针灸治疗慢性失眠的时效性与量效性临床研究  

Clinical Analysis on Chronergy and Quantitative Efficacy of Acupuncture in Treating Chronic Insomnia

作　　者：阮经文[1] 廖新学[2] 严英硕[3] 胡跃华[1] 饶忠东[1] 温明[1] 曾小香[4] 

机构地区：[1]中山大学附属第一医院针灸科,广东广州510080 [2]中山大学附属第一医院心内科,广东广州510080 [3]中山大学附属第一医院呼吸内科,广东广州510080 [4]珠海市人民医院,广东珠海519000

出　　处：《中山大学学报（医学科学版）》2008年第4期448-452,共5页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省科技计划项目(2004B3300102);广东省中医药局基金(1040058)

摘　　要：【目的】探讨针灸治疗慢性失眠的时效性与量效性。【方法】根据诊断标准和研究设计,共收集128例患者,并采用随机对照入组的临床研究方法,首先进行分批然后进行分组。第一批试验(69例)分为早上治疗组、下午治疗组和每天2次治疗组,从中筛选出最佳治疗时间(时效性);然后,依据第1批的结果,进行第2批试验(59例),分为每日治疗和隔日治疗组,进行量效分析。期间用匹兹堡睡眠质量指数(PSQI)对各组疗效进行评估。【结果】第1批3组患者治疗后的PSQI每项积分组间比较,除入睡时间积分比较差异有统计学意义外,PSQI其余各项积分比较差异无统计学意义(P>0.05)。第2批两组患者在治疗2个疗程后,PSQI每项积分组间比较,除安眠药物项外,睡眠质量、入睡时间、睡眠时间、睡眠效率、日间功能等差异均有统计学意义(P<0.05);组内PSQI各项比较:每日治疗组P<0.05,隔日治疗组P>0.05,说明隔日治疗组在治疗两个疗程时还没起效。但在治疗4个疗程后,两组PSQI每项积分组间比较差异无统计学意义(P>0.05);且两组治疗前后的组内PSQI比较:每日治疗组P<0.05,隔日治疗组P<0.05,说明两组治疗均有效果。【结论】针灸治疗慢性失眠的时效性不强,但对有入睡困难者,提倡下午治疗;针灸治疗慢性失眠的量效性非常重要,特别是针灸治疗初期,只有量积累到一定程度,疗效才能显现。[Objective] To explore the chronergy and quantitative efficiency of acupuncture in treating chronic insomnia. [Methods] According to diagnostic criteria and research design, 128 patients with chronic insomnia were randomly enrolled in the indicated experiment groups. Among them, 68 cases, who were divided into morning therapeutic group, afternoon （PM） therapeutic group and twice-a-day therapeutic group, were enrolled in the first research project. Based on the results from the first project, 59 cases were enrolled in the second project, which was composed of the every-day therapeutic group and every-other-day therapeutic one. The does-effect analysis was done.[Results] The results in each integral of Pittsburgh Sleep Quality Index （PSQI） from the first research project among the morning therapeutic group, the PM therapeutic group and the twice-a-day therapeutic group after acupuncture treatment showed that,except that the differences in the integral of hypnagogic time were significant statistically（P 〈 0.05）, the differences in the rest integral of PSQI among the indicated three therapeutic groups were not significant （P 〉 0.05）. The results from the second research project showed that except for the hypnagogue,the differences in each integral of PSQI such as sleep quality,hypnagogic time,sleep time,sleep efficacy and day function between every-day therapeutic group and every-other-day therapeutic group after acupuncture treatment for two courses （20 days） were significant （P〈 0.05）. The difference in PSQI between pre-treatment and post-treatment was significant （P〈0.05） in every-day therapeutic group but not in every-other-day therapeutic group （P〈 0.05）, suggesting no efficacy in the treatment for 20 days. However, after acupuncture treatment for 40 days, the difference in PSQI between the two groups was not significant （P 〈 0.05）, but the differences in PSQI between pre-treatment and post-treatment were significant （P〈0.05） in the two groups, indicating tha

关 键 词：针灸 慢性失眠 时效性 量效性 

分 类 号：R246.6[医药卫生—针灸推拿学]