Suan Zao Ren Tangin Combination withZhi Zi Chi Tangas a Treatment Protocol for Insomniacs with Anxiety: A Randomized Parallel-Controlled Trial

Abstract

Insomnia is a serious worldwide health problem that is often comorbid with anxiety. The purpose of the present study was to evaluate the efficacy of a Chinese formula containing Suan Zao Ren Tang (SZRT) and Zhi Zi Chi Tang (ZZCT; SZR-ZZC) for improving sleep quality and anxiety states with four indices of Polysomnography (PSG), the Insomnia Severity Index (ISI), the Pittsburgh Sleep Quality Index (PSQI), and the Self Rating Anxiety Scale (SAS). Methods. A randomized, parallel-controlled trial compared SZR-ZZC to lorazepam tablet in insomniacs with anxiety. Patients were randomized to the SZR-ZZC treatment group (n = 60) and the lorazepam tablet treatment group (n = 59). Results. SZR-ZZC significantly improved scores on all four treatment indices. Compared with lorazepam, treatment with SZR-ZZC resulted in a significant reduction in the ISI (P = 0.029), the PSQI (P = 0.017), and wake after sleep onset (WASO; P = 0.008) scores and improved sleep architecture (P = 0.000–0.003) after a 4-week treatment period. Only one subject in the SZR-ZZC group experienced adverse side effects. Conclusion. Treatment with SZR-ZZC for 4 weeks appears to be a relatively safe and effective complementary therapeutic option when aiming to improve sleep quality and anxiety in insomniacs with anxiety.

Efficacy and Safety of Jiawei Suanzaoren Decoction Combined with Lorazepam for Chronic Insomnia: A Parallel‐Group Randomized Controlled Trial

“…Although a single herb can have beneficial effects in the prevention and treatment of sleep disorders, it was believed that two or more compounds may have additive or synergistic effects when used together. Our previous study confirmed the short-term efficacy of JW-SZRD for insomniacs with anxiety and found that the administration of JW-SZRD for four weeks had a pronounced improvement in sleep quality and a remarkable alleviation of anxiety state [14].…”

“…In our previous research, we have verified the short-term efficacy of JW-SZRD for insomnia patients with yin-deficiency and fire-excess syndrome [14]. However, the longterm effects of JW-SZRD for chronic insomnia remain unclear.…”

“…Zhizichi decoction (ZZCD), comprising of Gardenia jasminoides fruit and fermented soybean, is also a traditional Chinese formula that has been widely used for depression and insomnia treatment for more than two thousand years [12]. In recent years, a combined formula of SZRD and ZZCD (Jiawei Suanzaoren Decoction, JW-SZRD) has been proven to be effective for insomnia with yin-deficiency and fire-excess syndrome [13,14]. Yin-deficiency and fire-excess syndrome usually shows palpitation, restlessness, headache, rapid pulse, hot flashes, and excessive sweating and is one of the common patterns of insomnia in clinical practice.…”

Modified Suanzaorentang Had the Treatment Effect for Generalized Anxiety Disorder for the First 4 Weeks of Paroxetine Medication: A Pragmatic Randomized Controlled Study

“…In our previous study, we found that SZRT together with Zhi Zi Chi Tang, which was the same formula as MSZRT in the present study, could decrease SAS scores and improve daytime function in insomniacs with anxiety [ 25 ]. Insomnia is one of the common symptoms of GAD [ 26 ] or it is frequently cooccurring [ 27 ].…”

Study on the Antianxiety Mechanism of Suanzaoren Decoction Based on Network Pharmacology and Molecular Docking

“…It has exhibited excellent effect on antianxiety or anti-insomnia in clinical practice in China for hundreds of years. Modern clinical studies showed that SZRT could improve GAD [4] and anxiety insomnia [5]; pharmacological studies also validated that SZRT can effectively improve anxiety disorder in a high plus maze experiment of rats and clinically alleviate anxiety symptoms [6]. e alcohol extracts of Ziziphi Spinosae Semen [7] and Anemarrhenae Rhizoma [8] had an antianxiety-like behavior in mice.…”