针灸配合耳尖放血治疗入睡困难型失眠的疗效观察  

Efficacy observation of acupuncture-moxibustion plus ear apex bloodletting for insomnia of difficulty falling asleep type

作　　者：何周欢[1] 龚显田 张恒[1] HE Zhouhuan;GONG Xiantian;ZHANG Heng(Chinese Traditional Medicine Hospital of Meishan,Meishan 620010,China)

机构地区：[1]眉山市中医医院,眉山620010

出　　处：《上海针灸杂志》2023年第8期791-796,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：眉山市科技局基金项目(kjzd202139)。

摘　　要：目的观察针灸配合耳尖放血治疗入睡困难型失眠的临床疗效及对患者血清神经肽Y(neuropeptide Y,NPY)和5-羟色胺(5-hydroxytryptamine,5-HT)水平的影响。方法将80例入睡困难型失眠患者随机分为观察组和对照组,每组40例。对照组采用口服艾司唑仑片治疗,观察组在对照组基础上予针灸配合耳尖放血治疗。观察两组治疗前后中医证候积分、匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)各项评分、多导睡眠图(polysomnography,PSG)各项参数[睡眠总时间、入睡时间、快速动眼睡眠(rapid eye movement,REM)时间、醒觉时间和睡眠效率]及血清NPY、5-HT水平的变化情况,比较两组临床疗效及不良反应发生情况。结果两组治疗后中医证候积分及PSG参数中入睡时间和醒觉时间均较同组治疗前下降(P<0.05),PSG参数中睡眠总时间、REM时间和睡眠效率及血清NPY和5-HT水平均较同组治疗前升高(P<0.05)。观察组治疗后PSQI各项评分均较同组治疗前下降(P<0.05),对照组治疗后PSQI中睡眠质量、入睡时间、睡眠时间、睡眠效率的评分以及总分均较同组治疗前下降(P<0.05)。两组治疗后中医证候积分、PSQI各项评分、PSG各项参数及血清NPY和5-HT水平比较,差异均具有统计学意义(P<0.05)。观察组总有效率及治疗期间不良反应发生率分别为92.5%和15.0%,对照组分别为75.0%和7.5%;两组总有效率组间比较,差异具有统计学意义(P<0.05)。结论在药物治疗基础上,针灸配合耳尖放血可提高入睡困难型失眠患者的睡眠质量,改善临床症状,临床疗效优于单一药物治疗。这可能与改善患者血清NPY和5-HT水平相关。Objective To observe the clinical efficacy of acupuncture-moxibustion plus ear apex bloodletting in treating insomnia of difficulty falling asleep type and the effects on serum neuropeptide Y(NPY) and 5-hydroxytryptamine(5-HT) levels.Method Eighty patients with insomnia of difficulty falling asleep type were randomized into an observation group and a control group,with 40 cases in each group.The control group received oral administration of Estazolam tablets,and the observation group received acupuncture-moxibustion and ear apex bloodletting based on the intervention in the control group.Before and after the treatment,the traditional Chinese medicine(TCM) symptom scores,Pittsburgh sleep quality index(PSQI) scores,polysomnography(PSG)parameters [total sleep time,sleep latency,rapid eye movement(REM) time,awake time,and sleep efficiency],and serum NPY and 5-HT levels were observed.Clinical efficacy and the adverse reaction rate were compared between the two groups.Result The TCM symptom scores and PSG sleep latency and awake time dropped after the treatment in the two groups(P<0.05);the PSG total sleep time,REM time,and sleep efficiency,and serum NPY and 5-HT levels increased after the treatment(P<0.05).In the observation group,the PSQI scores all declined after the intervention(P<0.05);in the control group,the PSQI sleep quality,sleep latency,sleep duration,sleep efficiency,and total scores dropped after the treatment(P<0.05).After the intervention,there was statistical significance in comparing the TCM symptom scores,PSQI scores,PSG parameters,and serum NPY and 5-HT levels between the two groups(P<0.05).The observation group had a total effective rate of 92.5% and an adverse reaction rate of 15.0% versus 75.0% and 7.5%in the control group;the difference in the total effective rate was statistically significant(P<0.05).Conclusion Based on the pharmaceutical treatment,acupuncture-moxibustion plus ear apex bloodletting can enhance sleep quality and improve clinical symptoms in patients with insomnia of difficulty fa

关 键 词：针灸疗法 艾条灸 放血疗法 针药并用 睡眠启动和维持障碍 睡眠障碍 神经肽Y 5-羟色胺 

分 类 号：R246.6[医药卫生—针灸推拿学]