综合疗法对心脾两虚型不寐患者多导睡眠图干预的相关性研究

发布时间：2018-01-06 19:22

本文关键词：综合疗法对心脾两虚型不寐患者多导睡眠图干预的相关性研究　出处：《长春中医药大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的:观察综合疗法治疗心脾两虚型不寐证的临床疗效,并探讨其对多导睡眠图干预的相关性研究。方法:研究选取于长春中医药大学附属医院中西医结合睡眠中心就诊的心脾两虚型不寐证患者72例,采用随机表法分为综合疗法治疗组36例,单纯中药治疗组36例,其中单纯中药治疗组患者应用归脾汤加减,综合疗法治疗组在对照组中药治疗基础上,配合耳穴贴敷疗法,7天为1疗程,共4疗程。应用多导睡眠监测系统检测不寐患者的睡眠变化情况,对两组监测结果进行评估和比较。结果:①综合疗法和单纯中药治疗均可有效延长不寐患者的总睡眠时间,缩短睡眠潜伏期、REM潜伏期,提高睡眠效率,但综合疗法治疗组总睡眠时间、睡眠潜伏期、睡眠效率水平的改善明显要优于单纯中药组(P0.05),但是REM潜伏期的改善方面两组比较无显著性差异(P0.05),提示对REM潜伏期的缩短方面疗效相近;②两组治疗均可明显增加不寐患者的NREM睡眠时间及REM睡眠时间(P0.05),但综合治疗组对NREM期睡眠时间和REM期睡眠时间的延长的作用优于单纯中药组(P0.05),在觉醒次数方面,两组治疗后觉醒次数均明显减少,综合治疗组对觉醒次数的减少方面要优于单纯中药组(P0.05),说明综合治疗组可有效减少觉醒事件在整体睡眠过程中的发生次数;③综合治疗组NREM睡眠期S1期、S2期、S3期时间在治疗前后均具有极显著性差异(P0.01),提示综合治疗通过缩短不寐患者的浅睡眠时间,延长深睡眠时间,实现对NREM睡眠的调节作用;单纯中药组NREM睡眠S1期、S2期在治疗前后具有极显著性差异(P0.01),S3期比较无显著性差异(P0.05),提示单纯中药治疗能够增加S2期睡眠时间,缩短S1期睡眠时间,但对深睡眠时间无明显影响。综合治疗对NREM睡眠的各期及总体的改善作用要优于单纯中药组(P0.05);④综合治疗组的总有效率为86.11%,在总体疗效方面临床比较优于单纯中药组(69.44%)(P0.05)。结论:中药、耳穴综合疗法治疗心脾两虚型不寐证安全、有效,可以在根本上优化失眠患者的睡眠结构,提高患者睡眠效率,增加REM、NREM睡眠时间,在改善睡眠质量方面具有显著优势。
[Abstract]:Objective: to observe the clinical effect of comprehensive therapy on insomnia with deficiency of both heart and spleen. Methods: 72 patients with insomnia with deficiency of both heart and spleen were selected from sleep center of TCM and Western medicine affiliated hospital of Changchun University of traditional Chinese Medicine. Random list method was used to divide the treatment group into three groups: 36 cases in the combined therapy group and 36 cases in the traditional Chinese medicine treatment group, in which the patients in the traditional Chinese medicine treatment group were treated with Guipi decoction, and the treatment group was based on the traditional Chinese medicine treatment in the control group. Combined with auricular acupoint application therapy for 7 days as a course of treatment, a total of 4 courses. The use of polysomnography monitoring system to detect sleep changes in patients with insomnia. Results the total sleep time of the patients with insomnia was prolonged, the REM latency was shortened and the sleep efficiency was improved. However, the improvement of total sleep time, sleep latency and sleep efficiency in the treatment group was significantly better than that in the traditional Chinese medicine group (P0.05). However, there was no significant difference in the improvement of REM latency between the two groups, indicating that the effect of shortening the latency of REM was similar. 2 the NREM sleep time and REM sleep time of the patients with insomnia were significantly increased in both groups (P 0.05). But the effect of comprehensive treatment group on NREM sleep time and REM stage sleep time prolongation was better than that of traditional Chinese medicine group (P0.05A). In the arousal times, the two groups after treatment significantly decreased the arousal times. The reduction of arousal times in the comprehensive treatment group was better than that in the traditional Chinese medicine group, which indicated that the comprehensive treatment group could effectively reduce the number of arousal events occurring in the whole sleep process. 3There was a significant difference in the time of NREM sleep stage S1, S2 and S3 before and after treatment in the combined treatment group, indicating that comprehensive treatment could shorten the shallow sleep time of the patients with insomnia. Prolonging the time of deep sleep and realizing the regulation of NREM sleep; There was no significant difference in NREM sleep stage S _ 1 / S _ 2 stage before and after treatment in Chinese medicine group (P 0.05). It is suggested that Chinese medicine alone can increase sleep time in S2 stage and shorten sleep time in S1 stage. But there was no significant effect on the time of deep sleep. The effect of comprehensive therapy on the improvement of NREM sleep was better than that of traditional Chinese medicine group (P 0.05). 4 the total effective rate of the combined treatment group was 86.11, which was better than that of the traditional Chinese medicine group in the total curative effect. Conclusion: traditional Chinese medicine is better than the traditional Chinese medicine group. Auricular point therapy is safe and effective in treating insomnia with deficiency of both heart and spleen. It can fundamentally optimize sleep structure of insomnia patients, improve sleep efficiency of patients, and increase sleep time of REMN NREM patients. It has significant advantages in improving sleep quality.
【学位授予单位】：长春中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R740

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