俞募配穴针刺治疗脑卒中后阴虚火旺型失眠的临床研究
发布时间：2018-10-10 12:11
【摘要】：目的：1.在常规治疗基础上,比较俞募配穴针刺与常规针刺治疗脑卒中后阴虚火旺型失眠的临床疗效。2.观察俞募配穴针刺对脑卒中后睡眠质量及日常生活活动能力的影响,初步探讨其作用机理。方法：将70例符合脑卒中后阴虚火旺型失眠患者随机分为试验组和对照组,每组35例。两组均在治疗基础病、营养脑神经、防治并发症及营养支持等基础治疗上,对照组采用常规穴位：神门、内关、百会、安眠、太溪、太冲、涌泉针刺治疗；试验组采用俞募配穴：心俞配巨阙、肾俞配京门、肝俞配期门针刺治疗。两组均每日治疗1次,连续治疗6天为1个疗程,1个疗程结束后,休息1天,共治疗2个疗程。观察两组患者治疗前后中医证候总积分、匹兹堡睡眠质量指数量表(PSQI)评分、睡眠状况自评量表(SRSS)评分及Barthel指数(BI)评定量表评分,并比较两组临床疗效。结果：1.一般资料治疗前两组患者在性别、年龄、病程、基础疾病等一般资料比较方面差异无统计学意义(均P0.05),提示两组患者基线资料比较基本一致,各影响因素分布均衡,具有可比性。2.中医证候总积分治疗后两组患者中医证候总积分均较治疗前改善,前后差异均具有统计学意义(均P0.05)：治疗后组间比较,试验组改善更明显,差异具有统计学意义(P0.05)。提示试验组在中医证候总积分改善方面优于对照组。3. PSQI评分治疗后两组患者PSQI评分均较治疗前改善,前后差异均具有统计学意义(均P0.05)；治疗后组间比较,试验组改善更明显,差异具有统计学意义(P0.05)。提示试验组在PSQI评分改善方面优于对照组。4. SRSS评分治疗后两组患者SRSS评分均较治疗前改善,前后差异均具有统计学意义(均P0.05)；治疗后组间比较,试验组改善更明显,差异具有统计学意义(P0.05)。提示试验组在SRSS评分改善方面优于对照组。5.BI评定量表评分治疗后两组患者BI评定量表评分均较治疗前改善,前后差异均具有统计学意义(均P0.05)；治疗后组间比较,试验组改善更明显,差异具有统计学意义(P0.05)。提示试验组在BI评定量表评分改善方面优于对照组。6.疗效评定治疗后试验组临床痊愈5例,显效17例,有效10例,无效3例,总有效率为91.4%(32/35)；对照组临床痊愈2例,显效11例,有效16例,无效6例,总有效率为82.9%(29/35)；两组临床疗效比较,差异有统计学意义(P0.05)。提示试验组临床疗效优于对照组。结论：1.俞募配穴针刺比常规针刺更能有效地改善脑卒中后阴虚火旺型失眠患者的临床症状,其临床疗效优于常规针刺。2.俞募配穴针刺能显著提高脑卒中后睡眠质量,对患者日常生活活动能力的改善具有促进作用,其作用机理可能是元神功能恢复,脏腑阴阳平调,脏神安藏守舍。
[Abstract]:Purpose 1. On the basis of routine treatment, the clinical curative effect of Shufu combined with acupoint acupuncture and conventional acupuncture in treating insomnia of Yin deficiency and fire flourishing type after stroke was compared. 2. Objective: to observe the effect of acupoint acupuncture on sleep quality and activity of daily living after stroke, and to explore its mechanism. Methods: 70 cases of insomnia were randomly divided into experimental group and control group with 35 cases in each group. Both groups were treated with basic diseases, neurotrophic nerves, prevention and treatment of complications and nutritional support. The control group was treated with routine acupoints: Shenmen, Neiguan, Baihui, Anmiens, Taixi, Taichong and Yongquan acupuncture. The experimental group was treated with acupoints Shu-Fu, Shenshu and Jingmen, and Ganshu, respectively. The two groups were treated once a day for 6 consecutive days as a course of treatment. After the end of one course of treatment, the two groups were given a rest for 1 day and a total of 2 courses of treatment. The total score of TCM syndromes, (PSQI) score of Pittsburgh Sleep quality Index, (SRSS) score of Sleep Self-Rating scale and (BI) rating scale of Barthel Index before and after treatment were observed in the two groups. The clinical efficacy of the two groups was compared. The result is 1: 1. There was no significant difference between the two groups in sex, age, course of disease, basic diseases and other general data before treatment (P0.05), indicating that the baseline data of the two groups were basically the same, and the distribution of the influencing factors was balanced. Comparable. 2. The total integral of TCM syndromes in the two groups was improved after treatment, and the difference was statistically significant before and after treatment (P0.05): after treatment, the improvement of the experimental group was more obvious, the difference was statistically significant (P0.05). The results suggest that the experimental group is superior to the control group in improving the total integral of TCM syndromes. PSQI scores after treatment of the two groups of patients PSQI scores were improved before and after treatment, the difference was statistically significant (P0.05); after treatment, the improvement of the experimental group was more obvious, the difference was statistically significant (P0.05). The results suggest that the improvement of PSQI score in the trial group is better than that in the control group. 4. 4. SRSS scores after treatment of the two groups of patients SRSS scores were improved before and after treatment, the difference was statistically significant (P0.05); after treatment, the improvement of the experimental group was more obvious, the difference was statistically significant (P0.05). The results suggest that the improvement of SRSS score in the trial group is better than that in the control group. The BI rating scale scores of the two groups after treatment are improved compared with those before and after treatment (P0.05), the difference between the two groups after treatment is significant (P0.05), the difference between the two groups after treatment is significant (P0.05). The improvement in the test group was more obvious, the difference was statistically significant (P0.05). The results suggest that the improvement of BI rating scale in the trial group is better than that in the control group. 6. 6%. In the experimental group, the total effective rate was 91.4% (32 / 35), and the total effective rate was 91.4% (32 / 35), while in the control group, there were 2 cases of clinical cure, 11 cases of remarkable effect, 16 cases of effective and 6 cases of ineffectiveness, the total effective rate was 82.9% (29 / 35). The difference between the two groups was statistically significant (P0.05). It suggested that the clinical effect of the test group was better than that of the control group. Conclusion 1. The clinical symptoms of insomnia patients with Yin deficiency and fire flourishing type after stroke were improved more effectively than that of routine acupuncture, and the clinical curative effect was better than that of routine acupuncture. 2. The acupuncture of Shu-Fu combined with acupoint can significantly improve the quality of sleep after stroke and promote the improvement of patients' activities of daily life. The mechanism may be the recovery of the function of the Yuan Shen, the regulation of the yin and yang of the viscera, and the regulation of the viscera and the yin and yang.
【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】：2016
【分类号】：R246.6
本文编号：2261719
[Abstract]:Purpose 1. On the basis of routine treatment, the clinical curative effect of Shufu combined with acupoint acupuncture and conventional acupuncture in treating insomnia of Yin deficiency and fire flourishing type after stroke was compared. 2. Objective: to observe the effect of acupoint acupuncture on sleep quality and activity of daily living after stroke, and to explore its mechanism. Methods: 70 cases of insomnia were randomly divided into experimental group and control group with 35 cases in each group. Both groups were treated with basic diseases, neurotrophic nerves, prevention and treatment of complications and nutritional support. The control group was treated with routine acupoints: Shenmen, Neiguan, Baihui, Anmiens, Taixi, Taichong and Yongquan acupuncture. The experimental group was treated with acupoints Shu-Fu, Shenshu and Jingmen, and Ganshu, respectively. The two groups were treated once a day for 6 consecutive days as a course of treatment. After the end of one course of treatment, the two groups were given a rest for 1 day and a total of 2 courses of treatment. The total score of TCM syndromes, (PSQI) score of Pittsburgh Sleep quality Index, (SRSS) score of Sleep Self-Rating scale and (BI) rating scale of Barthel Index before and after treatment were observed in the two groups. The clinical efficacy of the two groups was compared. The result is 1: 1. There was no significant difference between the two groups in sex, age, course of disease, basic diseases and other general data before treatment (P0.05), indicating that the baseline data of the two groups were basically the same, and the distribution of the influencing factors was balanced. Comparable. 2. The total integral of TCM syndromes in the two groups was improved after treatment, and the difference was statistically significant before and after treatment (P0.05): after treatment, the improvement of the experimental group was more obvious, the difference was statistically significant (P0.05). The results suggest that the experimental group is superior to the control group in improving the total integral of TCM syndromes. PSQI scores after treatment of the two groups of patients PSQI scores were improved before and after treatment, the difference was statistically significant (P0.05); after treatment, the improvement of the experimental group was more obvious, the difference was statistically significant (P0.05). The results suggest that the improvement of PSQI score in the trial group is better than that in the control group. 4. 4. SRSS scores after treatment of the two groups of patients SRSS scores were improved before and after treatment, the difference was statistically significant (P0.05); after treatment, the improvement of the experimental group was more obvious, the difference was statistically significant (P0.05). The results suggest that the improvement of SRSS score in the trial group is better than that in the control group. The BI rating scale scores of the two groups after treatment are improved compared with those before and after treatment (P0.05), the difference between the two groups after treatment is significant (P0.05), the difference between the two groups after treatment is significant (P0.05). The improvement in the test group was more obvious, the difference was statistically significant (P0.05). The results suggest that the improvement of BI rating scale in the trial group is better than that in the control group. 6. 6%. In the experimental group, the total effective rate was 91.4% (32 / 35), and the total effective rate was 91.4% (32 / 35), while in the control group, there were 2 cases of clinical cure, 11 cases of remarkable effect, 16 cases of effective and 6 cases of ineffectiveness, the total effective rate was 82.9% (29 / 35). The difference between the two groups was statistically significant (P0.05). It suggested that the clinical effect of the test group was better than that of the control group. Conclusion 1. The clinical symptoms of insomnia patients with Yin deficiency and fire flourishing type after stroke were improved more effectively than that of routine acupuncture, and the clinical curative effect was better than that of routine acupuncture. 2. The acupuncture of Shu-Fu combined with acupoint can significantly improve the quality of sleep after stroke and promote the improvement of patients' activities of daily life. The mechanism may be the recovery of the function of the Yuan Shen, the regulation of the yin and yang of the viscera, and the regulation of the viscera and the yin and yang.
【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】：2016
【分类号】：R246.6
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