振腹环揉法腹部推拿辅助治疗痰热内扰型失眠症伴“胃不和”症状的随机对照试验  

Vibration-Kneading Abdominal Tuina as An Adjunct Treatment for Insomnia of Phlegm-Heat Harassing the Interior Syndrome with"Stomach Disharmony":A Randomised Controlled Trial

作　　者：张秀红 周海芳 徐哲 ZHANG Xiuhong;ZHOU Haifang;XU Zhe(Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University,Hangzhou,310007)

机构地区：[1]浙江中医药大学附属杭州市中医院,浙江省杭州市310007

出　　处：《中医杂志》2024年第8期830-835,共6页Journal of Traditional Chinese Medicine

基　　金：浙江省中医药科技计划(2023ZL515)。

摘　　要：目的观察振腹环揉法腹部推拿辅助治疗痰热内扰型失眠症伴“胃不和”症状的疗效与安全性。方法选取痰热内扰型失眠症伴“胃不和”症状患者76例,随机分为治疗组和对照组各38例。对照组口服艾司唑仑片(每次2 mg,每晚1次)并给予睡眠卫生指导,治疗组在此基础上实施振腹环揉法腹部推拿,每周5次,每次30 min。两组均治疗4周。分别于治疗前后及随访时(治疗结束12周)进行匹兹堡睡眠质量指数(PSQI,包括睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、催眠药物、日间功能障碍评分及总积分)、“胃不和”中医症状评分。治疗期间观察不良事件发生情况。采用皮尔逊相关性分析观察72例患者治疗前PQSI总积分与“胃不和”中医症状评分之间的相关性。结果与本组治疗前比较,两组患者治疗后及随访时PSQI的睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、日间功能障碍评分及总积分均降低(P<0.05或P<0.01),“胃不和”中医症状评分亦降低(P<0.01)。治疗后,治疗组PSQI的睡眠质量、睡眠时间评分及“胃不和”中医症状评分低于对照组(P<0.05或P<0.01)。随访时,治疗组PSQI的睡眠质量、睡眠时间、睡眠效率、日间功能障碍评分及PQSI总积分均低于对照组(P<0.05或P<0.01),“胃不和”中医症状评分亦低于对照组(P<0.01)。研究过程中所有患者均未发生不良反应。患者治疗前PQSI总积分与“胃不和”中医症状评分之间呈正相关(r=0.88,P<0.01)。结论振腹环揉法腹部推拿辅助治疗可显著改善痰热内扰型失眠症伴“胃不和”症状患者的胃脘部不适症状,提高睡眠质量,具有较好的近期及远期疗效,且安全性佳。Objective To explore the effectiveness and safety of vibration-kneading abdominal tuina as an adjunct treatment for insomnia of phlegm-heat harassing the interior syndrome with"stomach disharmony"symptom.Methods Seventy-six insomnia patients of phlegm-heat harassing the interior syndrome with"stomach disharmony"symptom were recruited,and randomly divided into the treatment group and the control group with 38 cases in each group.The control group received eszopiclone 2mg once a night and sleep hygiene guidance,while the treatment group received vibration-kneading abdominal tuina additionally,5 times a week,30 min each time.Both groups were treated for 4 weeks.The Pittsburgh Sleep Quality Index(PSQI)(including sleep quality,time to fall asleep,sleep duration,sleep efficiency,sleep disorders,daytime functioning scores,and total scores)and traditional Chinese medicine(TCM)symptom scores of"stomach disharmony"was assessed before and after 4-week treatment and at follow-up(12 weeks after treatment).Adverse events were also observed and recorded during the study.Pearson cor⁃relation analysis was used to assess the correlation between the pre-treatment PQSI total score and TCM symptom score of"stomach disharmony".Results The PSQI scores of sleep quality,time to fall asleep,sleep duration,sleep effi⁃ciency,sleep disorders,daytime dysfunction scores,and total scores reduced in both groups decreased after treat⁃ment and at follow-up(P<0.05 or P<0.01),as well as the TCM symptom score of"stomach disharmony"(P<0.01).After treatment,the PSQI scores of sleep quality,sleep duration,and TCM symptom score of"stomach dis⁃harmony"of the treatment group were lower than those of the control group(P<0.05 or P<0.01).At follow-up,the PSQI scores of sleep quality,sleep duration,sleep efficiency,daytime dysfunction score,total score,and TCM symp⁃tom score of"stomach disharmony"of the treatment group were lower than those of the control group(P<0.05 or P<0.01).No adverse reactions occurred in any participants during the study.There

关 键 词：失眠症 胃不和 腹部推拿 振腹环揉法 匹兹堡睡眠质量指数 

分 类 号：R256.23[医药卫生—中医内科学]