Treatment of Adult Chronic Insomnia and the Effect of Assisting Benzodiazepine Withdrawl with a Combination of Suanzaoren Decoction and Huanglian Wendan Decoction: A Multicenter, Prospective Cohort Study

  OBJECTIVE  To explore the efficacy of Sour Jujube Seed Decoction combined with Huanglian Wendan Decoction on adult chronic insomnia and its effect on hypnotic withdrawal.

  METHODS  187 patients with chronic insomnia were included for analysis, including 102 in the traditional Chinese medicine (TCM) group and 85 in the western medicine group. The TCM group was treated with Sour Jujube Seed Decoction combined with Huanglian Wendan Decoction, while the western medicine group was treated with benzodiazepine under the consideration of doctor. The intervention period was 1 month, with assessments using the Pittsburgh Sleep Quality Index (PSQI) conducted before and after the intervention. Follow-up evaluations were performed at 3 months and 6 months respectively after the intervention.

  RESULTS  There was no significant difference between the two groups at baseline. After the intervention, the PSQI scores of patients in both groups were significantly improved (P < 0.01). Among them, the TCM group was better than the western medicine group in the improvement of sleep quality and sleeping pills, total PSQI score reduction (P < 0.01). The results of linear regression analysis showed that after controlling for confounding factors, the regression coefficients of the TCM group in two different models were1.821 and 1.922 respectively, and the former was statistically significant (P < 0.05). By screening patients who took hypnotics at baseline in the TCM group and comparing them with those in the western medicine group, the influencing factors of hypnotic withdrawal were analyzed. During the 3-month follow-up, 25 out of 39 patients in the TCM group and 17 out of 80 patients in the western medicine group had hypnotic withdrawal (χ²= 19.25, P < 0.001); during the 6-month follow-up, 23 of the 39 patients in the TCM group and 18 of the 79 patients in the western medicine group had hypnotic withdrawal (χ²= 13.53, P < 0.001), the withdrawal rate of patients in the TCM group was significantly higher than that in the western medicine group. Further regression analysis showed that after adjusting for confounding factors, the results showed that the western medicine group had a significantly higher rate of not withdrawal than the TCM group at 3 months (OR=5.50, 95%CI: 2.30~13.72) and 6 months (OR=6.43, 95%CI: 2.54~17.77), and the results were statistically different (P < 0.05).

  CONCLUSION  Sour Jujube Seed Decoction combined with Huanglian Wendan Decoction is effective in treating adult chronic insomnia and assisting in hypnotic withdrawal.