电针单穴与配伍腧穴对原发性失眠患者ET与AIS的影响
发布时间：2018-10-14 19:23
【摘要】：目的:以电针分别刺激单穴和配伍腧穴治疗原发性失眠,观察两种方法对患者脑电超慢涨落图(ET)和阿森斯失眠量表(AIS)的影响差异,从而对单穴与配伍腧穴治疗原发性失眠进行临床疗效的评价,为腧穴配伍理论和临床针灸治疗原发性失眠的处方选穴提供科学依据。方法:以原发性失眠症患者为研究对象,采用随机对照试验研究方法,将符合纳入标准的72例患者根据来访顺序随机分为两组,即单穴组与配穴组,每组各36例。治疗方法:单穴组取神门穴(双),配穴组取百会穴、神门穴(双)、三阴交穴(双);患者取仰卧位,针刺得气后加电针,连续波60Hz,强度以患者耐受为度,时间为30min。5天为1个疗程,疗程间隔2天,连续治疗5个疗程,治疗结束4周后随访。以脑电超慢涨落图为客观指标,阿森斯量表为主观指标,通过采集治疗前、治疗后、随访期三个时点的相关疗效指标的数据,总结临床疗效差异。结果:1、AIS疗效评价:(1)单穴组治疗前与治疗后,在入睡时间、夜间苏醒、总睡眠时间、总睡眠质量等各因子得分及总分与治疗前相比有显著差异(P0.05);单穴组治疗后与随访期比较,AIS中的8个因子各项得分及总分皆无显著差异(P0.05)。(2)配穴组治疗前与治疗后AIS中的8个因子各项得分及总分进行比较,皆有显著差异(P0.05);配穴组治疗后与随访期AIS中8个因子各项得分及总分进行比较,无显著差异(P0.05)。(3)组间比较:两组患者经治疗后,在入睡时间、夜间苏醒频次、总睡眠时间、总睡眠质量、改善白天情绪状态及身体功能等方面有显著差异(P0.05),而在调整早醒、白天思睡程度等方面未见显著差异(P0.05);两组患者随访期,在入睡时间、夜间苏醒频次、总睡眠时间、总睡眠质量、改善白天情绪状态及身体功能等方面有所差异(P0.05),而在调整早醒状态、改善白天思睡程度方面,配穴组与单穴组疗效无显著差别(P0.05)。2、ET检测结果:(1)单穴组GABA、Glu、DA与治疗前相比有显著差异(P0.05),而5-HT、Ach、NE等神经递质数值在治疗前后无显著差异(P0.05);(2)配穴组GABA、Glu、DA与治疗前相比有显著差异(P0.05),而5-HT、Ach、NE等神经递质数值在治疗前后无显著差异(P0.05);(3)组间比较:两组患者经治疗后进行比较,仅5-HT有所差异(P0.05),而GABA、Glu、Ach、NE、DA含量未见显著差异(P0.05)。3、组间总体临床疗效比较:单穴组30例,痊愈5例,显效6例,有效12例,无效7例,总有效率为76.67%;配穴组32例,痊愈11例,显效13例,有效5例,无效3例,总有效率为90.63%。两组有效率存在显著性差异(P=0.0260.05)。结论:针刺单穴与配伍腧穴治疗原发性失眠均有效,且配伍腧穴疗效优于单穴。
[Abstract]:Objective: to observe the effect of electroacupuncture on the treatment of primary insomnia by stimulating single point and matching acupoint, and to observe the difference between the two methods on (ET) and (AIS) of Ascension Insomnia scale. Therefore, the clinical efficacy of single point and combined acupoint in treating primary insomnia was evaluated, which provided scientific basis for the theory of acupoint compatibility and the prescription selection of acupuncture and moxibustion for treating primary insomnia. Methods: 72 patients with primary insomnia were randomly divided into two groups according to the visiting order: single point group and matching point group with 36 cases in each group. Treatment methods: Shenmen points (double) in single point group, Baihui points (double points), Shenmen points (double points), Sanyinjiao points (double points) in matching points group, supine position, acupuncture after Qi acupuncture plus electroacupuncture, continuous wave 60Hz. the intensity is patient tolerance, time is 30min.5 day as a course of treatment. The duration of treatment was 2 days and followed up for 4 weeks after 5 consecutive courses of treatment. Taking EEG ultraslow fluctuation chart as objective index and Ascension scale as subjective index, the difference of clinical curative effect was summarized by collecting the data of relevant curative effects at three time points before and after treatment. Results: 1 Evaluation of AIS efficacy: (1) the time of falling asleep, waking up at night and total sleep time before and after treatment in single point group; The scores and total scores of all factors such as total sleep quality were significantly different from those before treatment (P0.05), and the scores and total scores of 8 factors in AIS were not significantly different from those before and after treatment (P0.05). (2) in the single point group after treatment and in the follow-up period (P0.05). The scores and total scores of the eight factors were compared. There were significant differences between the two groups (P0.05), the scores and total scores of 8 factors in AIS were not significantly different between the two groups after treatment (P0.05). (3): the time of falling asleep, the frequency of waking up at night, and the total sleep time after treatment were not significantly different between the two groups. There were significant differences in total sleep quality, improvement of daytime emotional state and body function (P0.05), but there was no significant difference in adjusting early wakefulness and daytime sleep level (P0.05). There were differences in total sleep time, total sleep quality, improvement of daytime emotional state and physical function (P0.05). There was no significant difference in therapeutic effect between the combined point group and the single point group (P0.05). 2the results of et: (1) the GABA,Glu,DA of the single point group was significantly different from that of before and after treatment (P0.05), while the value of neurotransmitters such as 5-HT-AchNE had no significant difference before and after treatment (P0.05); (2). There was no significant difference in the values of neurotransmitters such as 5-HTTH-AchNE before and after treatment (P0.05); (3). There was only difference in 5-HT (P0.05), but there was no significant difference in GABA,Glu,Ach,NE,DA content (P0.05). 3. The total clinical curative effect was compared between the two groups: 30 cases of single point group, 5 cases of cure, 6 cases of remarkable effect, 12 cases of effective and 7 cases of ineffective, the total effective rate was 76.6767%, 32 cases of combined acupoint group, 11 cases of cure, 13 cases of remarkable effect. The total effective rate was 90.63. There was a significant difference in the effective rate between the two groups (P0. 026. 05). Conclusion: acupuncture at single point and compatibility acupoint are effective in treating primary insomnia, and the curative effect of compatible acupoint is better than that of single point.
【学位授予单位】：长春中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.6
[Abstract]:Objective: to observe the effect of electroacupuncture on the treatment of primary insomnia by stimulating single point and matching acupoint, and to observe the difference between the two methods on (ET) and (AIS) of Ascension Insomnia scale. Therefore, the clinical efficacy of single point and combined acupoint in treating primary insomnia was evaluated, which provided scientific basis for the theory of acupoint compatibility and the prescription selection of acupuncture and moxibustion for treating primary insomnia. Methods: 72 patients with primary insomnia were randomly divided into two groups according to the visiting order: single point group and matching point group with 36 cases in each group. Treatment methods: Shenmen points (double) in single point group, Baihui points (double points), Shenmen points (double points), Sanyinjiao points (double points) in matching points group, supine position, acupuncture after Qi acupuncture plus electroacupuncture, continuous wave 60Hz. the intensity is patient tolerance, time is 30min.5 day as a course of treatment. The duration of treatment was 2 days and followed up for 4 weeks after 5 consecutive courses of treatment. Taking EEG ultraslow fluctuation chart as objective index and Ascension scale as subjective index, the difference of clinical curative effect was summarized by collecting the data of relevant curative effects at three time points before and after treatment. Results: 1 Evaluation of AIS efficacy: (1) the time of falling asleep, waking up at night and total sleep time before and after treatment in single point group; The scores and total scores of all factors such as total sleep quality were significantly different from those before treatment (P0.05), and the scores and total scores of 8 factors in AIS were not significantly different from those before and after treatment (P0.05). (2) in the single point group after treatment and in the follow-up period (P0.05). The scores and total scores of the eight factors were compared. There were significant differences between the two groups (P0.05), the scores and total scores of 8 factors in AIS were not significantly different between the two groups after treatment (P0.05). (3): the time of falling asleep, the frequency of waking up at night, and the total sleep time after treatment were not significantly different between the two groups. There were significant differences in total sleep quality, improvement of daytime emotional state and body function (P0.05), but there was no significant difference in adjusting early wakefulness and daytime sleep level (P0.05). There were differences in total sleep time, total sleep quality, improvement of daytime emotional state and physical function (P0.05). There was no significant difference in therapeutic effect between the combined point group and the single point group (P0.05). 2the results of et: (1) the GABA,Glu,DA of the single point group was significantly different from that of before and after treatment (P0.05), while the value of neurotransmitters such as 5-HT-AchNE had no significant difference before and after treatment (P0.05); (2). There was no significant difference in the values of neurotransmitters such as 5-HTTH-AchNE before and after treatment (P0.05); (3). There was only difference in 5-HT (P0.05), but there was no significant difference in GABA,Glu,Ach,NE,DA content (P0.05). 3. The total clinical curative effect was compared between the two groups: 30 cases of single point group, 5 cases of cure, 6 cases of remarkable effect, 12 cases of effective and 7 cases of ineffective, the total effective rate was 76.6767%, 32 cases of combined acupoint group, 11 cases of cure, 13 cases of remarkable effect. The total effective rate was 90.63. There was a significant difference in the effective rate between the two groups (P0. 026. 05). Conclusion: acupuncture at single point and compatibility acupoint are effective in treating primary insomnia, and the curative effect of compatible acupoint is better than that of single point.
【学位授予单位】：长春中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.6
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