穴位贴敷治疗失眠的析因设计临床研究  

Clinical Study of Acupoint Application in Treatment of Insomnia Based on Factorial Design

作　　者：谢晨[1,2] 郑益鑫 方超君 陈云飞[2] XIE Chen;ZHENG Yixin;FANG Chaojun;CHEN Yunfei(Shanghai Research Institute of Acupuncture and Meridian, Shanghai 200030, China;Yueyang Integrated Hospital of Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China)

机构地区：[1]上海市针灸经络研究所,上海200030 [2]上海中医药大学附属岳阳中西医结合医院,上海200437

出　　处：《针灸临床杂志》2022年第6期20-26,共7页Journal of Clinical Acupuncture and Moxibustion

基　　金：国家自然科学基金青年项目,编号:81804200;上海市卫生和计划生育委员会科研课题,编号:20174Y0063。

摘　　要：目的:观察穴位贴敷治疗失眠的临床疗效,探讨穴位贴敷治疗失眠的最佳量效时间关系。方法:将121例肝郁脾虚型失眠患者随机分为A组(高剂量7 d组)31例、B组(高剂量14 d组)30例、C组(低剂量7 d组)30例和D组(低剂量14 d)30例。4组均给予3次针刺治疗,A组采用高剂量的穴位贴敷治疗7 d,B组采用高剂量的穴位贴敷治疗14 d,C组采用低剂量的穴位贴敷治疗7 d,D组采用低剂量的穴位贴敷治疗14 d。观察治疗前各量表直接的直线相关关系,同时观察4组治疗前后匹兹堡睡眠质量指数(PSQI)、健康调查简表(SF-36)、睡眠严重程度量表(ISI)、贝克焦虑量表(BAI)和贝克抑郁量表(BDI)评分变化,并比较4组临床疗效及年龄、性别等一般资料对疗效的影响。结果:治疗前各量表间存在明显的直线相关。4组治疗前后PSQI、ISI及SF-36评分比较,差异具有统计学意义(P<0.05)。不同剂量穴位贴敷治疗后PSQI、ISI评分及治疗前后差值和治疗后SF-36评分比较,差异无统计学意义(P>0.05);不同时间比较,差异具有统计学意义(P<0.05);剂量与时间无交互作用(P>0.05)。4组治疗前后BAI、BDI评分比较,差异具有统计学意义(P<0.05)。不同剂量和时间穴位贴敷治疗后BAI、BDI评分及差值比较,差异无统计学意义(P>0.05);剂量与时间无交互作用(P>0.05)。4组临床疗效比较差异无统计学意义(P>0.05)。患者的年龄分布、性别、职业、学历分布和病程对临床疗效没有影响。结论:穴位贴敷能够改善患者的失眠症状,提高生活质量,改善焦虑和抑郁情绪。穴位贴敷治疗14 d效果优于治疗7 d,穴位贴敷治疗失眠效果与时间相关,与剂量无关。Objective:To observe the clinical effect of acupoint application in the treatment of insomnia and to explore the optimal time-dose/effect relationship.Methods:121 patients with insomnia due to Liver-depression and Spleen-deficiency were randomized into group A(n=31),group B(n=30),group C(n=30)and group D(n=30).The patients in each group received acupuncture treatment for 3 times.Group A was given high-dose acupoint application for 7 days,group B was given high-dose acupoint application for 14 days,group C was given low-dose acupoint application for 7 days,and group D was given low-dose acupoint application for 14 days.The direct linear correlation of each scale was observed,and the scores of PSQI,SF-36,ISI,BAI and BDI were assessed before and after the treatment in the four groups.Clinical efficacy was compared among the four groups,and the influences of age,gender,vocation,education background and course of disease to clinical efficacy was analyzed in the groups.Results:There was obvious linear correlation among each scale in the four groups before the treatment.There were statistical difference in the scores of PSQI,ISI and SF-36 between before and after the treatment in the four groups(P<0.05).There were no statistical difference in the scores of PSQI and ISI after the treatment,pre/post difference and the score of SF-36 after the treatment between the two groups of different doses(P>0.05);there were significant differences between the groups of different treatment time(P<0.05);there was no interaction between dose and time(P>0.05).There were statistical difference in the scores of BAI and BDI between before and after the treatment in the four groups(P<0.05);there were no statistical differences in the scores of BAI and BDI after the treatment,and in the pre/post difference among the groups of different doses and different treatment time(P>0.05);there was no interaction between dose and time(P>0.05).There were no statistical differences in clinical efficacy among the four groups(P>0.05).The factors of age,gend

关 键 词：穴位贴敷法 失眠 针刺疗法 析因设计 

分 类 号：R246.6[医药卫生—针灸推拿学]