调神针法治疗失眠的临床疗效观察

发布时间：2018-01-05 20:03

本文关键词：调神针法治疗失眠的临床疗效观察　出处：《广州中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:失眠是临床的多发病、常见病,目前西医主要是以药物治疗,但其易产生依赖性和不良反应。本次研究通过分析比较调神针法与安神补心胶囊治疗失眠的临床疗效,客观评价调神针法对失眠的疗效,并为其在临床治疗失眠,增加睡眠时间、提高睡眠质量的应用及推广提供参考依据。方法:选取广州中医药大学第一附属医院针灸科及推拿科门诊2016年3月至2016年12月符合研究纳入标准且自愿参加本研究的患者90例。随机分为针刺组(30例)、药物组(30例)、针刺加药物组(30例)。针刺组采取调神针法治疗,主要选穴:四神针、神庭、印堂、神门、三阴交、申脉、照海,随症加减。针刺组治疗每天1次,每次留针30分钟,治疗4周。药物组口服安神补心胶囊(聚协昌(北京)药业有限公司,批号:Z10960053),一次4粒,一日3次,治疗4周后观察疗效。针刺加药物组则同时接受调神针法及口服安神补心胶囊治疗。分别于首次就诊当日(治疗前)及治疗4周后(治疗后)对患者进行匹兹堡睡眠质量指数(PSQI)及睡眠状况自评量表(SRSS)的评估。完成数据收集及整理工作后,使用SPSS20.0软件进行数据统计学分析,评价调神针法对原发性失眠的临床疗效。结果:本研究对三组患者进行两次数据采集,分别在首次治疗前、治疗4周后,以P0.05,(进一步作两两比较,其校正检验水准取α'=0.017)为差异具有统计学意义。1.治疗前,三组患者一般资料(性别、年龄、病程、职业分布、睡眠质量、入睡时间、睡眠时间、日间功能障碍、PSQI评分及SRSS评分)经统计学分析,差异均无统计学意义(P0.05),表明组间具有可比性。2.治疗后三组患者睡眠质量、入睡时间、睡眠时间、日间功能障碍、PSQI评分及SRSS评分较治疗前均有所改善(P0.05),表明三组治疗均有显著疗效。3.临床疗效:针刺组、药物组、针刺加药物组的总有效率分别为93.3%、73.3%、96.7%,经等级秩和检验,P0.05,差异具有统计学意义。对治疗后总有效率进一步进行两两比较,取校正检验水准取α' =0.017:针刺组与药物组比较P0.017;针刺组与针药组比较:P0.017;药物组与针药组比较:P0.017;说明:三组临床疗效比较具有显著的统计学意义,针刺组与针药组总有效率均优于药物组,但针药组与针刺组效果相仿。4.三组患者治疗后的睡眠质量评分经秩和检验,P0.05,三组患者治疗后睡眠质量评分比较有统计学意义。进一步做两两比较,校正的α' =0.017,进行χ2分割算法,其中针刺组与药物组比较,P0.017;针刺组与针药组比较P0.017;药物组与针药组比较,P0.017;说明改善睡眠质量方面,针刺组与针药组均优于药物组,但针药组与针刺组效果相仿。5.三组患者治疗后的入睡时间经单因素的方差分析,P0.05,说明三组治疗后的入睡时间有统计学意义。进一步用SNK法和LSD法对均数进行两两比较,其中:针刺组与药物组比较P0.05;针刺组与针药组比较P0.05;药物组与针药组比较P0.05;说明改善入睡时间方面,针刺组与针药组均优于药物组,但针药组与针刺组效果相仿。6.三组患者治疗后的睡眠时间经单因素的方差分析,P0.05,说明三组治疗后的入睡时间有统计学意义。进一步用SNK法和LSD法对均数进行两两比较,其中:针刺组与药物组比较P0.05;针刺组与针药组比较P0.05;药物组与针药组比较P0.05;说明改善睡眠时间方面,针刺组与针药组均优于药物组,但针刺组与针药组效果相仿。7.三组患者治疗后的日间功能障碍评分经秩和检验,P0.05,三组患者治疗后日间功能障碍评分比较有统计学意义。进一步做两两比较,校正的α' =0.017,进行χ2分割算法,其中针刺组与药物组比较P0.017;针刺组与针药组比较P0.017;药物组与针药组比较,P0.017;说明改善日间功能障碍评分,针刺组与药物、针药组效果相仿,但针药组优于药物组。8.三组患者治疗后的PSQI、SRSS评分经单因素的方差分析,P0.05,说明三组治疗后的睡眠总体质量有统计学意义。进一步用SNK法和LSD法对均数进行两两比较,其中:针刺组与药物组比较P0.05;针刺组与针药组比较P0.05;药物组与针药组比较P0.05;说明改善总体睡眠质量方面,针刺组与针药组均优于药物组,但针刺组与针药组效果相仿。结论:本研究提示调神针法、安神补心胶囊及调神针法加安神补心胶囊对治疗失眠的疗效均具有显著性,并且均能改善入睡质量、缩短入睡时间、延长睡眠时间、改善日间功能,但三组间具有差异性。三组临床疗效相比较:针刺组与针药组均优于药物组,但针刺组与针药组效果相仿;改善入睡眠质量、缩短入睡时间、延长睡眠时间方面:针刺组与针药组均优于药物组,但针刺组与针药组效果相仿;改善入日间功能障碍评分方面:针刺组与药物、针药组效果相仿,但针药组优于药物组。
[Abstract]:Objective: insomnia is a frequently occurring disease, clinical common disease, western medicine is mainly to drug treatment, but it is easy to produce dependence and adverse reactions. This study by comparing the clinical effect of mind regulating acupuncture and Anshenbuxin capsules in the treatment of insomnia, objectively evaluate the effect of regulating acupuncture for insomnia, and for its clinical treatment of insomnia, increase sleep time, to provide reference for the application and promotion of improving sleep quality. Methods: the First Affiliated Hospital of Guangzhou University of Chinese Medicine Department of acupuncture and massage department from March 2016 to December 2016 with a total of 90 patients were analyzed in this study and voluntary. Randomly divided into acupuncture group (30 cases), treatment group (30 cases), acupuncture plus drug group (30 cases). The acupuncture group take regulating acupuncture therapy, the main acupoints: Sishen needle, shenting, Yintang, Shenmen, Sanyinjiao, Shen Mai, Zhao Hai, with disease. Acupuncture treatment 1 times a day, every time For 30 minutes, for 4 weeks. Oral drug group Anshenbuxin capsules (poly Xiechang (Beijing) Pharmaceutical Co. Ltd., batch number: Z10960053), 4 tablets each time, 3 times a day, to observe the curative effect after 4 weeks of treatment. Acupuncture plus drug group received both regulating acupuncture and oral Anshenbuxin capsules in the treatment respectively. For the first time on the first day (before treatment) and after 4 weeks of treatment (after treatment) of Pittsburgh sleep quality index of patients (PSQI) and self rating scale of sleep (SRSS). The assessment data collection and collation, use SPSS20.0 software for data statistics, analysis and evaluation of the clinical curative effect of regulating acupuncture for primary insomnia. Results: in this study, two data acquisition of three groups of patients, respectively, at first before treatment, after 4 weeks of treatment with P0.05 (22 for further comparison, the calibration of inspection standard a'=0.017) has significant difference before.1. treatment, the three groups General data of patients (gender, age, duration, occupation distribution, sleep quality, sleep time, sleep time, daytime dysfunction, PSQI score and SRSS score) by statistical analysis, there were no significant differences (P0.05), that is comparable to that of.2. in three groups after treatment between groups of sleep quality, sleep time, sleep time, daytime dysfunction, PSQI score and SRSS score were improved than before treatment (P0.05), showed that the clinical curative effect of the treatment of the three groups had significant effect.3. acupuncture group, drug group, the total effective rate of acupuncture plus drug group were 93.3%, 73.3%, 96.7%, by rank sum test, P0.05, with statistical significance the difference of total effective rate after treatment further compare the 22, take the calibration of inspection standard a '=0.017: acupuncture group and medicine group P0.017; acupuncture group compared with the acupuncture group: P0.017; drug group and acupuncture group: P0.017 group: three; Comparison of the clinical efficacy was statistically significant, acupuncture group and acupuncture group, the total effective rate was better than the drug group, but the acupuncture group and the acupuncture group had a similar effect with.4. three groups of patients after treatment, sleep quality score of the rank and inspection, P0.05, three groups of patients after treatment, the sleep quality score is statistically significant further. 22, the correction for x 2 'alpha =0.017 segmentation algorithm, which compared with the drug group P0.017; acupuncture group and acupuncture group P0.017; drug group and acupuncture group P0.017; instructions to improve sleep quality, acupuncture group and acupuncture group was better than the drug group, but the needle the medicine group and the acupuncture group had a similar effect with.5. three groups of patients after treatment of sleep time by single factor variance analysis, P0.05, shows that the three groups had statistical significance after treatment of sleep time. Further on average 22 compared with SNK method and LSD method: Acupuncture Group and drug group P0.05; acupuncture group and acupuncture group P0.05; drug group and acupuncture group P0.05; instructions to improve the sleep time, the acupuncture group and the acupuncture group was better than the drug group, but the acupuncture group and the acupuncture group had a similar effect with.6. three groups of patients after treatment of sleep time by variance analysis, the single factor P0.05, that the three groups had statistical significance after treatment of sleep time. Further on average 22 comparison, using SNK method and LSD method of acupuncture group and medicine group P0.05; acupuncture group and acupuncture group P0.05; drug group and acupuncture group P0.05; that improving sleep time the acupuncture group, and acupuncture group was better than the drug group, but the acupuncture group and the acupuncture group had a similar effect with.7. three groups of patients after treatment of daytime dysfunction score by rank sum test, P0.05, three groups of patients after treatment of daytime dysfunction score was statistically significant further. 22, the correction for x 2 'alpha =0.017 segmentation algorithm, which compared with the drug group P0.017; acupuncture group and acupuncture group P0.017; drug group and acupuncture group P0.017; the improvement of daytime dysfunction score, acupuncture group and drug group, acupuncture effect is similar, but the needle the medicine group is better than the drug group.8. of the three groups after treatment of PSQI, the single factor variance analysis, the SRSS score of P0.05, indicating that three groups after treatment was statistically significant. The overall quality of sleep on average for 22 further compared with SNK method and LSD method of acupuncture group and medicine group P0.05 acupuncture group; with the needle medicine group P0.05; drug group and acupuncture group P0.05; that improving sleep quality overall, acupuncture group and acupuncture group was better than the drug group, but the acupuncture group and the acupuncture group had a similar effect. Conclusion: This study suggests that regulating acupuncture, Anshenbuxin capsule and metality needle The curative effect with Anshenbuxin capsules on the treatment of insomnia were significant, and can improve sleep quality, shorten sleep time, prolong the sleep time, improve daytime function, but has the difference between the three groups. The clinical curative effect of the comparison of the three groups: acupuncture group and acupuncture group was better than the drug group, but the acupuncture group and acupuncture the medicine group had a similar effect; improve the quality of sleep, shorten the sleep time, extended sleep time: acupuncture group and acupuncture group was better than the drug group, but the acupuncture group and the acupuncture group had a similar effect; the improvement in daytime dysfunction score: Acupuncture group and drug group, acupuncture effect is similar, but the acupuncture medicine group is better than that of drug group.

【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.6

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