通督调神针刺治疗卒中后失眠的临床研究

发布时间：2018-09-12 12:38

【摘要】：目的:通过观察通督调神针刺法治疗卒中后失眠的临床疗效和安全性,并与西药组的治疗进行对比,为本疗法的临床可行性提供依据。方法:首先将脑三科门诊和病房收入的,符合受试条件的60例卒中后失眠患者,随机把他们分为:通督调神针刺组(治疗组30例)与佐匹克隆药物组(对照组30例)两组。治疗组,针灸一天一次,每次要求留针30分钟,在留针期间,10分钟行1次针。如此,连续治疗4周。对照组,要求口服佐匹克隆,每日睡前半小时服用7.5 mg,连续服用4周。全部患者在治疗前后,进行匹兹堡睡眠质量指数量表(PSQI)评分和日常生活活动能力(ADL)评分的评定。最后,将这两种评分的结果进行计算和对比,比较出两组的临床有效率。并且在整个治疗过程中,密切观察治疗组和对照组在用药期间的患者反应,进而比较出这两种不同的治疗方法他们各自的优、劣势。结果:(1)组内对比结果:从匹兹堡睡眠质量量表(PSQI)的评分上看,经统计学分析,治疗后,治疗组各因子及总分的评分都较治疗前有显著差异(P0.01);而对照组中仅有入睡时间、睡眠时间、睡眠效率及总分较治疗前有显著差异(P0.01),其中睡眠质量和睡眠障碍有统计学意义(P0.05),在日间功能方面无统计学意义(P0.05)。从整体上看,无论是治疗组还是对照组,在治疗中风后失眠的方法上都是有效的。从日常生活活动能力(ADL)评分的比较看,经统计学分析,治疗后,无论是治疗组的总分还是对照组的总分都较治疗前有显著差异(P0.01)。这足以说明两组的方法对于治疗中风后后失眠都有显著效果。(2)治疗前后总分进行对比:从匹兹堡睡眠质量量表(PSQI)评分上看,治疗后,治疗组的分数比对照组的分数更低,经统计学分析,具有统计学差异(P0.05或P0.01),说明治疗组治疗中风后失眠的方法更优于对照组。从日常生活活动能力(ADL)评分上看,治疗后,治疗组的分数明显高于对照组,经统计学分析,具有统计学差异(P0.05或P0.01),这就说明治疗组的疗效明显要优于对照组。(3)治疗后两组睡眠有效率的对比:治疗组的总有效率高达86.67%,而对照组的总有效率仅为63.33%。经统计学的分析,差异具有统计学意义(P0.05)。这就说明治疗组相较于对照组的疗效要更好。(4)不良反应方面的比较:治疗组在整个治疗期间,并未出现有任何的不良反应(包括滞针、晕针等)。而对照组在治疗过程中,出现了2例不良反应(包括口干、口苦、头晕、乏力等)。结论:(1)运用通督调神针刺法来治疗中风后失眠,其临床疗效显著。(2)运用通督调神针刺法来治疗中风后的失眠,无论从匹兹堡睡眠质量量表(PSQI)的评分还是日常生活活动能力(ADL)的评分上看,都要比对照组效果好。(3)运用通督调神针刺法来治疗中风后的失眠,其在临床治疗、安全性等方面优于对照组,方治疗法安全可行,值得我们临床推广与应用。
[Abstract]:Objective: to observe the clinical efficacy and safety of TongduTiaoshen acupuncture in treating insomnia after stroke, and compare it with the treatment of western medicine group, so as to provide the basis for the clinical feasibility of this therapy. Methods: at first, 60 patients with insomnia after stroke were randomly divided into two groups: 30 cases in the treatment group (treatment group) and 30 cases in the Zopicron drug group (control group). Treatment group, acupuncture once a day, each time required to keep the needle 30 minutes, 10 minutes during the needle. Thus, the treatment lasted 4 weeks. In the control group, Zopicron was taken orally for 4 weeks, half an hour before bedtime. All patients were evaluated with Pittsburgh Sleep quality Index (Pittsburgh Sleep quality Index) (PSQI) and ADL (ADL) before and after treatment. Finally, the results of the two scores were calculated and compared to compare the clinical efficacy of the two groups. And in the whole treatment process, the treatment group and the control group during the treatment period of the patient response, and then compared the two different treatment methods, their respective advantages and disadvantages. Results: (1) comparison results: according to the (PSQI) score of Pittsburgh Sleep quality scale, the scores of all factors and total scores in the treatment group were significantly different from those before the treatment (P0.01), while in the control group there was only sleep time. Sleep time, sleep efficiency and total score were significantly different compared with before treatment (P0.01), sleep quality and sleep disorders were statistically significant (P0.05), no statistical significance in daytime function (P0.05). Overall, both the treatment group and the control group are effective in treating insomnia after stroke. From the comparison of the (ADL) score of ADL, after the treatment, the total scores of both the treatment group and the control group were significantly different (P0.01). This indicated that the two groups had significant effects on post-stroke insomnia. (2) the total scores before and after treatment were compared: from the (PSQI) score of Pittsburgh Sleep quality scale, the scores of the treatment group were lower than those of the control group. After statistical analysis, there was statistical difference (P0.05 or P0.01), indicating that the treatment group is better than the control group in the treatment of insomnia after stroke. From the (ADL) score of daily living ability, the scores of the treatment group were significantly higher than those of the control group after treatment. The difference was statistically significant (P0.05 or P0.01), which indicated that the curative effect of the treatment group was obviously better than that of the control group. (3) the comparison of the two groups' sleep effective rate after treatment: the total effective rate of the treatment group was as high as 86.67 and the total effective rate of the control group was only 63.33. By statistical analysis, the difference was statistically significant (P0.05). This shows that the therapeutic effect of the treatment group is better than that of the control group. (4) adverse reactions: the treatment group did not have any adverse reactions (including acupuncture stagnation, halo needle, etc.) during the whole treatment period. In the control group, there were 2 adverse reactions (including dry mouth, bitter mouth, dizziness, fatigue and so on). Conclusion: (1) the acupuncture method of Tongdu regulating the mind was used to treat the insomnia after stroke, and the clinical effect was remarkable. (2) the acupuncture method of Tongdu regulating the mind was used to treat the insomnia after stroke. No matter from the score of Pittsburgh Sleep quality scale (PSQI) or the score of activity of Daily living (ADL), it was better than the control group. (3) the acupuncture method of Tongdu regulating the mind was used to treat the insomnia after stroke, which was treated clinically. The safety is better than the control group, and the prescription therapy is safe and feasible.
【学位授予单位】：安徽中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.6

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