2026 年第 7 期 第 21 卷

通督调腹法联合枣仁宁神胶囊对心脾两虚型失眠症患者觉醒程度及血清褪黑素含量的影响

Effects of Tongdu Tiaofu method combined with Zaoren Ningshen capsules on arousal level and serum melatonin content in insomnia patients with heart-spleen deficiency syndrome

作者：李晋文1李建仲1马红青1张永琴2

英文作者：Li Jinwen1 Li Jianzhong1 Ma Hongqing1 Zhang Yongqin2

单位：1山西省中医药研究院（山西省中医院）推拿科，太原030012；2山西省太原市中医医院康复科，太原030009

英文单位：1Department of Massage Shanxi Traditional Chinese Medical Hospital Shanxi Academy of Traditional Chinese Medicine Taiyuan 030012 China; 2Department of Rehabilitation Taiyuan Hospital of Traditional Chinese Medicine Shanxi Province Taiyuan 030009 China

关键词：失眠症；通督调腹法；枣仁宁神胶囊；心脾两虚型

英文关键词：Insomnia;TongduTiaofumethod;ZaorenNingshencapsules;Heart-spleendeficiencysyndrome

• 摘要：

• 目的 探究通督调腹法联合枣仁宁神胶囊对心脾两虚型失眠症患者觉醒程度及血清褪黑素含量的影响。方法 选取2024年9月至2025年9月于山西省中医药研究院治疗的96例失眠症患者作为研究对象。根据随机数字表法将患者分为对照组和观察组，每组48例。对照组给予枣仁宁神胶囊治疗，观察组在对照组基础上给予通督调腹法治疗。比较2组患者疗效、治疗前、治疗2周后、治疗4周后及治疗结束后4周的中医证候积分、匹兹堡睡眠质量指数（PSQI）、阿森斯失眠量表（AIS）、过度觉醒量表（HAS）、汉密尔顿焦虑量表（HAMA）评分、治疗前后的血清褪黑素、皮质醇、血管活性肠肽（VIP）、食欲素A水平。结果 观察组总有效率高于对照组［95.8%（46/48）比81.2%（39/48）］，差异有统计学意义（χ2=5.031，P=0.025）。治疗2周后、4周后、治疗结束后4周，观察组中医证候积分、PSQI、HAS、AIS评分均明显低于对照组（均P＜0.05）。治疗4周后、治疗结束后4周，观察组HAMA评分均明显低于对照组（均P＜0.05）。治疗后，2组褪黑素水平均高于治疗前，且观察组高于对照组；2组皮质醇、VIP、食欲素A水平均低于治疗前，且观察组均低于对照组（均P<0.05）。结论 通督调腹法联合枣仁宁神胶囊治疗心脾两虚型失眠症效果确切，能有效改善患者的中医证候、睡眠质量及焦虑状态，调节机体的觉醒程度，并可通过影响血清相关激素及神经肽水平发挥治疗作用。

• Objective To explore the effects of Tongdu Tiaofu method combined with Zaoren Ningshen capsules on arousal level and serum melatonin content in insomnia patients with heart-spleen deficiency syndrome. Methods A total of 96 insomnia patients treated at Shanxi Traditional Chinese Medical Hospital from September 2024 to September 2025 were selected as research subjects. Patients were divided into control group and observation group according to random number table method, with 48 cases in each group. The control group was treated with Zaoren Ningshen capsules, and the observation group was additionally treated with Tongdu Tiaofu method on the basis of the control group. The therapeutic effects, scores of traditional Chinese medicine (TCM) syndrome scale, Pittsburgh Sleep Quality Index (PSQI), Athens Insomnia Scale (AIS), Hyperarousal Scale (HAS), Hamilton Anxiety Scale (HAMA) before treatment, 2 weeks after treatment, 4 weeks after treatment and 4 weeks after the end of treatment, as well as serum levels of melatonin, cortisol, vasoactive intestinal peptide (VIP) and orexin A before and after treatment were compared between the two groups. Results The total effective rate of the observation group was higher than that of the control group ［95.8%(46/48) vs 81.2%(39/48)］(χ2=5.031, P=0.025). At 2 weeks after treatment, 4 weeks after treatment and 4 weeks after the end of treatment, TCM syndrome scores, PSQI, HAS and AIS scores in the observation group were significantly lower than those in the control group (all P<0.05). At 4 weeks after treatment and 4 weeks after the end of treatment, HAMA scores in the observation group were significantly lower than those in the control group (both P<0.05). After treatment, melatonin levels in both groups were higher than those before treatment, and the observation group was higher than the control group; levels of cortisol, VIP and orexin A in both groups were lower than those before treatment, and the observation group were lower than the control group (all P<0.05). Conclusion Tongdu Tiaofu method combined with Zaoren Ningshen capsules has definite efficacy in the treatment of insomnia with heart-spleen deficiency syndrome. It can effectively improve patients′ TCM syndromes, sleep quality and anxiety state, regulate the body′s arousal level, and exert therapeutic effects by affecting serum levels of related hormones and neuropeptides.