针刺五心穴治疗卒中后心肾不交型失眠临床观察  

Clinical observation on acupuncturing’Wuxin acupoints’in treating insomnia after stroke with disharmony between heart and kidney

作　　者：张向宇[1] 高旸[1] 武连仲[1] 牛博真[1] 陆中英 戴晓矞[1] ZHANG Xiang-yu;GAO Yang;WU Lian-zhong;NIU Bo-zhen;LU Zhong-ying;DAI Xiao-yu(The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,National Clinical Research Center for Traditional Chinese Medicine,Tianjin 300193,China;Shenzhen Bao'an District Hospital of Traditional Chinese Medicine,Shenzhen 518101,China)

机构地区：[1]天津中医药大学第一附属医院,国家中医临床医学研究中心,天津300193 [2]深圳宝安区中医院,深圳518101

出　　处：《中华中医药杂志》2020年第9期4517-4520,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家中医药管理局国家中医临床研究基地业务建设科研专项(No.JDZX2015018);武连仲全国名中医传承工作室国家中医药管理局科研基金项目。

摘　　要：目的:观察针刺五心穴治疗卒中后失眠(心肾不交型)的临床疗效。方法:将50例卒中后失眠(心肾不交型)的住院患者随机分为五心穴组(劳宫、涌泉、人中)15例、常规穴组(百会、四神聪)18例、西药组(艾司唑仑1mg/d)17例。连续治疗7d。治疗后及治疗后1周,评价匹兹堡睡眠质量量表(PSQI)、Barthel评分和汉密尔顿抑郁量表(HAMD)和焦虑量表(HAMA)总分,以及有效率变化。结果:治疗后及治疗后1周五心穴组PSQI评分较同期西药组显著改善(P<0.01,P<0.05)。3组的Barthel评分均较治疗前改善,差异无统计学意义。3组HAMD和HAMA评分均较治疗前降低,五心穴组较西药组下降差异有统计学意义(P<0.05)。治疗后3组总有效率差异有统计学意义(P<0.05),五心穴组与西药组疗效分布差异有统计学意义(P<0.05)。结论:针刺五心穴治疗心肾不交型卒中后失眠疗效优于艾司唑仑,且患者焦虑及抑郁改善程度优于艾司唑仑。Objective:To observe the clinical efficacy of acupuncturing‘Wuxin acupoints’on for insomnia after stroke with disharmony between heart and kidney.Methods:A total of 50 patients with for insomnia after stroke with disharmony between heart and kidney were randomly divided into wuxin acupionts group with 15 cases[Laogong(PC 8),Yongquan(KI 1),Renzhong(GV 26)],routine acupoints group with 18 cases[Baihui(GV 20),Sishencong(EX-HN 1)]and western medicine group with 17 cases(Estazolamum 1 mg/d).All groups were treated continuously for 7 d.Pittsburgh sleep quality index(PSQI),the Barthel index,Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA)and evaluation of therapeutic effects were measured after and 1 week after treatment respectively.Results:After treatment,the improvement of PSQI scores in wuxin acupoints group was higher than those of western medicine group(P<0.01,P<0.05).The Barthel scores in the three groups were improved compared with those before treatment,and the differences were not statistically significant.After treatment,the scores of HAMD and HAMA was lower than those before in three groups,the improvement degree in Wuxin acupoints group was higher than those of western medicine group(P<0.05).The differences of the total effective rate in three groups were statistically significant(P<0.05).While there were statistically significant of the curative effect distribution between Wuxin acupoints group and the western medicine group(P<0.05).Conclusion:Acupuncturing Wuxin acupoints can improve the sleep quality,the anxiety and depression motion of insomnia after stroke with disharmony between heart and kidney,and is better than that of oral Estazolam.

关 键 词：五心穴 卒中后失眠 心肾不交 睡眠质量 抑郁 焦虑 

分 类 号：R246.1[医药卫生—针灸推拿学]