针刺联合耳穴压豆治疗原发性失眠  

Acupuncture Combined with Auricular Acupoint Pressing Beans for Primary Insomnia

作　　者：王彦华[1] 赵敏[1] 杨国防[1] 李凤勤 刘俊红[1] 刘向哲[1] 路永坤[1] 陈丽花 陈俊华[1] 冉龙龙 WANG Yanhua;ZHAO Min;YANG Guofang;LI Fengqin;LIU Junhong;LIU Xiangzhe;LU Yongkun;CHEN Lihua;CHEN Junhua;RAN Longlong(The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou Henan China 450000)

机构地区：[1]河南中医药大学第一附属医院,河南郑州450000

出　　处：《中医学报》2023年第9期1992-1998,共7页Acta Chinese Medicine

基　　金：河南省重点研发与推广专项项目(科技攻关)(212102311124);河南省中医药科学研究专项课题项目(2023ZY2041)。

摘　　要：目的:基于“肝脾不和”理论应用多导睡眠监测(polysomnography,PSG)评估针刺联合耳穴压豆治疗原发性失眠的临床疗效。方法:144例患者按照随机数字表法平均分为对照组和观察组。对照组给予针刺,每次30 min;观察组在对照组治疗基础上给予耳穴压豆,两耳交替耳穴压豆,每天3~6次。比较两组患者治疗前及治疗2周、4周、8周后患者的匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)评分,广泛性焦虑量表(generalized anxiety disorder scale,GAD-7)评分,9条目患者健康问卷抑郁量表(9-entry patient health questionnaire depression scale,PHQ-9)评分,肝郁脾虚型失眠证候(中医证候)评分;采用PSG监测患者睡眠总时间,睡眠效率和睡眠潜伏期;比较两组患者临床疗效。结果:(1)观察组有效率为95.8%(69/72),对照组为77.8%(56/72),两组有效率比较,差异有统计学意义(P<0.05)。(2)治疗后两组患者的PSQI、GAD-7、PHQ-9和中医证候评分均低于治疗前,与治疗前比较,两组治疗2周、4周和8周后PSQI、GAD-7、PHQ-9和中医证候评分均明显降低(P<0.05),且观察组低于同期对照组(P<0.05)。(3)治疗后,两组患者睡眠总时间、睡眠效率均高于治疗前,睡眠潜伏期均低于治疗前,差异均有统计学意义(P<0.05);观察组睡眠总时间、睡眠效率均高于同期对照组,睡眠潜伏期少于同期对照组,差异均有统计学意义(P<0.05)。结论:针刺联合耳穴压豆治疗原发性失眠疗效显著,能有效改善患者睡眠效率,降低患者睡眠潜伏期,延长睡眠总时长,进而缓解患者焦虑和抑郁情绪。Objective:Based on the theory of"disharmony between Liver and Spleen",polysomnography(PSG)was used to evaluate the treatment of primary insomnia.Methods:144 patients were randomly divided into control group and observation group.The control group was given acupuncture for 30min;each time;On the basis of the treatment in the control group,the observation group was given auricular point pressing bean,and auricular point pressing bean alternately in both ears,3-6 times a day.Pittsburgh sleep quality index(PSQI)and generalized anxiety disorder scale(GAD-7),the 9-entry patient health questionnaire depression scale(PHQ-9),insomnia syndrome(TCM syndrome)score of liver depression and spleen deficiency were compared between the two groups before treatment and after 2 weeks,4 weeks and 8 weeks of treatment.PSG was used to monitor the total sleep time,sleep efficiency and sleep latency.The clinical efficacy of the two groups was compared.Results:(1)The effective rate of the observation group was 95.8%(69/72),while that of the control group was 77.8%(56/72).The difference was statistically significant(P<0.05).(2)After treatment,the scores of PSQI,GAD-7,PHQ-9 and TCM syndrome in the two groups were lower than those before treatment.Compared with before treatment,the scores of PSQI,GAD-7,PHQ-9 and TCM syndrome in the two groups were significantly lower after 2 weeks,4 weeks and 8 weeks of treatment(P<0.05),and the observation group was lower than the control group(P<0.05).(3)After treatment,the total sleep time and sleep efficiency of the two groups were higher than those before treatment,and the sleep latency was lower than that before treatment,with statistical significance(P<0.05).The total sleep time and sleep efficiency of the observation group were higher than those of the control group at the same period,and the sleep latency was less than that of the control group at the same period,with statistical significance(P<0.05).Conclusion:Acupuncture combined with auricular point pressing bean is effective in treating primary

关 键 词：原发性失眠 肝脾不和 针刺 耳穴压豆 多导睡眠监测 

分 类 号：R277.7[医药卫生—中医学]