针药结合治疗老年性失眠:随机对照研究  

Senile insomnia treated with integrated acupuncture and medication therapy:a randomized controlled trial

作　　者：汪建平[1] 王建兵[1] 王利朝[1] 张一鸣[2] 

机构地区：[1]河北医科大学第一医院中医科,石家庄050031 [2]河北医科大学病理教研室

出　　处：《中国针灸》2015年第6期544-548,共5页Chinese Acupuncture & Moxibustion

基　　金：河北省中医药管理局指导性课题项目:2013153

摘　　要：目的:比较西药、针刺和西药结合针刺3种方法治疗老年性失眠的疗效差异。方法:将98例老年性失眠患者随机分为西药组30例、针刺组33例、针药组35例。西药组予舒乐安定1mg,每晚睡前30min服用,口服谷维素20mg,每日3次,共治疗4周;针刺组采用单纯针刺治疗,取穴神门、安阴交、安眠、百会、四神聪,并配合辨证取穴,每日1次,每周治疗5天,共治疗4周;针药组采用西药结合针刺治疗,西药给药量与服用方法同西药组,针刺取穴及治疗方法同针刺组,3组均治疗4周。观察3组于治疗前、治疗4周后及停止治疗4周后匹兹堡睡眠质量指数(PSQI)和临床疗效。结果:治疗4周后西药组、针刺组和针药组的临床治愈率分别为3.3%(1/30)、21.2%(7/33)和25.7%(9/35),3组的总有效率分别为70.0%(21/30)、93.9%(31/33)和97.1%(34/35),针药组和针刺组的临床治愈率和总有效率均高于西药组(均P<0.01);治疗4周后3组PSQI评分与治疗前比较均有改善(均P<0.05),针药组和针刺组PSQI评分均低于西药组,差异具有统计学意义(均P<0.05);停止治疗4周后,针刺、针药组均疗效平稳,PSQI评分与治疗第4周时比较无变化,而西药组出现反复,PSQI评分接近治疗前水平(P>0.05)。治疗过程中西药组少数患者出现口干,其他两组未见不良反应。结论:针药结合治疗老年性失眠症,起效快,能迅速改善症状,临床治愈率和总有效率较高,且远期疗效较西药好,是3种治疗方法中之首选。Objective To compare the efficacy difference in the treatment of senile insomnia among western medication,acupuncture and the integrated therapy of acupuncture and western medication.Methods Ninetyeight patients of senile insomnia were randomized into a western medication group（30 cases）,an acupuncture group（35 cases）and an integrated acupuncture and medication group（35 cases）.In the western medication group,estazolam 1mg was prescribed,taken 30 min before going to bed,oryzanol 20 mg,oral administration,three times a day,for 4 weeks totally.In the acupuncture group,the simple acupuncture therapy was applied at Shenmen（HT 7）,Sanyinjiao（SP 6）,Anmian（Extra）,Baihui（GV 20）and Sishencong（EX-HN 1）,as well as the supplementary points selected according to the differentiation.The acupuncture treatment was given once a day,5 treatments a week,for 4 weeks totally.In the integrated acupuncture and medication group,the western medication was combined with acupuncture.The dosage and usage of western medication were same as those in the western medication group;and acupoints in acupuncture treatment were same as those in the acupuncture group.The treatment lasted for 4 weeks in the three groups.Pittsburgh sleep quality index（PSQI）and clinical efficacy were observed before treatment,after 4 weeks＇ treatment and in 4weeks after discontinuity of treatment in the three groups.Results Four weeks after treatment,the clinical curative rates were 3.3%（1/30）,21.2%（7/33）and 25.7%（9/35）in the western medication group,the acupuncture group and the integrated acupuncture and medicines group separately.The total effective rates were 70.0%（21/30）,93.9%（31/33）and 97.1%（34/35）in the three groups separately.The curative rates and the total effective rates in the integrated acupuncture and medication group and the acupun cture group were higher than those in the western medication group separately（all P〈0.01）.PSQI scores after 4 weeks＇ treatment were all improved as compared wi

关 键 词：老年性失眠 舒乐安定 针药治疗 针刺疗法 匹兹堡睡眠质量指数 

分 类 号：R246.6[医药卫生—针灸推拿学]