穴位注射结合针剌治疗心肾不交型失眠症的临床疗效观察

发布时间：2018-05-07 20:06

本文选题：失眠 + 心肾不交型　；参考：《广西中医药大学》2017年硕士论文

【摘要】：目的:此课题旨在对穴位注射结合针刺疗法治疗失眠症的疗效进行临床观察,以期对其疗效进行评定,从而研究治疗心肾不交型失眠症时穴位注射结合针刺疗法对其的有效率;并总结过往临床用于治疗失眠的研究,以便于对比出在临床治疗中,穴位注射结合针刺疗法治疗失眠的独特性。并在最后进行相关的临床经验总结,对此种疗法的理论根据进行梳理,以期对临床治疗心肾不交及其他类型的失眠有一定价值。方法:以2015年9月--2016年9月在广西中医药大学附属瑞康医院针灸门诊、瑞康医院南宁市南棉社区卫生服务中心针灸门诊收集到符合本课题纳入标准的失眠患者70例,通过随机数字表随机分为两组,其中,治疗组35例,对照组35例,治疗组使用穴位注射维生素B12并结合泻南补北针刺疗法,而对照组仅单纯使用泻南补北针刺疗法治疗,治疗周期为每周治疗2次,每4次为一个疗程,两组的治疗时间均为连续治疗两个疗程。同时以匹兹堡睡眠质量指数量表的评分作为参考的治疗指标,最后分别在一个疗程结束时以及两个疗程结束时做出疗效的对比观察,使用spss22.0软件统计分析收集到的数据,从而比较两组疗效的差异和可比性。结果:通过统计学数据和临床研究有如下的结论:对治疗组和对照组的性别、年龄、病程以及两组治疗前的PSQI评分进行统计学比较,p0.05,即差异无统计学意义,两组的数据具有可比性。通过临床疗效统计和对比显示,治疗组共患者35例,痊愈13例,显效8例,有效19例,无效2例,脱落1例,总有效率为94.11%;对照组共35例,痊愈7例,显效6例,有效21例,无效6例,脱落1例,总有效率为82.35%,经过秩和检验结果:w=1008.012,p0.05,治疗组优于对照组,差异有统计学的意义;比较PSQI评分方面,治疗组在两个疗程的治疗后得出的PSQI总分以及各成份评分较对照组有明显减少,说明了治疗组睡眠质量高于对照组,差异有统计学意义(t=2.54,p0.05)。结论:(1)穴位注射结合针刺治疗心肾不交型失眠症有很好的近期疗效。(2)穴位注射结合针刺疗法能够滋阴潜阳、安神利眠,有效改善患者睡眠,在减少入睡时间的同时增加睡眠时间,并可以提高睡眠效率和睡眠质量,改善患者的日间疲乏与夜间入睡困难。(3)穴位注射结合针刺治疗治疗失眠症可以有效减少患者的就诊频率,并提高患者的依从性,节省患者不必要的就诊费用。同时还可以增强患者的自我调节能力,调整患者心理作用,适合生活节奏快的现代人用于治疗失眠。(4)治疗组在治疗过程中未出现强烈的不良反应,其效果安全可靠。
[Abstract]:Objective: to observe the curative effect of acupoint injection combined with acupuncture therapy on insomnia in order to evaluate its curative effect, and to study the effective rate of acupoint injection combined with acupuncture therapy in the treatment of heart and kidney disjoint insomnia. In order to compare the uniqueness of acupoint injection combined with acupuncture therapy in the treatment of insomnia. In the end, the author summarized the relevant clinical experience and combed the theoretical basis of this therapy, hoping to have certain value for clinical treatment of heart and kidney disconnection and other types of insomnia. Methods: from September 2015 to September 2016, 70 patients with insomnia were collected from the clinic of acupuncture and moxibustion in Ruikang Hospital affiliated to Guangxi University of traditional Chinese Medicine. Among them, 35 cases in treatment group and 35 cases in control group were randomly divided into two groups. The treatment group was treated with acupoint injection of vitamin B12 and combined with Xionan Bubei acupuncture therapy, while the control group was only treated with Xionan Bubei acupuncture therapy. The treatment cycle was 2 times a week and every 4 times as a course of treatment. At the same time, the score of Pittsburgh Sleep quality Index scale was taken as the reference treatment index. At the end of one course of treatment and at the end of two courses of treatment, the curative effect was compared and observed, and the collected data were analyzed with spss22.0 software. Therefore, the difference and comparability of curative effect between the two groups were compared. Results: according to the statistical data and clinical study, there were no significant differences in sex, age, course of disease and PSQI score before treatment between treatment group and control group (P 0.05), which indicated that there was no significant difference between treatment group and control group in sex, age, course of disease and PSQI score before treatment. The two groups of data are comparable. According to the clinical curative effect statistics and comparison, 35 patients in the treatment group were cured, 13 cases were cured, 8 cases were effective, 19 cases were effective, 2 cases were ineffective, 1 case was lost, the total effective rate was 94.111.The control group consisted of 35 cases, 7 cases were cured, 6 cases were effective, 21 cases were effective. The total effective rate was 82.35. The results of rank sum test showed that the treatment group was superior to the control group (P 0.05), and the difference was statistically significant. After two courses of treatment, the total score of PSQI and the scores of each component in the treatment group were significantly reduced compared with the control group, which indicated that the sleep quality of the treatment group was higher than that of the control group, and the difference was statistically significant. Conclusion (1) Acupoint injection combined with acupuncture in the treatment of heart-kidney disjoint insomnia has a good short-term curative effect. (2) Acupoint injection combined with acupuncture therapy can nourish yin and latent yang, soothe the mind and rest sleep, and effectively improve the sleep of the patients. Reducing sleep time while increasing sleep time, and can improve sleep efficiency and sleep quality, Improvement of daytime fatigue and nocturnal difficulty in falling asleep.) Acupoint injection combined with acupuncture in the treatment of insomnia can effectively reduce the frequency of the patient visit and improve the patient's compliance and save the patient unnecessary expenses. At the same time, it can also enhance the self-regulation ability of patients, adjust the psychological role of patients, suitable for modern people with fast life rhythm for the treatment of insomnia. 4) in the treatment group, there is no strong adverse reaction in the treatment process, and the effect is safe and reliable.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.6

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