基于“通督调神”理论的不同针灸组方治疗失眠症:随机对照研究  

Insomnia treated with three acupuncture combinations guided by theory of Tongdu Tiaoshen: a randomized controlled trial

作　　者：赵亚楠 吴文忠 刘成勇 王晓秋 奚晗清 郑诗雨 李佳欢 ZHAO Ya-nan;WU Wen-zhong;LIU Cheng-yong;WANG Xiao-qiu;XI Han-qing;ZHENG Shi-yu;LI Jia-huan(Department of Acupuncture-Moxibustion and Rehabilitation,Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,Jiangsu Province,China)

机构地区：[1]南京中医药大学附属医院针灸康复科,江苏南京210029

出　　处：《中国针灸》2020年第11期1149-1153,共5页Chinese Acupuncture & Moxibustion

基　　金：江苏省人力资源与社会保障厅“六大人才高峰”高层次人才资助培养计划项目:WSN-015;江苏省中医药管理局科技项目:JD201810;江苏省中医院面上项目:Y18017。

摘　　要：目的:比较通督调卫、通督养心、通督调脏3种针灸组方治疗失眠症的临床疗效及安全性。方法:将90例失眠症患者随机分为通督调卫组(30例,脱落1例)、通督养心组(30例,脱落2例)、通督调脏组(30例,脱落1例)。通督调卫、通督养心、通督调脏3组在电针百会、印堂的基础上依次加针刺申脉、照海,神门、三阴交,五脏俞(肺俞、心俞、肝俞、脾俞、肾俞),均隔日1次,每周3次,连续治疗4周。观察各组患者治疗前后匹兹堡睡眠质量指数(PSQI)量表评分;治疗后评定各组疗效,并记录不良反应。结果:治疗后,各组患者PSQI量表中睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、日间功能障碍6项因子评分及总分均较治疗前降低(P<0.05);治疗后,通督调卫组入睡时间及日间功能障碍评分低于其余两组(P<0.05),通督养心组睡眠时间评分低于其余两组(P<0.05),通督调脏组睡眠质量评分低于其余两组(P<0.05);治疗后通督调卫组、通督养心组、通督调脏组总有效率分别为96.6%(28/29)、96.4%(27/28)、96.6%(28/29),差异无统计学意义(P>0.05)。治疗过程中各组均出现1例轻度不良反应。结论:通督调卫、通督养心、通督调脏3种针灸组方均能有效改善失眠患者的睡眠情况,且安全性均较好;通督调卫针灸组方可能在缩短入睡时间及改善日间功能方面更具优势,通督养心针灸组方可能在增加睡眠时间方面更具优势,通督调脏针灸组方可能在改善睡眠质量方面更具优势。Objective To compare the clinical therapeutic effect and safety on insomnia among three acupuncture combinations, named Tongdu Tiaowei(promoting the circulation of the governor vessel and regulating the defensive system), Tongdu Yangxin(promoting the circulation of the governor vessel and nourishing the heart) and Tongdu Tiaozang(promoting the circulation of the governor vessel and regulating zang functions). Methods A total of 90 patients with insomnia were randomized into a Tongdu Tiaowei group(30 cases, 1 case dropped off), a Tongdu Yangxin group(30 cases, 2 cases dropped off) and a Tongdu Tiaozang group(30 cases, 1 case dropped off). Besides electroacupuncture(EA) applied to Baihui(GV 20) and Yintang(GV 29) in all of the three groups, acupuncture was added at Shenmai(BL 62) and Zhaohai(KI 6), Shenmen(HT 7) and Sanyinjiao(SP 6) as well as back-shu points of five zang organs [Feishu(BL 13), Xinshu(BL 15), Ganshu(BL 18), Pishu(BL 20) and Shenshu(BL 23)] in the Tongdu Tiaowei group, the Tongdu Yangxin group and the Tongdu Tiaozang group successively. The treatment was given once every two days, 3 times weekly, consecutively for 4 weeks. The score of Pittsburgh sleep quality index(PSQI) before and after treatment was observed, the therapeutic effect was evaluated and the adverse reactions were recorded in the patients of each group. Results After treatment, the score of each of 6 factors, named sleep quality, sleep latency, sleep time, sleep efficiency, sleep disturbance and daytime dysfunction, as well as the total score of PSQI scale were all reduced as compared with the scores before treatment in the patients of each group(P<0.05). After treatment, the scores of sleep latency and daytime dysfunction in the Tongdu Tiaowei group were lower than the other two groups(P<0.05). The score of sleep time in the Tongdu Yangxin group was lower than the other two groups(P<0.05) and the score of sleep quality in the Tongdu Tiaozang group was lower than the other two groups(P<0.05). After treatment, the total effective rates

关 键 词：失眠症 针刺 通督调神 穴位配伍 随机对照试验 

分 类 号：R246.6[医药卫生—针灸推拿学]