穴位埋线配合认知行为疗法治疗原发性失眠的临床观察

发布时间：2018-11-11 21:17

【摘要】：目的:本研究通过对原发性失眠患者治疗前后主症各项症状评分及总评分临床疗效的观察,探讨穴位埋线配合认知行为疗法治疗失眠的临床疗效,并与艾司唑仑片治疗比较,为穴位埋线配合认知行为疗法提供临床依据,为原发性失眠的临床治疗提供新的思路,为临床应用的推广提供依据。方法:采用随机化研究方法,将符合入选标准的原发性失眠患者60例随机分为治疗组和对照组,每组30例。两组均进行认知行为疗法支持治疗,治疗组采用穴位埋线治疗,于入组后第0周、第2周、第4周进行治疗,1次为1疗程,共3个疗程。对照组采用艾司唑仑片治疗,且予以“按需服药”原则,疗程与治疗组一致。于治疗前、治疗2周后、治疗4周后、随访第2周以及随访第6周后随访行症状评估。结果:(1)治疗2周后、治疗4周后、随访第2周、随访第6周两组PSQI总评分及各项评分与治疗前相比,差异均有统计学意义(p0.05),且随治疗时间的延长均呈下降趋势。(2)治疗后两组间PSQI总评分及各项评分相比较,差异均无统计学意义(p0.05)。(3)随访第6周两组PSQI总评分及各项评分与治疗前相比,差异均有统计学意义(p0.05)。两组间比较差异有统计学意义。结论:(1)穴位埋线配合认知行为疗法治疗原发性失眠有一定的治疗作用,且疗效与对照组相当;穴位埋线配合认知行为疗法具有镇静安神,改善睡眠,能够减少入睡时间,增加睡眠时间,有效地提高患者睡眠质量,提高睡眠效率,改善患者入睡困难,日间疲乏;(2)穴位埋线配合认知行为疗法不仅有很好的近期疗效,也有不错的远期疗效;(3)随访期间,两组治疗方法虽未能维持治疗后的效果,但与治疗前相比,穴位埋线组配合认知行为疗法和艾司唑仑组仍有一定疗效,且穴位埋线配合认知行为疗法优于西药组。
[Abstract]:Objective: to investigate the clinical efficacy of acupoint catgut embedding combined with cognitive behavioral therapy in the treatment of insomnia by observing the clinical efficacy of the patients with primary insomnia before and after treatment. To provide clinical basis for acupoint catgut embedding combined with cognitive behavioral therapy, to provide new ideas for clinical treatment of primary insomnia, and to provide basis for clinical application. Methods: 60 patients with primary insomnia were randomly divided into treatment group (n = 30) and control group (n = 30). Both groups were treated with cognitive behavior therapy. The treatment group was treated with catgut embedding at acupoint, and was treated at 0 week, 2 week and 4 week after entering the group, once as a course of treatment, for 3 courses of treatment. The control group was treated with Estrazolam tablets and was treated with the principle of "taking medicine on demand". The course of treatment was the same as that of the treatment group. Symptoms were evaluated before, 2 weeks, 4 weeks, 2 weeks and 6 weeks. Results: (1) after 2 weeks of treatment, 4 weeks of treatment, 2 weeks of follow-up, 6 weeks of follow-up, there were significant differences between the two groups in the total score of PSQI and the scores before treatment (p0. 05). With the prolongation of treatment time, there was a downward trend. (2) after treatment, the total PSQI score and the scores were compared between the two groups. There was no significant difference (p0. 05). (3) between the two groups in the total PSQI score and the scores before treatment (p0. 05). The difference between the two groups was statistically significant. Conclusion: (1) Acupoint catgut implantation combined with cognitive behavioral therapy has a certain therapeutic effect on primary insomnia, and the curative effect is similar to that of the control group. Acupoint catgut embedding combined with cognitive behavior therapy can calm and calm the mind, improve sleep, reduce the time of falling asleep, increase the time of sleep, improve the quality of sleep, improve the efficiency of sleep, improve the difficulty of falling asleep, and improve the daytime fatigue. (2) Acupoint catgut implantation combined with cognitive behavioral therapy not only has a good short-term effect, but also has a good long-term effect; (3) during the follow-up period, although the two treatment methods could not maintain the effect after treatment, the acupoint embedding group combined with cognitive behavioral therapy and eszolam group still had some curative effects compared with those before treatment. And acupoint catgut embedding combined with cognitive behavior therapy was superior to western medicine group.
【学位授予单位】：湖南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.6

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