推拿治疗失眠临床研究进展  

Clinical Research Progress of Tuina Therapy for Insomnia

作　　者：张嘉程 苏志超[1] 朱文静 白雪 王金贵[1,4] ZHANG Jjacheng;SU Zhichao;HU Wenjing;BAI Xue;WANG Jingui(First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion,Tianjin,China,300193;Tianjin University of Traditional Chinese Medicine,Tianjin,China,301617;Liaoning University of Traditional Chinese Medicine,Shenyang,Liaoning,China,110847;Level II Laboratory of Biological Effects of Massage Techniques of National Administration of Traditional Chinese Medicine,Tianjin,China,300193)

机构地区：[1]天津中医药大学第一附属医院,国家中医针灸临床医学研究中心,天津300193 [2]天津中医药大学,天津301617 [3]辽宁中医药大学,辽宁沈阳110847 [4]国家中医药管理局推拿手法生物效应三级实验室,天津300193

出　　处：《河南中医》2024年第3期474-479,共6页Henan Traditional Chinese Medicine

基　　金：区域中医(推拿专科)诊疗中心项目(963042);2023年国家优势中医药重点学科建设项目-推拿学(2023ZDXK002);国家中医药管理局中医药传承与创新“百千万”人才工程(岐黄工程)项目(885022);第七批全国老中医药专家学术经验继承工程项目(202276)。

摘　　要：失眠的根本病机为阳不入阴,病位在心,与肝胆、脾胃、肺、肾关系密切,先天禀赋、个性特征、内伤七情、饮食不节、病理产物等均为发病的相关因素,脏腑功能失调、气机失常、气血亏虚等均是其重要病机。推拿疗法治疗失眠的方法有:单纯推拿疗法(循经推拿疗法、点穴推拿疗法、腹部推拿疗法等)、推拿联合针刺疗法、推拿联合中药、推拿联合拔罐、推拿联合其他疗法等。推拿治疗失眠仍存在以下不足:(1)手法、穴位、治疗部位的选择繁杂不一,难以对不同手法以及不同穴位的疗效进行比较;(2)手法的力度、频率、刺激量没有统一的标准;(3)采用的疗效评价标准不统一,多为临床主观评价量表,缺少客观指标证据;(4)缺少病例回访报道,对推拿有无长期疗效、复发率高低研究较少;(5)缺少多中心、大样本、双盲对照试验;(6)缺少高质量外文文献,国外多将推拿作为失眠的补充疗法,相关研究较少,中文文献多注重研究推拿对失眠的有效性,对于其作用机制的研究较少。The basic pathogenesis of insomnia is that yang cannot enter yin,and the disease is in the heart,closely related to the liver,gallbladder,spleen,stomach,lung and kidney.The congenital endowment,personality characteristics,emotional disorders,irregular diets,pathological products,etc.are all related factors of the disease.The dysfunction of the viscera,qi disorder movement,qi-blood deficiency,etc.are all important pathogenesis.The methods of tuina therapy for insomnia include simple tuina therapy(such as tuina along the affected meridian;point-pressing tuina therapy;abdominal tuina therapy,etc.),tuina combined with acupuncture therapy,tuina combined with Chinese drugs,tuina combined with cupping,tuina combined with other therapies,etc.However,there are still the following shortcomings in the treatment of insomnia with tuina:(1)The choice of manipulation,point and treatment site is complicated,making it difficult to compare the efficacy of different manipulations and different points;(2)There is no unified standard for the strength,frequency and stimulation of the manipulation;(3)The evaluation criteria for the efficacy are not unified,most of which are clinical subjective evaluation scales,lacking objective evidence;(4)There is a lack of case visit reports,and there are few studies on the long-term efficacy and recurrence rate of tuina;(5)There is a lack of multi-center,large sample,double-blind controlled trials;(6)There is a lack of high-quality foreign literature.Many foreign countries mostly use tuina as a supplementary therapy for insomnia,with few related studies.Chinese literature mostly focuses on the effectiveness of tuina for insomnia,with few studies on its mechanism of action.

关 键 词：失眠 推拿疗法 按摩 阳不入阴 循经推拿疗法 点穴推拿疗法 腹部推拿疗法 

分 类 号：R256.23[医药卫生—中医内科学]