基于心胆同治针刺结合刺血疗法治疗颈源性失眠的临床观察

发布时间：2018-09-10 08:22

【摘要】：目的:观察心胆同治针刺结合刺血疗法治疗颈源性失眠的临床疗效。方法:选择符合纳入标准的颈源性失眠患者60例,按PEMS3.1统计软件随机平均分为观察组与对照组各30例。观察组采用针刺结合刺血疗法治疗,对照组采用常规针刺治疗。1、观察组:(1)针刺主穴:颈夹脊、风池、神门、列缺、照海、百会;(2)刺法:患者取仰卧位,穴位直刺10-30mm,行小幅度提插捻转致得气,留针30分钟,期间每10分钟行针1次;(3)刺血疗法取穴及操作:心俞、胆俞、颈百劳、大椎,操作时充分暴露患者项背部,先在刺血点行推、按、揉、捋等手法,使局部充血,皮肤做常规消毒,以左手拇指、食指固定腧穴周围皮肤,右手持三棱针快速点刺2-3针,刺入深约0.5-0.8cm,选择适当大小的火罐迅速叩在刺血部位,放血量为自然出血停止量,留罐10-15分钟,起罐后用无菌棉签擦拭,再做常规消毒。2、对照组:(1)针刺主穴参考新世纪(第二版)全国高等中医药院校规划教材《针灸治疗学》取穴:神门、内关、百会、安眠、颈夹脊、大椎。(2)针具、配穴及针刺刺法同观察组。3、疗程及评价方法:每周进行2次治疗,分别于周二、周五进行1次,连续治疗10次,于治疗前与10次治疗结束后采用匹兹堡睡眠质量指数(PSQI)、SF-36生活质量量表评分进行疗效评价。采用统计软件PEMS3.1对数据进行统计分析。结果:1.治疗前两组患者性别、年龄、病程等一般资料差异无统计学意义(P0.05)。2.治疗后,观察组在改善总体临床疗效方面优于对照组(P0.05)。3.治疗前后PSQI评分比较,观察组在睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、PSQI总分方面具有显著性差异(P0.01),在催眠药物、日间功能障碍方面具有显著性差异(P0.05);对照组在睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、日间功能障碍方面具有显著性差异(P0.01),在PSQI总分方面具有显著性差异(P0.05)。治疗后两组颈源性失眠患者的生活质量较前有所改善。4.治疗前后比较,SF-36生活质量量表各因子评分,观察组在生理机能、生理职能、躯体疼痛、精力、精神健康方面具有显著性差异(P0.01),在一般健康状况、社会功能方面具有显著性差异(P0.05);对照组在精力方面具有显著性差异(P0.01),在生理机能、精神健康方面具有显著性差异(P0.05)。治疗后两组颈源性失眠患者的生活质量较前有所改善。5.治疗后,两组PSQI评分比较,在睡眠质量、入睡时间、睡眠效率、睡眠障碍、催眠药物、日间功能障碍、总分方面具有显著性差异(P0.05)。观察组在改善颈源性失眠患者睡眠质量方面优于对照组。6.治疗后,两组SF-36生活质量量表各因子评分比较,在生理机能、生理职能、精力方面具有显著性差异(P0.01),在一般健康状况、社会功能、情感职能、精神健康方面具有显著性差异(P0.05),观察组在改善颈源性失眠患者生活质量方面优于对照组。结论:基于心胆同治针刺结合刺血疗法治疗的观察组与采用常规针刺治疗的对照组均能有效治疗颈源性失眠,但观察组在改善颈源性失眠患者睡眠质量与生活质量方面均优于对照组。
[Abstract]:Objective:To observe the clinical effect of acupuncture combined with blood-pricking therapy on cervical insomnia.Methods:60 cases of cervical insomnia were selected and randomly divided into observation group and control group according to PEMS 3.1 statistical software. Observation group: (1) Acupuncture the main points: cervical Jiaji, Fengchi, Shenmen, lie vacant, Zhaohai, Baihui; (2) Acupuncture: patients take supine position, acupoint straight 10-30 mm, twist to get gas by small amplitude lifting and inserting, needle retained for 30 minutes, needle every 10 minutes during the needle 1 time; (3) Acupuncture and operation of blood therapy: Xinshu, Danshu, Bailao, Dazhui, fully expose the patient's back during operation, first Push, press, knead and rub at the puncture point to make the local congestion, and disinfect the skin routinely. Fix the skin around the acupoint with the left thumb and index finger. Puncture 2-3 needles quickly with the right hand trigonometric needle. Push into the puncture point about 0.5-0.8 cm deep. Choose the appropriate size of the cup and tap the puncture site quickly. The amount of bleeding stops naturally. Keep the cup for 10-15 minutes. Wipe with sterile cotton swab, and then do routine disinfection. 2, control group: (1) Acupuncture the main points reference to the new century (second edition) National College of Traditional Chinese Medicine planning textbook < Acupuncture Therapy > Acupoints: Shenmen, Neiguan, Baihui, sleeping, cervical Jiaji, Dazhui. (2) Acupuncture, acupoints and acupuncture methods with the observation group. 3, treatment course and evaluation method: twice a week, respectively, treatment. Pittsburgh Sleep Quality Index (PSQI) and SF-36 Quality of Life Scale (SF-36) were used to evaluate the efficacy before and after 10 consecutive treatments. The data were analyzed by statistical software PEMS 3.1. Results: 1. There was no significant difference in the general data of gender, age and course of disease between the two groups before treatment. After treatment, the observation group in improving the overall clinical efficacy is better than the control group (P 0.05). 3. Before and after treatment PSQI score comparison, the observation group in sleep quality, sleep time, sleep efficiency, sleep disorders, PSQI total score has a significant difference (P 0.01), in hypnotics, daytime dysfunction has a significant difference (P 0.01). There were significant differences in sleep quality, sleep time, sleep efficiency, sleep disorders and daytime dysfunction between the control group and the control group (P 0.01). There were significant differences in total PSQI scores between the two groups (P 0.05). After treatment, the quality of life of patients with cervical insomnia was improved. 4. Before and after treatment, SF-36 was born. There were significant differences in physical function, physiological function, physical pain, energy and mental health in the observation group (P 0.01), and significant differences in general health status and social function (P 0.05); there were significant differences in energy in the control group (P 0.01), physiological function and mental health. After treatment, the quality of life of the two groups of cervical insomnia patients was improved. 5. After treatment, PSQI scores of the two groups in sleep quality, sleep time, sleep efficiency, sleep disorders, hypnotics, daytime dysfunction, the total score was significantly different (P 0.05). Sleep quality was better than that of the control group. 6. After treatment, there were significant differences in physiological function, physiological function and energy between the two groups (P 0.01). There were significant differences in general health, social function, emotional function and mental health (P 0.05). The observation group improved cervical insomnia patients. Conclusion: Both the observation group and the control group with routine acupuncture can effectively treat cervical insomnia, but the observation group is better than the control group in improving the quality of sleep and life of patients with cervical insomnia.
【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】：2016
【分类号】：R246.6

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