灵龟八法结合火针针刺对心脾两虚型失眠患者觉醒状态的影响  

Effect of Ling Gui Ba Fa Combined with Fire Needling on Daytime Arousal of Patients with Insomnia Due to Heart-spleen Deficiency

作　　者：洪秋阳[1,2] 杨惠民[3] 王世广 赵杰 毛雪文 王桂玲[4] 

机构地区：[1]北京中医医院顺义医院,北京101300 [2]北京中医药大学,北京100029 [3]北京中医药大学东直门医院,北京100700 [4]首都医科大学附属北京中医医院,北京100010

出　　处：《针灸临床杂志》2017年第8期26-31,共6页Journal of Clinical Acupuncture and Moxibustion

基　　金：北京市中医管理局专项资助;编号:QN2016-12

摘　　要：目的:比较灵龟八法结合火针与口服艾司唑仑治疗心脾两虚型失眠症的临床疗效差异。方法:将90例心脾两虚型失眠症患者随机分为灵龟八法结合火针针刺组(45例)和药物组(45例),共剔除3例,最后针刺组44例、药物组43例。针刺组采用灵龟八法按时开穴配合火针背俞穴等治疗,每日治疗1次,每周5次,连续治疗4周;药物组睡前半小时口服艾司唑仑片1 mg,每天1次,连续服用4周。治疗前后分别观察两组患者匹兹堡睡眠质量指数(PSQI)量表各维度评分及总分、Epworth思睡量表评分和中医症状积分,并评定两组临床疗效。结果:针刺组治疗后PSQI总分及各因子评分、Epworth总分、中医症状量表总分及各因子评分均较治疗前降低(均P<0.05);药物组治疗后PSQI总分及各因子评分、Epworth总分、中医症状量表中的难以入寐、多梦易醒、头晕、心悸评分及总分均较治疗前降低(均P<0.05);两组患者治疗后PSQI总分及睡眠质量、睡眠效率、睡眠障碍、日间功能障碍、Epworth评分、中医症状量表积分比较差异均有统计学意义(均P<0.05)。针刺组总有效率为93.2%,高于药物组的83.7%(P<0.05)。结论:灵龟八法结合火针较艾司唑仑能更有效的改善心脾两虚型失眠患者的症状,尤其是改善患者的睡眠质量和提高日间的觉醒程度。Objective： To compare the difference of clinical efficacy between Ling Gui Ba Fa combined with fire needling method and oral administration of Estazolam in the treatment of insomnia due to heart-spleen deficiency. Methods： 90 patients were randomly divided into the acupuncture group（ 45 cases） and the medication group（ 45 cases）. 44 cases from the acupuncture group and 43 cases from the medication group were used for the final statistics because of three missing cases. The acupuncture group was applied with Ling Gui Ba Fa combined with fire needling method（ once a day,five times per week）,in which the back-shu points were selected according to the time; the medication group was given 1mg Estazolam half an hour before going to bed;the intervention duration for both groups were four weeks. Scores of PSQI,Epworth,and TCM symptoms were recorded,also the clinical efficacy was assessed before and after the treatment between the two groups. Results：The total score and each factor score of PSQI,the total score of Epworth,and the total score and each factor score of TCM symptoms were all lower after treatment than those before treatment in the acupuncture group（ P〈 0. 05）. In the medication group,the total score and each factor score of PSQI,the total score of Epworth,the scores of difficulty in falling asleep,dreaminess,restless sleep,dizziness,palpitation and total scores of TCM symptoms were all lower after treatment than those before treatment（ P〈 0. 05）. There were significant differences between the two groups after the treatment in terms of the total score of PSQI,Epworth and TCM symptom,as well as sleep quality,sleep efficiency,sleep disturbance,daytime dysfunction（ P 〈 0. 05）. The total effective rate was 93. 2% in the acupuncture group,which was higher than 83. 7% in the medication group（ P 〈0. 05）. Conclusion： The method of Ling Gui Ba Fa combined with fire needling can improve the symptoms of insomnia in patients with heart-spleen deficiency,especially to improve s

关 键 词：失眠 心脾两虚 针刺疗法 灵龟八法 火针 觉醒状态 

分 类 号：R246.1[医药卫生—针灸推拿学]