针刺配合子午流注开穴推拿治疗老年顽固性失眠疗效观察  

Therapeutic observation of acupuncture plus midnight-noon ebb-flow point-opening Tuina for senile intractable insomnia

作　　者：金海涛 周芳[1] 马剑然 郭真甄 于淼 李智杰 JIN Haitao;ZHOU Fang;MA Jianran;GUO Zhenzhen;YU Miao;LI Zhijie(Hubei University of Chinese Medicine,Wuhan 430065,China)

机构地区：[1]湖北中医药大学,武汉430065

出　　处：《上海针灸杂志》2024年第9期969-973,共5页Shanghai Journal of Acupuncture and Moxibustion

基　　金：国家科技部重点研发计划-中医药现代化研究项目(SQ2018YFC175600)。

摘　　要：目的观察“和胃安神”针刺法配合子午流注开穴推拿治疗老年顽固性失眠临床疗效及其对患者睡眠质量及认知功能的影响。方法将150例老年顽固性失眠患者随机分为观察组和对照组,每组75例。观察组采用“和胃安神”针刺法联合子午流注开穴推拿治疗,对照组采用口服艾司唑仑片治疗。观察两组治疗前后匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)评分、蒙特利尔认知评估量表(Montreal cognitive scale,MoCA)评分、汉密顿抑郁量表(Hamilton depression scale,HAMD)评分、汉密顿焦虑量表(Hamilton anxiety scale,HAMA)评分及5羟色胺(5-hydrox-ytryptamine,5-HT)、多巴胺(dopamine,DA)、褪黑素水平的变化情况,比较两组临床疗效。结果两组治疗后PSQI、HAMD、HAMA评分及DA水平较同组治疗前均显著降低,Mo CA评分及5-HT、褪黑素水平均显著升高,差异均具有统计学意义(P<0.05)。观察组治疗后PSQI、HAMD、HAMA评分及DA水平均明显低于对照组,Mo CA评分及5-HT、褪黑素水平均明显高于对照组,差异均具有统计学意义(P<0.05)。观察组总有效率为92.0%,明显高于对照组的80.0%,两组比较差异具有统计学意义(P<0.05)。结论“和胃安神”针刺法配合子午流注开穴推拿治疗老年顽固性失眠疗效确切,能提高患者睡眠质量和认知水平,改善其抑郁、焦虑情绪。Objective To observe the clinical efficacy of“He Wei An Shen”(stomach-soothing mind-calming)acupuncture plus midnight-noon ebb-flow point-opening Tuina(Chinese therapeutic massage)in treating senile intractable insomnia and its effects on the patient’s sleep quality and cognitive function.Method A total of 150 aged patients with intractable insomnia were randomized into an observation group and a control group,with 75 cases in each group.The observation group was treated with“He Wei An Shen”acupuncture plus midnight-noon ebb-flow point-opening Tuina,and the control group received oral administration of Estazolam tablets.The scores of Pittsburgh sleep quality index(PSQI),Montreal cognitive scale(MoCA),Hamilton depression scale(HAMD),and Hamilton anxiety scale(HAMA)and the levels of 5-hydroxytryptamine(5-HT),dopamine(DA),and melatonin(MT)were observed before and after the treatment,and the clinical efficacy was also compared.Result The scores of PSQI,HAMD,and HAMA and the DA level decreased significantly after the treatment in both groups,and the MoCA score and the levels of 5-HT and MT increased significantly(P<0.05).After the intervention,the scores of PSQI,HAMD,and HAMA and the DA level were notably lower in the observation group than in the control group,and the MoCA score and the levels of 5-HT and MT were higher in the observation group(P<0.05).The total effective rate was 92.0%in the observation group,markedly higher than 80.0%in the control group,and the difference was statistically significant(P<0.05).Conclusion“He Wei An Shen”acupuncture plus midnight-noon ebb-flow point-opening Tuina is effective in treating senile intractable insomnia.This method can enhance the patient’s sleep quality and cognitive level and improve their depression and anxiety.

关 键 词：针刺疗法 失眠 睡眠障碍 推拿 子午流注纳子法 认知功能 睡眠质量 

分 类 号：R246.6[医药卫生—针灸推拿学]