“和脉调神”针法治疗高血压伴失眠患者血压变异性及睡眠情况的临床研究  

Clinical Study on Effect of ‘Hemai Tiaoshen’ Acupuncture on Blood Pressure Variability and Sleep Quality in Treatment of Hypertension Accompanied by Insomnia

作　　者：石鸿伟 任飞 周浩玲 赖思华 张聪[1] 陈理[1] SHI Hongwei;REN Fei;ZHOU Haoling;LAI Sihua;ZHANG Cong;CHEN Li(Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,China)

机构地区：[1]南京中医药大学附属医院,江苏南京210029

出　　处：《针灸临床杂志》2025年第4期18-23,共6页Journal of Clinical Acupuncture and Moxibustion

基　　金：江苏省科技计划专项资金(重点研发计划社会发展)项目,编号:BE2023794;江苏省研究生科研与实践创新计划,编号:SJCX23_0894;江苏省中医院科主任学术提升专项课题,编号:Y2022ZR31。

摘　　要：目的:观察“和脉调神”针刺法对高血压伴失眠患者血压变异性及睡眠情况的临床疗效。方法:收集2022年6月—2023年11月曾于江苏省中医院就诊并满足纳排标准的高血压伴失眠的患者,将60例患者随机分为试验组和对照组,对照组予常规西药治疗及健康宣教,试验组在对照组基础上予“和脉调神”针刺法[百会、内关_((双))、厥阴俞_((双))、神门_((双))和太冲_((双))]治疗,两组均治疗8周后,观察两组患者治疗前后血压变异性(BPV)、平均血压(MBP)、失眠严重程度指数(ISI)总评分以及匹兹堡睡眠质量指数量表(PSQI)总评分和各项目评分的变化情况。结果:与治疗前比较,治疗8周后试验组24 h收缩压标准差(24 h-SSD)、白天收缩压标准差(d-SSD)、夜间收缩压标准差(n-SSD)、24 h舒张压标准差(24 h-DSD)、白天舒张压标准差(d-DSD)、夜间舒张压标准差(n-DSD)、24 h收缩压变异系数(24 h-SCV)、白天收缩压变异系数(d-SCV)和夜间收缩压变异系数(n-SCV)以及24 h舒张压变异系数(24 h-DCV)、白天舒张压变异系数(d-DCV)和夜间舒张压变异系数(n-DCV)均显著低于治疗前,差异具有统计学意义(P<0.05),且低于对照组(P<0.05);同时24 h平均收缩压(24 h-SBP)、白天平均收缩压(d-SBP)、夜间平均收缩压(n-SBP)、24 h平均舒张压(24 h-DBP)、白天平均舒张压(d-DBP)和夜间平均舒张压(n-DBP)均较治疗前降低,差异具有统计学意义(P<0.05);此外,试验组的ISI评分与PSQI总评分及其各项评分在治疗后均较对照组有显著改善,差异具有统计学意义(P<0.05)。结论:“和脉调神”针法可有效改善高血压失眠共病患者的血压变异性,提高患者的睡眠质量。Objective:To observe the clinical effect of ‘Hemai Tiaoshen' acupuncture on blood pressure variability and sleep quality in treatment of hypertension accompanied by insomnia.Methods:60 hypertensive patients with insomnia were randomly assigned into the trial group and the control group.The control group was treated with routine western medication and health education;on which basis,the trial group was treated with ‘Hemai Tiaoshen' needling Baihui(DU20),Neiguan(PC6),Jueyinshu(BL14),Shenmen(HT7) and Taichong(LR3).The changes of blood pressure variability(BPV),mean blood pressure(MBP),the total score of insomnia severity index(ISI),and the total score of Pittsburgh sleep quality index(PSQI) and the subscale scores were observed before and after 8 weeks of the treatment in the two groups.Results:24 h-SSD,d-SSD,n-SSD,24 h-DSD,d-DSD,n-DSD,24 h-SCV,d-SCV,n-SCV,24 h-DCV,d-DCV and n-DCV were all significantly lower after 8 weeks of the treatment than those before the treatment in the treatment group(P<0.05);which were lower in the treatment group than those in the control group after the treatment(P<0.05).24 h-MSBP,d-MSBP,n-MSBP,24 h-MDBP,d-MDBP and n-MDBP were all significantly lower after the treatment than those before the treatment in the trial group(P<0.05).The ISI score,total PSQI score,and all subscale scores were all significantly improved in the group compared to those in the control group after the treatment(P<0.05).Conclusion:‘Hemai Tiaoshen' acupuncture can effectively improve the blood pressure variability and sleep quality of the patients with hypertension and insomnia.

关 键 词：高血压 失眠 和脉调神 血压变异性 

分 类 号：R246.1[医药卫生—针灸推拿学]