耳穴刮痧配合药物治疗心脾两虚型失眠症的疗效观察  

Therapeutic observation of ear point Guasha plus medication for insomnia due to deficiency of the heart and spleen

作　　者：范阳阳 刘倩 王英哲 丁改丽 谷红霞[1] 宿英豪[1] FAN Yangyang;LIU Qian;WANG Yingzhe;DING Gaili;GU Hongxia;SU Yinghao(Hebei Provincial Hospital of Traditional Chinese Medicine,Shijiazhuang 050011,China)

机构地区：[1]河北省中医院,石家庄050011

出　　处：《上海针灸杂志》2024年第7期744-749,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：河北省中医药管理局科研计划项目(2022356,2022029,2022357)。

摘　　要：目的观察耳穴刮痧配合药物治疗心脾两虚型失眠症的临床疗效。方法将90例心脾两虚型失眠症患者随机分为观察组和对照组,每组45例。对照组予以艾司唑仑片及中药安神汤口服治疗,观察组在对照组基础上予以耳穴刮痧治疗。观察两组治疗前后各项中医证候评分(主症评分、次症评分及总分)、匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)评分、阿森斯失眠量表(Athens insomnia scale,AIS)评分、多导睡眠图(polysomnography,PSG)相关指标(睡眠潜伏期、睡眠效率、觉醒时间、总睡眠时间)及血清食欲素A(orexin A,OXA)、褪黑素(melatonin,MT)水平的变化情况,比较两组临床疗效。结果两组治疗后各项中医证候评分、PSQI评分、AIS评分、睡眠潜伏期、觉醒时间及血清OXA水平均较同组治疗前显著下降,睡眠效率、总睡眠时间及MT水平均显著上升,差异均具有统计学意义(P<0.01)。治疗组治疗后各项中医证候评分、PSQI评分、AIS评分、睡眠潜伏期、觉醒时间及血清OXA水平均明显低于对照组,睡眠效率、总睡眠时间及MT水平均明显高于对照组,差异均具有统计学意义(P<0.01)。观察组总有效率为91.1%,明显高于对照组的71.1%,差异具有统计学意义(P<0.05)。结论耳穴刮痧配合安神汤及常规药物治疗可提高心脾两虚型失眠症患者的睡眠质量,改善其睡眠结构,其机制可能与调节血清OXA、MT含量有关。Objective To observe the clinical efficacy of ear point Guasha plus medication in treating insomnia due to deficiency of the heart and spleen.Method Ninety patients with insomnia due to deficiency of the heart and spleen were randomly divided into an observation group and a control group,with 45 cases in each group.The control group was treated with Estazolam tablets and Chinese medicine An Shen decoction,and the observation group received additional ear point Guasha.Before and after the treatment,the traditional Chinese medicine(TCM)symptom scores(the primary symptom score,secondary symptom score,and total score),Pittsburgh sleep quality index(PSQI)score,Athens insomnia scale(AIS)score,polysomnography(PSG)-related parameters(sleep latency,sleep efficiency,awake time,and total sleep time),and serum levels of orexin A(OXA)and melatonin(MT)were observed.The clinical efficacy was compared between the two groups.Result After the treatment,the TCM symptom scores,PSQI score,AIS score,sleep latency,awake time,and serum OXA level dropped in both groups,and sleep efficiency,total sleep time,and MT level increased,all showing statistical significance(P<0.01).After the intervention,TCM symptom scores,PSQI score,AIS score,sleep latency,awake time,and serum OXA level were lower in the observation group than in the control group,and sleep efficiency,total sleep time,and MT level were higher in the observation group;the between-group differences were statistically significant(P<0.01).The total effective rate was 91.1%in the observation group,significantly higher than 71.1%in the control group(P<0.05).Conclusion Ear point Guasha plus An Shen decoction and conventional medication can improve sleep quality and structure in patients with insomnia due to deficiency of the heart and spleen,and the mechanism may be related to regulating serum OXA and MT levels.

关 键 词：失眠症 心脾两虚 耳穴疗法 刮痧 安神汤 食欲素A 褪黑素 

分 类 号：R246.6[医药卫生—针灸推拿学]