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Volume 41 Issue 4
Apr.  2023
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MENG Xiangqing, WEI Nini, HUANG Xiangchun, XU Jiacheng, DONG Wei, JIA Min. Study on the efficacy of the resolving depression and tranquilizing TCM sachets in alleviating sleep disorders of soldiers in naval vessels[J]. Journal of Pharmaceutical Practice and Service, 2023, 41(4): 252-254. doi: 10.12206/j.issn.2097-2024.202105063
Citation: MENG Xiangqing, WEI Nini, HUANG Xiangchun, XU Jiacheng, DONG Wei, JIA Min. Study on the efficacy of the resolving depression and tranquilizing TCM sachets in alleviating sleep disorders of soldiers in naval vessels[J]. Journal of Pharmaceutical Practice and Service, 2023, 41(4): 252-254. doi: 10.12206/j.issn.2097-2024.202105063

Study on the efficacy of the resolving depression and tranquilizing TCM sachets in alleviating sleep disorders of soldiers in naval vessels

doi: 10.12206/j.issn.2097-2024.202105063
  • Received Date: 2021-05-14
  • Rev Recd Date: 2022-01-03
  • Available Online: 2023-07-14
  • Publish Date: 2023-04-25
  •   Objective  To explore the efficacy of the resolving depression and tranquilizing herbal sachets in alleviating sleep disorders of soldiers in naval vessels.   Methods  Fifty-nine soldiers with sleep disorders (PSQI scale score ≥8 and SAS scale score ≥50) were selected before training at sea, and were randomly divided into sachet treatment group, mindfulness meditation group and control group. During the training period, the sachet treatment group was given traditional Chinese medicine sachet treatment, the mindfulness meditation group was trained in mindfulness meditation, and the control group was not given any intervention.   Results  Compared with the control group, the PSQI and SAS scores of soldiers in both the experimental sachet treatment group and the positive meditation group were significantly improved; compared with the pre-intervention data, the PSQI and SAS scores of both the positive meditation group and the sachet treatment group were significantly decreased, and the degree of decrease was comparable.   Conclusion  The homemade improving depression and tranquilizing TCM sachets have the effect of alleviating the sleep disorders of naval troops served on vessels, which is equivalent to mindfulness meditation. It is easy to use and operate, which is suitable for promotion in the military.
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Study on the efficacy of the resolving depression and tranquilizing TCM sachets in alleviating sleep disorders of soldiers in naval vessels

doi: 10.12206/j.issn.2097-2024.202105063

Abstract:   Objective  To explore the efficacy of the resolving depression and tranquilizing herbal sachets in alleviating sleep disorders of soldiers in naval vessels.   Methods  Fifty-nine soldiers with sleep disorders (PSQI scale score ≥8 and SAS scale score ≥50) were selected before training at sea, and were randomly divided into sachet treatment group, mindfulness meditation group and control group. During the training period, the sachet treatment group was given traditional Chinese medicine sachet treatment, the mindfulness meditation group was trained in mindfulness meditation, and the control group was not given any intervention.   Results  Compared with the control group, the PSQI and SAS scores of soldiers in both the experimental sachet treatment group and the positive meditation group were significantly improved; compared with the pre-intervention data, the PSQI and SAS scores of both the positive meditation group and the sachet treatment group were significantly decreased, and the degree of decrease was comparable.   Conclusion  The homemade improving depression and tranquilizing TCM sachets have the effect of alleviating the sleep disorders of naval troops served on vessels, which is equivalent to mindfulness meditation. It is easy to use and operate, which is suitable for promotion in the military.

MENG Xiangqing, WEI Nini, HUANG Xiangchun, XU Jiacheng, DONG Wei, JIA Min. Study on the efficacy of the resolving depression and tranquilizing TCM sachets in alleviating sleep disorders of soldiers in naval vessels[J]. Journal of Pharmaceutical Practice and Service, 2023, 41(4): 252-254. doi: 10.12206/j.issn.2097-2024.202105063
Citation: MENG Xiangqing, WEI Nini, HUANG Xiangchun, XU Jiacheng, DONG Wei, JIA Min. Study on the efficacy of the resolving depression and tranquilizing TCM sachets in alleviating sleep disorders of soldiers in naval vessels[J]. Journal of Pharmaceutical Practice and Service, 2023, 41(4): 252-254. doi: 10.12206/j.issn.2097-2024.202105063
  • 舰艇官兵由于个人空间狭小,工作压力大,气候潮湿,环境嘈杂等因素,睡眠状态易受到影响[1]。因此,较容易出现睡眠障碍,由此可引发各类负性情绪[2]。冯晨曦[3]等观察到在以青壮年为主的海勤人员远航中,焦虑和抑郁情绪明显高于航前。睡眠质量还会影响官兵的生存质量[4],不利于训练、执勤等任务完成的质量[5]。在舰艇出海训练期间,做到提高官兵睡眠质量,又不干扰正常训练是非常有意义的。本研究利用解郁安神中药香囊挥发油的有效成分,通过嗅闻吸入的无创方式,明显改善了舰艇官兵的睡眠质量,现报告如下。

    • 在海军某舰艇部队出海训练前1周筛选出有睡眠障碍(匹茨堡睡眠质量指数量表PSQI评分≥8[6]且焦虑评分量表SAS评分≥50[7])的官兵59人,他们中无精神类疾病及过敏体质。随机分为香囊试验组20人、正念冥想组20人和空白对照组19人。所选官兵均为男性,在年龄、学历、婚姻、岗位、人员素质等方面差别无统计学意义(P>0.05)。三组官兵在治疗前的PSQI评分与SAS评分无统计学差异,具有可比性。

    • 试验组使用自制解郁安神中药香囊(石菖蒲、柏子仁、当归、荆芥、薰衣草等)。将香囊放置于床头,晚睡前打开香囊袋,将鼻口置于距香囊口约10 cm距离,深嗅3 min,每2周为官兵更换1次香囊,治疗8周。正念冥想训练主要借鉴正念认知疗法 [8-9]。的8周课程结构,每周在指导音频带领下集中训练1次,每次2 h,包括训练和体验分享,其余时间根据课后作业自行训练。空白对照组与香囊试验组和正念冥想组保持相同作息,工作活动。统计比较三组官兵治疗前后的PSQI和SAS评分差值。

    • PSQI量表评分,总分≥8表示有睡眠障碍,分值越高表明睡眠障碍越严重。疗效评价标准[10]:根据匹茨堡睡眠质量指数量表PSQI评分减分率进行评价,痊愈:PSQI评分减分率在75%以上;显效:减分率在50%~74% 之间;有效:减分率在25%~49% 之间;无效:减分率在25%以内。SAS量表评分,评分<50分无焦虑,≥50分轻度焦虑,≥60分中度焦虑,≥70分重度焦虑[8]

    • 采用 SPSS 21.0软件进行数据统计分析,计量资料以均数±标准差($\bar x $±s)表示。三组PSQI评分与SAS评分前后差值采用单因素方差分析及SNK检验,所有检验均以P<0.05为检验标准。

    • 空白对照组PSQI与SAS评分分别升高27.93%、15.56%,提示睡眠障碍和焦虑有不同程度加重,正念冥想组与香囊试验组官兵PSQI评分分别下降24.64%和25.47%,SAS评分分别下降15.27%和15.58%,说明睡眠障碍与焦虑的症状得到明显改善(表1),三组官兵两个量表评分结果经方差分析,P< 0.05,差异有统计学意义。经SNK检验,香囊试验组与正念冥想组在降低PSQI和SAS评分上作用相当,两组降低程度无统计学差异(表234)。

      组别例数PSQI评分SAS评分
      治疗前治疗后治疗前后差值治疗前治疗后治疗前后差值
      正念冥想组2010.60±1.857.90±2.192.70±0.9058.40±4.9349.30±4.849.10±1.76
      香囊试验组2010.55±1.917.95±1.532.60±1.0758.30±4.7249.40±4.658.90±1.81
      空白对照组1910.74±1.8313.74±2.86−3.00±1.4958.16±4.6867.21±3.78−9.05±1.93
      F142.18592.08
      P00
      组别例数α=0.05 的子集
      12
      空白对照组19−3
      香囊试验组202.6
      正念冥想组202.7
      P10.795
      组别例数α=0.05 的子集
      12
      空白对照组19−9.0526
      香囊试验组208.9
      正念冥想组209.1
      P10.74
      组别例数痊愈显效有效无效总有效率
      正念冥想组200(0)0(0)11(55)9(45)11(55)
      香囊试验组200(0)0(0)11(55)9(45)11(55)
      空白对照组190(0)0(0)0(0)19(100)0(0)
    • 三组实验官兵均能坚持完成治疗项目,治疗期间均未发生明显不良反应。

    • 最新研究证据表明,战时剥夺睡眠是军人执行军事战斗任务之后罹患创伤后应激障碍、抑郁和焦虑障碍的重要危险因素[11]。本研究空白对照组的结果与吴刚[12]等发现焦虑和抑郁是海勤人员长航过程中易发生的两种负性情绪, 且与睡眠质量密切相关的报告相吻合。姜萍[13]研究显示,舰艇官兵借助药物催眠,极易产生副作用,长期服药还会产生耐受性和依赖性,停药后会出现戒断症状,因此,催眠药不宜长期服用[14]

      正念冥想是近年来研究非药物治疗睡眠障碍的热点,目前许多研究也都证明正念对慢性失眠有较好的疗效[9]。Black等[15]在一项随机对照临床试验中发现:与接受睡眠卫生教育的对照组相比,参加冥想训练的受试者的匹兹堡睡眠质量指数降低更明显。国内王晓明等[16]研究发现受试者的正念冥想水平和睡眠质量呈现显著正相关,冥想训练可以通过降低受试者焦虑水平有效改善睡眠质量。本研究中正念冥想组官兵SAS量表评分变化也证实了这一点。正念训练的效果受到治疗师自身经验与技术的影响,国外实证类文献在报告正念疗效时,会提到正念训练师的培训资质,而目前大多数的国内文献都没有提到培训师的资质以及培训经历[9],这可能是正念冥想在实践应用中的一个缺陷。

      本研究中香囊试验组采用了自行研制的解郁安神中药香囊,借鉴传统中药香囊具有平衡阴阳、开泄腠理、宣畅肺卫、调节脏腑功能的作用[17],查阅古籍药方及参考现代药理研究进展,本方选用石菖蒲、柏子仁、荆芥、当归、薰衣草等药材研制成粉末制成,通过药材中的挥发油达到改善睡眠治疗的作用。现代药理研究证实,石菖蒲、柏子仁、当归、薰衣草都具有镇静催眠作用[18-21],荆芥油具有祛痰作用,能缓解密闭船舱内潮湿的气体环境对官兵呼吸道的刺激[22]。通过合理调整中药配比,可以达到宣畅肺卫、解郁清心、安神助眠的作用。试验结果表明解郁安神香囊对失眠障碍的治疗有明显效果,作用与正念冥想相当,但香囊在舰艇上使用更加简单实用、安全可靠。与西药相比,香囊作用相对温和,无不良反应,不影响日常训练。

    • 解郁安神中药香囊在治疗睡眠障碍,改善睡眠质量方面具有明显疗效,并且简单实用、安全有效、使用方便,在治疗过程中无明显的不良反应,且有简单价廉的优势,是改善舰艇官兵睡眠障碍切实可行的方法,值得在军队中进行推广。

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