养心安神汤联合耳穴揿针治疗脑卒中后失眠的临床观察  

Clinical Observation of Yangxin Anshen Decoction Combined with Ear Acupuncture for Insomnia After Stroke

作　　者：郭旭东 翟珍惜 李延红[1] 闫莹莹 GUO Xu-dong;ZHAI Zhen-xi;LI Yan-hong;YAN Ying-ying(The First Affiliated Hospital of Henan University,Henan Kaifeng 475000)

机构地区：[1]河南大学第一附属医院,河南开封475000

出　　处：《深圳中西医结合杂志》2022年第1期8-11,共4页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

基　　金：河南省医学科技攻关计划(联合共建)项目(LHGJ20190530)。

摘　　要：目的:观察养心安神汤联合耳穴揿针治疗心脾两虚型脑卒中后失眠患者的临床疗效。方法:选取河南大学第一附属医院2018年11月至2020年6月期间收治的74例心脾两虚型脑卒中后失眠患者,随机分为观察组和对照组,各37例。对照组给予阿普唑仑治疗,观察组在对照组治疗的基础上给予养心安神汤联合耳穴揿针治疗。观察两组的匹茨堡睡眠质量指数量表(PSQI)评分、汉密尔顿抑郁量表(HAMD)评分、血清5–羟色胺(5–HT)及去甲肾上腺素(NE)水平,比较两组患者临床疗效。结果:观察组患者的治疗总有效率为94.59%,高于对照组的78.38%,差异具有统计学意义(P<0.05)。治疗2周和治疗4周后两组患者的PSQI评分均有不同程度降低,且观察组低于对照组,差异具有统计学意义(P<0.05)。治疗后两组患者HAMD评分均有不同程度的下降,且观察组的HAMD评分低于对照组,差异具有统计学意义(P<0.05)。治疗后两组患者的5–HT水平不同程度提高,NE水平有不同程度下降,且观察组患者的5–HT水平高于对照组,NE水平低于对照组,差异具有统计学意义(P<0.05)。对照组出现头痛2例,头晕2例,胃肠道反应3例,不良反应总发生率为18.92%(7/37);观察组仅1例患者局部针刺部位出现发痒发红,不良反应总发生率为2.70%(1/37),观察组明显低于对照组,差异具有统计学意义(P<0.05)。结论:养心安神汤联合耳穴揿针治疗脑卒中后失眠疗效较好,可有效改善患者的睡眠质量,调节神经递质水平,缓解抑郁情绪,提高生活质量。Objective To observe the clinical efficacy of Yangxin Anshen decoction combined with ear acupuncture in the treatment of post-stroke insomnia patients with deficiency of both heart and spleen.Methods A total of 74 patients with poststroke insomnia admitted to the First Affiliated Hospital of Henan University from November 2018 to June 2020 were randomly divided into observation group and control group,with 37 cases in each group.The control group was given alprazolam,and the observation group was given Yangxin Anshen decoction combined with ear acupuncture treatment on the basis of the control group.The pittsburgh sleep quality index(PSQI),hamilton depression scale(HAMD)score,serum 5-hydroxytryptamine(5-HT)and norepinephrine(NE)of the two groups were observed,and the clinical efficacy were compared.Results The total effective rate of treatment in the observation group was 94.59%,which was higher than 78.38%in the control group.The difference was statistically significant(P<0.05).After 2 weeks of treatment and 4 weeks of treatment,the PSQI scores of the two groups of patients were reduced to varying degrees,and the PSQI score of the observation group was lower than that of the control group,the difference was statistically significant(P<0.05).After treatment,the HAMD scores of the two groups of patients decreased to varying degrees,and the HAMD score of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).After treatment,the level of 5-HT of the two groups of patients increased to different degrees,and the level of NE decreased to different degrees.The level of 5-HT of the observation group was higher than that of the control group,and the level of NE was lower than that of the control group.The differences were statistically significant(P<0.05).In the control group,there were 2 cases of headache,2 cases of dizziness,and 3 cases of gastrointestinal reactions,the total incidence of adverse reactions was 18.92%(7/37).In the observation group,only 1 p

关 键 词：脑卒中 失眠 养心安神汤 耳穴揿针 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R256.23[医药卫生—临床医学]