火针心脾论治对顽固性失眠治疗作用的多中心随机对照研究  

Multicenter RCTs of Intractable Insomnia with Fire Needling Treatment Focusing on Heart and Spleen

作　　者：孙旭[1] 胡徽星[2] 李晓梅[3] 余晓璐 马新平[1] 宋晓琳[1] 李净草[1] 李柱[1] 刘思妤[1] 马建伟[1] 

机构地区：[1]中国人民解放军空军总医院,北京100142 [2]安徽省针灸医院,安徽合肥230001 [3]深圳市第二人民医院,广东深圳518028 [4]芜湖市中医医院,安徽芜湖241000

出　　处：《针灸临床杂志》2017年第8期31-34,共4页Journal of Clinical Acupuncture and Moxibustion

摘　　要：目的:观察火针心脾论治方法对顽固性失眠的临床治疗效果。方法:采取多中心联合的方式,收集2015年3月至2016年3月期间就诊于各中心且符合纳入标准的顽固性失眠患者280例,按照随机化原则分为火针治疗组与普通针刺组,其中脱落16例,最终火针治疗组136例,普通针刺组128例。火针治疗组予火针针刺,1周3次,3周为1个疗程,普通针刺组行常规针刺手法,疗程与火针治疗组一致。两个疗程后比较两组患者临床疗效、PSQI评分指数和催眠药物减停率。结果:火针治疗组总有效率94.85%,普通针刺组79.69%,经秩和检验,疗效比较有统计学意义(P<0.05)。两组治疗前后的PSQI量表评分比较显示火针治疗和普通针刺治疗均对顽固性失眠患者睡眠质量、入睡时间、睡眠时间、睡眠障碍、催眠药物和日间功能评分有改善作用(P<0.05),其中火针治疗组前后对照比较对催眠药物的减少作用效果明显(P<0.01),火针治疗组与普通针刺组比较显示在睡眠质量、入睡时间和催眠药物使用以及总体评分上有明显优势(P<0.05)。火针治疗组催眠药物减停率明显优于普通针刺组(P<0.01)。结论:火针从心脾论治对顽固性失眠疗效显著,能够明显改善患者睡眠质量、入睡时间和对药物的依赖性。Objective： To observe the clinical efficacy of intractable insomnia by fire needling treatment focusing on heart and spleen. Methods： 280 patients from multicenter collected from Mar. 2015 to Mar. 2016 were randomized into the fire needling group and the common acupuncture group; finally,136 cases were in the fire needling group,and 128 cases in the common acupuncture group because of 16 missing cases. The fire needling group was treated with fire needles,whereas the common acupuncture group was treated with conventional acupuncture techniques. The needling times were three times a week,and the one treatment course was three weeks for both groups. Clinical curative effect,PSQI,and hypnotics reduction were compared between the two groups after two courses of treatment. Results： The clinical curative effect of the fire needling group was 94. 85%compared to 79. 69% of the common acupuncture group,with a statistical significance（ P〈 0. 05）. The scores of PSQI showed that both groups after the treatment improved sleep quality,time of falling asleep,sleep hours,dissomnia,hypnotics reduction,and daytime function compared to those before the treatment（ P〈 0. 05）,in which the fire needling group had significant effect on hypnotics reduction（ P〈 0. 01）; the fire needling group had obvious advantages over the common acupuncture group in terms of sleep quality,time of falling asleep,hypnotics reduction and general scores（ P〈 0. 05）. Hypnotics reduction of the fire needling group was superior to the common acupuncture group（ P〈 0. 01）. Conclusion： That fire needling has significant clinical effect for intractable insomnia when focusing on treating heart and spleen,which can significantly improve patients＇ sleep quality,time of falling asleep,and hypnotics dependency.

关 键 词：火针 失眠 心脾论治 多中心 随机对照 

分 类 号：R245.316[医药卫生—针灸推拿学]