脐针疗法为主治疗心肾不交型失眠的临床疗效观察

发布时间：2018-02-27 06:11

本文关键词： 心肾不交型失眠脐针疗法疗效观察　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:通过用脐针疗法治疗心肾不交型失眠患者,评估其中医证候积分和匹兹堡睡眠质量指数量表(PSQI)评分,观察其临床疗效,为针灸治疗失眠提供一种新的临床思路和治疗方法。方法:将符合纳入标准的60例患者按照随机数字表分配法分为治疗组与对照组,每组各为30例。治疗组予针刺肚脐离位、坎位和常规针刺;对照组予常规针刺。治疗疗程为每周治疗3次,每次30分钟,1周为一个疗程,连续治疗3个疗程。疗程结束后分别评估治疗组和对照组治疗前后的中医证候积分、匹兹堡睡眠质量指数量表(PSQI)评分,再做统计学分析与处理。结果:(1)临床疗效方面:脐针加常规针刺组治愈5例,显效14例,有效10例,无效1例,总有效率为96.67%。常规针刺组治愈1例,13例显效,7例有效,无效9例。总有效率为70.00%。治疗组与对照组两组疗效比较,经稚和检验,差异有统计学意义(P0.05),显示治疗组的总有效率高于对照组。(2)PSQI评分方面:经治疗三个疗程后,两组患者的失眠症状均有所好转,PSQI评分明显下降,三个疗程结束后两组的PSQI总评分分别为5.07±1.41、8.33±1.56,治疗组与对照组相比,主要在患者入睡时间、睡眠质量、睡眠时间、睡眠障碍、日间功能障碍、睡眠效率方面差异有统计学意义。通过治疗前后两组差值进行比较,提示差异均无统计学意义(P0.05);表明脐针组和常规针刺组对于心肾不交型失眠患者均有改善,但两组改善相当。(3)中医证候积分方面:经治疗三个疗程后,两组患者在中医证候方面均有好转,中医证候积分均较前下降,治疗第三个疗程后,两组中医证候积分分别为4.47±1.81、7.07±1.82。治疗组较对照组中医证候方面主要表现在多梦、心烦、健忘、神疲乏力、头晕头痛、口干津少等方面差异具有统计学意义。治疗组与对照组治疗前后自身比较,差异均有显著统计学意义(P0.01);表明脐针加常规针刺组在改善患者多梦、心烦、健忘、神疲乏力、头晕头痛、口干津少等方面效果更好。以上结果表明,脐针加常规针刺对于治疗心肾不交型失眠患者效果较好,且效果优于常规针刺疗法。结论:脐针和常规针刺两种方法均能有效改善心肾不交型失眠患者的症状,且脐针加常规针刺组疗效优于常规针刺组。相比较常规针刺而言,脐针在改善失眠患者的睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、日间功能障碍、多梦、心烦、健忘、口干津少、神疲乏力、头晕头痛等方面效果更好。
[Abstract]:Objective: to evaluate the scores of TCM syndromes and Pittsburgh Sleep quality Index (PSQI) in the treatment of insomnia patients with heart and kidney disjunction by using umbilical needle therapy, and to observe the clinical efficacy. Methods: 60 patients with insomnia were divided into treatment group (n = 30) and control group (n = 30). The control group was treated with routine acupuncture. The course of treatment was 3 times a week for 30 minutes and 1 week for a course of treatment. After the treatment, the TCM syndromes score, Pittsburgh Sleep quality Index scale and PSQI score were evaluated before and after treatment in the treatment group and the control group, respectively. Results in the clinical curative effect, 5 cases were cured, 14 cases were markedly effective, 10 cases were effective, 1 case was ineffective, the total effective rate was 96.67%. In the routine acupuncture group, 13 cases were cured and 7 cases were effective. The total effective rate of the treatment group was 70.00g. The difference between the treatment group and the control group was statistically significant (P 0.05), which showed that the total effective rate in the treatment group was higher than that in the control group (P < 0.05). The total effective rate of the treatment group was higher than that of the control group (P < 0.05). After three courses of treatment, the total effective rate of the treatment group was higher than that of the control group. The total PSQI scores of the two groups were 5.07 卤1.41 卤8.33 卤1.56 after three courses of treatment. Compared with the control group, the patients in the treatment group were mainly in sleep time, sleep quality, sleep time, sleep disorder. The differences in daytime dysfunction and sleep efficiency were statistically significant. The difference between the two groups before and after treatment showed that there was no significant difference between the two groups, indicating that the umbilical needle group and routine acupuncture group both improved the heart and kidney disjoint insomnia patients. However, the improvement of TCM syndromes between the two groups was equivalent. (3) after three courses of treatment, the patients in both groups had improved in TCM syndromes, the scores of TCM syndromes were all lower than before, and after the third course of treatment, The scores of TCM syndromes in the two groups were 4.47 卤1.81 卤7.07 卤1.82 respectively. Compared with the control group, the TCM syndromes in the treatment group were mainly characterized by more dreams, upset, amnesia, fatigue, dizziness and headache. The difference between the treatment group and the control group before and after treatment was statistically significant (P 0.01), which indicated that the navel acupuncture plus routine acupuncture group could improve the patients' dreaminess, boredom, forgetfulness and fatigue. The above results show that navel acupuncture combined with routine acupuncture is more effective in treating patients with heart and kidney disjoint insomnia. Conclusion: both navel acupuncture and routine acupuncture can effectively improve the symptoms of patients with heart and kidney disjoint insomnia, and the effect of navel acupuncture plus routine acupuncture group is better than that of routine acupuncture group. Navel needle can improve sleep quality, sleep time, sleep time, sleep efficiency, sleep disorder, daytime dysfunction, dreamy, upset, forgetful, dry mouth, fatigue, dizziness, headache and so on.
【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

【参考文献】