内科

目的研究穴位注射红花黄色素联合四逆酸枣仁合方在首发中风后不寐（肝郁血虚型）患者中的应用效果。方法选取158例首发中风后不寐（肝郁血虚型）患者作为研究对象，将其随机分为常规组、观察组，每组各79例。在常规西药治疗的基础上，常规组行穴位注射红花黄色素治疗，观察组行穴位注射红花黄色素联合四逆酸枣仁合方治疗，两组均治疗4周。比较两组治疗4周后的临床疗效和治疗前、治疗4周后中医证候积分、匹兹堡睡眠质量指数（PSQI）、脑卒中专用生活质量（SS‑QOL）量表评分、血清神经递质水平、血清核转录因子‑κB（NF‑κB）、促食欲素A水平，以及不良反应发生率。结果治疗4周后，观察组临床总有效率高于常规组（P<0.05）；观察组中医证候积分、PSQI和血清去甲肾上腺素、P物质、NF‑κB、促食欲素A水平均低于常规组，SS‑QOL量表评分和血清多巴胺、5‑羟色胺水平高于常规组（均P<0.05）；两组不良反应总发生率差异无统计学意义（P>0.05）。结论穴位注射红花黄色素联合四逆酸枣仁合方治疗首发中风后不寐（肝郁血虚型）患者疗效显著，可有效地缓解临床症状，调节神经递质水平，促进病情恢复。

Objective To study the application effect of safflower yellow acupoint injection combined with Sini Suanzaoren Decoction in patients with insomnia of liver depression and blood deficiency patterns after the first stroke. Methods A total of 158 patients with insomnia of liver depression and blood deficiency patterns after the first stroke were selected as research subjects and randomly divided into a conventional group or an observation group, with 79 cases in each group. Based on conventional western medicine treatment, the conventional group was treated with safflower yellow acupoint injection, the observation group was treated with safflower yellow acupoint injection combined with Sini Suanzaoren Decoction, and both groups were treated for 4 weeks. The clinical efficacy after 4 weeks of treatment, the traditional Chinese medicine (TCM) syndrome score, Pittsburgh Sleep Quality Index (PSQI), Stroke-Specific Quality of Life (SS-QOL) scale score, serum neurotransmitters levels, and serum nuclear factor-κB (NF-κB) and orexin A levels before and after 4 weeks of treatment, as well as the incidence of adverse reactions, were compared between the two groups. Results After 4 weeks of treatment, the total clinical effective rate of the observation group was higher than that of the conventional group (P<0.05); the TCM syndrome score, PSQI, and serum levels of norepinephrine, substance P, NF-κB, and orexin A in the observation group were lower than those in the conventional group, while the SS-QOL scale score and serum dopamine and 5-hydroxytryptamin levels in the observation group were higher than those in the conventional group (all P<0.05); there was no statistically significant difference in the total incidence of adverse reactions between the two groups (P>0.05). Conclusion Safflower yellow acupoint injection combined with Sini Suanzaoren Decoction has significant efficacy in the treatment of patients with insomnia of liver depression and blood deficiency patterns after the first stroke, which can effectively alleviate clinical symptoms, regulate neurotransmitters levels, and promote the recovery of the disease.