压灸百会穴结合针刺治疗心脾两虚型失眠的临床疗效观察

发布时间：2018-06-14 16:03

本文选题：失眠 + 心脾两虚　；参考：《广州中医药大学》2017年硕士论文

【摘要】：目的:观察压灸百会穴治疗心脾两虚型失眠的临床疗效,比较压灸百会穴结合传统针刺,与单纯常规针刺,两者对比于心脾两虚型失眠的疗效差异。旨在评估和探讨压灸百会穴结合针刺治疗心脾两虚型失眠有效性,为临床针灸疗法治疗心脾两虚型失眠提供新的临床研究思路和资料。方法:本研究课题严格按照纳入标准选取心脾两虚型患者76例,按照随机数字表法分为治疗组(压灸百会穴结合常规针刺)和对照组(常规针刺),每组各38例。治疗组百会穴压灸五壮,接着待余热自头皮入脑或向四神聪方向穴位传导,休息五分钟后进行同对照组同样穴位常规针刺,而对照组为单纯进行常规针刺,然后进行临床治疗效果的观察。所有患者按既定方案进行治疗,隔1天治疗1次,10天为一个疗程,共治疗两个疗程。观察记录两组受试者治疗前后的总有效率、中医症候积分和匹兹堡睡眠质量指数(PSQI)积分的变化水平,以及治疗后比较两组的临床疗效差异。并在疗程结束后,根据各项指标及临床疗效对治疗后与治疗前的评分进行对比比较,再运用SPSS 22.0进行统计学分析,得出最后的量化结果。结果:本课题根据病例纳入标准筛取了心脾两虚型失眠患者76例,研究实行过程中,治疗组出现脱落3例(均因治疗期间服用干扰药物自行退出),对照组脱落3例(2例因依从性差中断治疗,1例中途无故中断治疗),故实际共观察患者例数70例。1.经2个疗程治疗后比较两组治疗结果,对照组治疗总有效率为80%,治疗组的总有效率为94.29%,压灸百会穴结合针刺治疗组在临床有效率方面要优于常规针刺对照组,差异有统计学意义(P0.05)。2.中医症候积分比较:两组治疗后结果相较治疗前均发生明显改善,且差异显著(P0.05);治疗组与对照组治疗效果相比,治疗组结果要优于对照组,且差异显著,有统计学意义(P0.05)。3.匹兹堡失眠质量指数(PSQI)量表积分对比:治疗后,两组在积分变化上比较,压灸百会穴治疗组在量表总分、睡眠质量、睡眠时间及入睡时间上效果均优于对照组,差异有统计学意义(P0.05),在日间功能和睡眠效率方面,两组临床治疗效果相当,比较未见明显差异,无统计学意义(P0.05)。结论:1.压灸百会穴结合传统针刺治疗心脾两虚型失眠临床疗效在总有效率方面,要高于单纯传统针刺组,表明将百会穴压灸与针刺相结合治疗心脾两虚型失眠不寐在临床中会有产生更好的治疗效果。2.压灸百会穴治疗心脾两虚型失眠对中医症状方面和PSQI减分率的影响明显均优于传统针刺组,表明运用本治法可改善患者失眠的伴随症状,提高患者生活质量,是一种结合中医理念且无副作用的治疗手段,具有相当大的优势与前景,值得临床推广和更多学者进一步研究。
[Abstract]:Objective: to observe the clinical effect of pressing moxibustion on insomnia with deficiency of heart and spleen, compare the curative effect of compression moxibustion with traditional acupuncture and simple routine acupuncture, and compare the curative effect of pressure moxibustion with traditional acupuncture in treating insomnia with deficiency of heart and spleen. The purpose of this study was to evaluate the efficacy of moxibustion at Baihui point combined with acupuncture in the treatment of insomnia with deficiency of both heart and spleen, and to provide new clinical research ideas and data for clinical acupuncture therapy in treating insomnia with deficiency of both heart and spleen. Methods: 76 patients with deficiency of both heart and spleen were selected according to the inclusion criteria. According to the random number table, they were divided into treatment group (moxibustion combined with routine acupuncture) and control group (38 cases in each group). The treatment group was treated with moxibustion at Baihui point, followed by heat from scalp into the brain or point conduction to Sishencong. After five minutes of rest, the treatment group was treated with routine acupuncture at the same acupoint as the control group, while the control group was treated with simple routine acupuncture. Then the effect of clinical treatment was observed. All patients were treated in accordance with the established program, once a day for 10 days as a course of treatment, a total of two courses of treatment. The changes of total effective rate, TCM symptom score and Pittsburgh Sleep quality Index (PSQI) score before and after treatment were observed and recorded. At the end of the course of treatment, the scores after treatment and before treatment were compared and compared according to the indexes and clinical efficacy, and then SPSS 22.0 was used for statistical analysis, and the final quantitative results were obtained. Results: 76 cases of insomnia with deficiency of both heart and spleen were selected according to the standard of inclusion of the case, and the course of the study was carried out. There were 3 cases of shedding in the treatment group (all due to the withdrawal of interference drugs during the treatment, 2 cases of the control group due to poor compliance and 1 case of interruption of treatment for no reason), so 70 cases were observed. After two courses of treatment, the results of the two groups were compared. The total effective rate of the control group was 80 and the total effective rate of the treatment group was 94.29. The clinical effective rate of the moxibustion combined with acupuncture treatment group was better than that of the conventional acupuncture control group. The difference was statistically significant (P 0.05). Comparison of TCM symptom score: the results of the two groups were obviously improved after treatment, and the difference was significant (P 0.05), the results of the treatment group were better than the control group, and the difference was significant (P 0.05 路3), compared with the control group, the results of the treatment group were better than that of the control group, and there was significant difference between the treatment group and the control group. Comparison of Pittsburgh Insomnia quality Index (PSQI) scale: after treatment, the score changes of the two groups were compared. The effect of moxibustion on the total score, sleep quality, sleep time and sleep time of the treatment group was better than that of the control group. The difference was statistically significant (P 0.05). In the aspects of daytime function and sleep efficiency, the two groups had the same therapeutic effect, but there was no significant difference between the two groups, and there was no significant difference between the two groups in terms of daytime function and sleep efficiency. Conclusion 1. The total effective rate of moxibustion on Baihui point combined with traditional acupuncture in treating insomnia with deficiency of both heart and spleen was higher than that in simple traditional acupuncture group. The results showed that the combination of moxibustion at Baihui point and acupuncture in treating insomnia with deficiency of heart and spleen could produce better therapeutic effect in clinic. The effect of moxibustion on insomnia of deficiency of both heart and spleen was better than that of the traditional acupuncture group, which indicated that this method could improve the accompanying symptoms of insomnia and improve the quality of life of the patients. It is a kind of treatment method which combines the concept of traditional Chinese medicine and has no side effects, and has considerable advantages and prospects, which is worthy of clinical promotion and further research by more scholars.
【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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