循经选穴针刺治疗原发性失眠:多中心随机对照研究  

Acupuncture at acupoints along the meridians for primary insomnia: a multi-center randomized controlled trial

作　　者：吴雪芬[1] 郑雪娜[1] 王艳[1] 陈小丽[1] 刘丽[1] 魏歆然[1] 岳增辉[1] WU Xue-fen;ZHENG Xue-na;WANG Yan;CHEN Xiao-li;LIU Li;WEI Xin-ran;YUE Zeng-hui(College of Acupuncture-Moxibustion and Tuina,Hunan University of CM,Changsha 410208,China)

机构地区：[1]湖南中医药大学针灸推拿学院,长沙410208

出　　处：《中国针灸》2020年第5期465-471,共7页Chinese Acupuncture & Moxibustion

基　　金：国家重点基础研究计划项目:2014CB543102。

摘　　要：目的:比较不同取穴针刺治疗原发性失眠的临床疗效。方法:于3个临床中心共纳入333例原发性失眠患者,随机分为A组(111例,脱落7例)、B组(111例,脱落5例)、C组(111例,脱落2例)。A组针刺神门、百会,B组针刺三阴交、百会,C组针刺非经非穴点、百会。每天1次,每次30 min,均5次为一疗程,治疗5个疗程。比较各组患者治疗前后、治疗结束后4周随访时匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)评分、阿森斯失眠量表(Athensinsomniascale,AIS)评分;观察各组患者治疗前后脑电超慢涨落图(encephalofluctuograph technology,ET)的差异。结果:治疗后、随访时,各组患者PSQI评分均较治疗前显著降低(P<0.01),且A组、B组降低幅度大于C组(P<0.01);治疗后、随访时,各组患者AIS评分均较治疗前显著降低(P<0.01),治疗后A组降低幅度大于C组(P<0.05);治疗前后,各组患者组间与组内ET检测结果比较,差异均无统计学意义(P>0.05)。结论:循经选穴针刺治疗原发性失眠有改善患者睡眠质量的作用,循本经穴、循他经穴疗效优于非经非穴。Objective To compare the clinical effect differences among different acupoint selection methods for primary insomnia. Methods A total of 333 patients with primary insomnia were recruited from 3 study centers and randomly divided into a group A(111 cases, 7 cases dropped off), a group B(111 cases, 5 cases dropped off) and a group C(111 cases, 2 cases dropped off). The patients in the group A were treated with acupuncture at Shenmen(HT 7) and Baihui(GV 20), the patients in the group B were treated with acupuncture at Sanyinjiao(SP 6) and Baihui(GV 20), and the patients in the group C were treated with acupuncture at non-acupoint and Baihui(GV 20). All the treatment was given once a day, 30 min each time;5 treatments were taken as a course and 5 courses of treatment were given. The Pittsburgh sleep quality index(PSQI) and Athens insomnia scale(AIS) scores were evaluated before and after treatment as well as 4 weeks after treatment. The encephalofluctuograph technology(ET) was observed before and after treatment. Results Compared before treatment, the PSQI scores after treatment and at follow-up were significantly decreased in three groups(P<0.01), and the decrease in the group A and the group B was greater than that in the group C(P<0.01). Compared before treatment, the AIS scores after treatment and at follow-up was significantly decreased in three groups(P<0.01), and the decrease in the group A was greater than that in the group C(P<0.05). The interclass and between-groups ET before and after treatment had no significant difference(P>0.05). Conclusion The acupuncture at acupoints along the meridians could improve the sleep quality in patients with primary insomnia, and the therapeutic effect of acupoint along the meridians is better than that of non-acupoint.

关 键 词：原发性失眠 腧穴配伍 针刺 匹兹堡睡眠质量指数(PSQI) 脑电超慢涨落图(ET) 随机对照试验(RCT) 

分 类 号：R246.1[医药卫生—针灸推拿学]