DA水平低于对照组（P＜0.05）。结论 归脾丸与唑吡坦协同治疗，能使失眠症患者症状缓解时间加快，对患者睡眠质量改善明显。

Objective To explore the clinical effect of Guipi Pills combined with zolpidem in treatment of heart spleen deficiency type. Methods The clinical data of patients (126 cases) with heart spleen deficiency type in the Third Affiliated Hospital of Henan University of Traditional Chinese Medicine from April 2022 to May 2024 were analyzed retrospectively. They were divided into control (63 cases) and treatment (63 cases) group based on different treatments. Patients in the control group were po administered with Zolpidem Tartrate Tablets, 10 mg/time, once daily. Patients in the treatment group were po administered with Guipi Pills on the basis of the control group, 8 — 10 pills/time, three times daily. Patients in two groups were treated for 15 d. After treatment, the clinical evaluations were evaluated, the symptom relief time, the scores of SPIEGEL and PSQI, the levels of 5-HT, GABA, BDNF and DA in two groups before and after treatment were compared. Results After treatment, the total effective rate of the treatment group (96.83%) was significantly higher than that of the control group (85.71%, P < 0.05). After treatment, compared with the control group, the treatment group was easy to wake up, fatigue, difficulty falling asleep, and the improvement time of physical decline were shorter (P < 0.05). After treatment, SPIEGEL score and PSQI score of two groups were significantly decreased (P < 0.05), and after treatment, SPIEGEL score and PSQI score of the treatment group were significantly lower than that of the control group (P < 0.05). After treatment, the levels of 5-HT, GABA and BDNF in both groups were significantly increased, while the levels of DA were significantly decreased (P < 0.05). After treatment, compared with the control group, the levels of 5-HT, GABA and BDNF in the treatment group were higher than those in the control group, while the levels of DA were lower than those in the control group (P< 0.05). Conclusion The synergistic treatment of Guipi Pills combined with zolpidem can accelerate the recovery of insomnia patients, significantly improve their sleep quality.

R971