针药结合治疗心胆气虚型失眠的临床观察

发布时间：2018-03-02 09:30

本文关键词： 针药结合普通针剌失眠　出处：《辽宁中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:研究针药结合治疗心胆气虚型失眠的疗效和作用机制。并尝试与单纯针刺组作对照,通过治疗前后两组患者的PSQI评分比较,评价其临床疗效。材料与方法:根据符合失眠诊断标准、纳入标准和排除标准临床选择48例患者,按照统计学随机数字表法分为两组,治疗组(针刺结合酸枣仁汤加减疗法)24例,对照组(单纯针刺疗法)24例。治疗组采用针刺治疗:取百会、大陵、神门、三阴交、丘虚、心俞、胆俞。每日1次。并予酸枣仁汤加减口服,每日2次。对照组采用常规针刺疗法:取百会、大陵、神门、三阴交、丘虚、心俞、胆俞。每日一次。每周连续治疗6日,治疗2周。两组患者治疗2周后,于总疗程前后进行匹兹堡睡眠质量指数(PSQI)评分进行睡眠评估;临床疗效评定采用《中药新药治疗失眠的临床研究指导原则》进行评定。数据结果采用SPSS17.0进行统计分析。结果:PSQI评分比较:治疗前,两组患者PSQI评分比较,P0.05,差异无统计学意义,具有可比性。治疗2周后,两组患者PSQI评分均有降低,经统计学分析,P0.05,差异有统计学意义,表明二者均能改善评分,即对失眠均有确切疗效。组间比较,治疗2周后,两组患者PSQI评分组间比较,P0.05,差异有统计学意义,表明针药结合治疗组较单纯针刺治疗组更能改善评分。两组治疗后组间比较,入睡时间、睡眠效率、睡眠障碍的评分数据经统计学分析,P0.01,差异有统计学意义,表明针药结合组的入睡时间、睡眠效率、睡眠障碍疗效显著优于单纯针刺组。临床疗效比较:两组患者治疗2周后最终临床疗效比较,治疗组痊愈5例,显效11例,有效5例,无效3例,总有效率87%;对照组痊愈4例,显效8例,有效10例,无效6例,总有效率75%。经统计学分析,P0.05,差异有统计学意义,表明针药结合疗法治疗失眠较单纯针刺疗法治疗失眠更具有临床疗效。结论:1.针刺结合酸枣仁汤及单纯针刺对治疗心胆气虚型失眠的患者均有较好的临床疗效。针刺结合酸枣仁汤治疗组的入睡时间、睡眠效率、睡眠障碍疗效优于单纯针刺组,表明针刺结合酸枣仁汤对失眠患者临床症状有较全面的改善。2.针刺结合方药治疗失眠,充分发挥出针刺疏通经脉气血,中药调和气血的效用,有效提高失眠患者的生活质量,减轻临床症状。
[Abstract]:Objective: to study the curative effect and mechanism of acupuncture combined with medicine in treating insomnia of heart and gallbladder qi deficiency type, and to compare the PSQI score between the two groups before and after treatment. Materials and methods: according to the diagnostic criteria of insomnia, inclusion criteria and exclusion criteria, 48 patients were selected and divided into two groups according to the statistical random digital table method. The treatment group (acupuncture combined with Suanzaoren decoction, 24 cases) and the control group (24 cases) were treated with acupuncture: Baihui, Daling, Shenmen, Sanyinjiao, Qiu deficiency, Xinshu, Danshu. 1 times a day, 2 times a day. The control group was treated with routine acupuncture therapy: Baihui, Daling, Shenmen, Sanyinjiao, Qiu Xu, Xinshu, Danyu. After 2 weeks of treatment, the patients in both groups were evaluated with Pittsburgh Sleep quality Index (PSQI) score before and after the total course of treatment. The clinical curative effect was evaluated by "guiding principles of Clinical Research on the treatment of Insomnia with traditional Chinese Medicine". The data were statistically analyzed by SPSS17.0. Results: before treatment, the PSQI scores of the two groups were compared with that of the two groups (P 0.05), the difference was not statistically significant. After 2 weeks of treatment, the PSQI scores of the two groups were decreased, and the difference was statistically significant (P 0.05), which indicated that both of them could improve the score, that is, there was a definite curative effect on insomnia. The comparison between the two groups, after 2 weeks of treatment, showed that there was no significant difference between the two groups. The difference of PSQI score between the two groups was statistically significant, indicating that the acupuncture and medicine combined treatment group could improve the score better than that of the simple acupuncture treatment group, the sleep time, sleep efficiency and sleep time of the two groups after treatment were better than those in the simple acupuncture treatment group. The score data of sleep disorder were statistically analyzed (P 0.01), the difference was statistically significant, which indicated that the time of falling asleep and sleep efficiency of acupuncture and medicine combination group, The curative effect of sleep disorder was significantly better than that of simple acupuncture group. Comparison of clinical efficacy: after 2 weeks of treatment, 5 cases were cured, 11 cases were markedly effective, 5 cases were effective, 3 cases were ineffective, the total effective rate was 87% in the treatment group, 4 cases in the control group, 4 cases in the control group, and 4 cases in the control group. There were 8 cases of remarkable effect, 10 cases of effective and 6 cases of failure. The total effective rate was 750.The difference was statistically significant (P 0.05). The results showed that acupuncture combined with medicine therapy was more effective than simple acupuncture therapy in the treatment of insomnia. Conclusion the combination of acupuncture and Suanzaoren decoction and simple acupuncture have better clinical effect on insomnia of heart and gallbladder qi deficiency type. The time of falling asleep in the treatment group of acupuncture combined with Suanzaoren decoction, Sleep efficiency and sleep disorder were better than simple acupuncture group, indicating that acupuncture combined with Suanzaoren decoction could improve the clinical symptoms of insomnia patients. 2.Acupuncture combined with prescription medicine was used to treat insomnia and give full play to acupuncture to dredge the meridians and qi and blood. The effect of Chinese medicine to harmonize qi and blood, effectively improve the quality of life of insomnia patients, alleviate clinical symptoms.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R256.23

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