疏肝调神耳穴刮痧法联合耳尖放血治疗肝郁化火型失眠临床研究  

Clinical Study on Shugan Tiaoshen Auricular Point Scraping Method Combined with Ear-Apex Blood-letting with Insomnia of Liver Constraint Transforming into Fire Type

作　　者：朱佳欣 苏广 蔡冬美 陈家敏 张瑜 阎路达 钟小玲 ZHU Jiaxin;SU Guang;CAI Dongmei;CHEN Jiamin;ZHANG Yu;YAN Luda;ZHONG Xiaoling(Shenzhen Bao'an Traditional Chinese Medicine Hospital Affiliated to Guangzhou University of Chinese Medicine,Shenzhen Guangdong 518101,China)

机构地区：[1]广州中医药大学附属宝安中医院,广东深圳518101

出　　处：《新中医》2024年第13期203-207,共5页New Chinese Medicine

基　　金：深圳市政府“医疗卫生三名工程”广东省中医院符文彬教授针灸学团队资助项目(SZSM201806077);深圳宝安区针灸临床研究中心项目(BAZJ2018239);深圳市自然科学基金项目(JCYJ20220530141402005)。

摘　　要：目的:观察疏肝调神耳穴刮痧法联合耳尖放血治疗肝郁化火型失眠患者的临床疗效。方法:选取80例肝郁化火型失眠患者作为研究对象,按随机数字表法分为对照组和观察组各40例。对照组给予常规治疗,观察组在对照组基础上进行疏肝调神耳穴刮痧法和耳尖放血治疗,每周2次,连续治疗8周。比较2组治疗前后失眠严重程度指数量表(ISI)、匹兹堡睡眠质量指数量表(PSQI)评分,血清促肾上腺皮质激素释放激素(CRH)、促肾上腺皮质激素(ACTH)、皮质醇(CORT)含量;并比较2组临床疗效。结果:治疗后,2组ISI、PSQI评分均降低(P<0.05),且观察组低于对照组(P<0.05)。治疗后,2组血清CRH、ACTH、CORT水平均降低(P<0.05),且观察组低于对照组(P<0.05)。观察组总有效率95.00%,高于对照组77.50%(P<0.05)。结论:疏肝调神耳穴刮痧法联合耳尖放血能够有效改善失眠患者主观睡眠质量,降低下丘脑-垂体-肾上腺(HPA)轴相关激素水平。Objective:To observe the clinical effect of the therapy of Shugan Tiaoshen auricular point scraping method combined with ear-apex blood-letting on patients with insomnia of liver constraint transforming into fire type.Methods:A total of 80 patients with insomnia of liver constraint transforming into fire type were selected as the study objects and divided into the control group and the observation group according to the random number table method,with 40 cases in each group.The control group was given routine treatment,and the observation group was additionally treated with Shugan Tiaoshen auricular point scraping method combined with ear-apex blood-letting based on the treatment of the control group,twice a week and eight weeks in total.The scores of Insomnia Severity Index(ISI)and Pittsburgh Sleep Quality Index(PSQI)and levels of serum corticotropin releasing hormone(CRH),adrenocor ticotropic hormone(ACTH)and corticosterone(CORT)before and after treatment,and the clinical effects were compared between the two groups.Results:After treatment,the scores of ISI and PSQI in the two groups were decreased(P<0.05),and the above two levels in the observation group were lower than those in the control group(P<0.05).After treatment,the levels of serum CRH,ACTH and CORT in the two groupswere decreased(P<0.05),and the above three levels in the observation group were lower than those inthe control group(P<0.05).The total effective rate was 95.00%in the observation group,higher than thatof 77.50%in the control group(P<0.05).Conclusion:The therapy of Shugan Tiaoshen auricular pointscraping method combined with ear-apex blood-letting can effectively improve the subjective sleep qualityof patients with insomnia and decrease the levels of hormones related to the hypothalamic-pituitaryadrenocortical(HPA)axis.

关 键 词：失眠 肝郁化火证 疏肝调神法 铜砭刮痧 耳尖放血 睡眠质量 下丘脑-垂体-肾上腺轴 

分 类 号：R256.23[医药卫生—中医内科学]