调督安神针刺疗法联合交泰汤对心肾不交型失眠患者临床疗效、中医证候、神经递质、焦虑情绪、睡眠质量的影响  

Effects of Tiaodu Anshen acupuncture combined with Jiaotai Decoction on clinical efficacy,TCM syndrome,neu-rotransmitters,anxiety,and sleep quality in patients with insomnia due to heart-kidney imbalance

作　　者：徐芳增 陈正高 冯威 李国庆 XU Fang-zeng;CHEN Zheng-gao;FENG Wei;LI Guo-qing(Department of Rehabilitation,Department of Encephalopathy,Shangqiu 476000,Henan,CHINA;Department of Rehabilitation,Shangqiu Hospital of Traditional Chinese Medicine,Shangqiu 476000,Henan,CHINA)

机构地区：[1]商丘市中医院康复科,河南商丘476000 [2]商丘市中医院脑病科,河南商丘476000

出　　处：《海南医学》2025年第8期1092-1097,共6页Hainan Medical Journal

基　　金：河南省中医药科学研究专项课题项目(编号:2019ZY3038)。

摘　　要：目的探讨调督安神针刺疗法联合交泰汤对心肾不交型失眠患者临床疗效、中医证候、神经递质、焦虑情绪、睡眠质量的影响。方法前瞻性选取2022年6月至2024年3月商丘市中医院收治的135例心肾不交型失眠患者纳入研究,按随机数表法分为汤剂组、针刺组和联合组各45例。三组患者均给予艾司唑仑片,在此基础上,汤剂组给予加味交泰汤,针刺组给予调督安神针刺疗法,联合组给予加味交泰汤联合调督安神针刺疗法,三组均治疗4周。比较三组患者的治疗效果,治疗前、治疗4周后的中医证候积分、神经递质[血清多巴胺(DA)、5羟色胺(5-HT)、神经肽Y(NPY)]、焦虑情绪[汉密尔顿焦虑量表(HAMA)]、睡眠质量[匹兹堡睡眠质量指数量表(PSQI)],同时比较三组患者治疗期间的不良反应发生情况。结果治疗后,联合组患者的总有效率为95.56%,明显高于汤剂组和针刺组的75.56%、80.00%,差异均有统计学意义(P<0.05),而汤剂组与针刺组的治疗总有效率比较差异无统计学意义(P>0.05);治疗后,联合组患者的彻夜不寐、寐而易醒、五心烦热、腰膝酸软积分分别为(1.23±0.16)分、(1.41±0.19)分、(1.33±0.17)分、(1.14±0.14)分,明显低于汤剂组的(1.91±0.24)分、(2.03±0.23)分、(1.97±0.21)分、(1.85±0.26)分和针刺组的(1.49±0.18)分、(1.82±0.25)分、(1.75±0.18)分、(1.42±0.20)分,而针刺组患者的彻夜不寐、寐而易醒、五心烦热、腰膝酸软积分也明显低于汤剂组,差异均有统计学意义(P<0.05);治疗后,联合组患者DA、5-HT水平分别为(47.20±5.31)ng/mL、(60.17±6.53)ng/mL,明显低于汤剂组的(53.26±5.78)ng/mL、(68.31±8.11)ng/mL和针刺组的(58.03±6.25)ng/mL、(75.48±8.79)ng/mL,NPY水平为(7.84±0.88)μg/mL,明显高于汤剂组的(7.09±0.73)μg/mL和针刺组的(6.44±0.70)μg/mL,而汤剂组患者的DA、5-HT水平也明显低于针刺组,NPY水平明显高于针刺组,差异均有统计学意义(P<0.05);治Objective To investigate the effects of Tiaodu Anshen acupuncture combined with Jiaotai Decoc-tion on clinical efficacy,TCM syndrome,neurotransmitters,anxiety,and sleep quality in patients with insomnia due to heart-kidney imbalance.Methods A total of 135 patients with insomnia due to heart-kidney imbalance admitted to Shangqiu Hospital of Traditional Chinese Medicine from June 2022 to March 2024 were prospectively selected and ran-domly divided into three groups:the decoction group,the acupuncture group,and the combined group,with 45 patients in each group.All three groups were treated with estazolam tablets.Additionally,the decoction group received modified Jiaotai Decoction,the acupuncture group received Tiaodu Anshen acupuncture therapy,and the combined group received both modified Jiaotai Decoction and Tiaodu Anshen acupuncture therapy.All groups were treated for 4 weeks.The thera-peutic efficacy,TCM syndrome scores,neurotransmitter levels(dopamine[DA],serotonin[5-HT],neuropeptide Y[NPY]),and anxiety levels(Hamilton Anxiety Scale[HAMA]),sleep quality(Pittsburgh Sleep Quality Index[PSQI])were compared before and after treatment.Adverse reactions during treatment were also compared.Results After treat-ment,the total effective rate in the combined group was 95.56%,significantly higher than 75.56%in the decoction group and 80.00%in the acupuncture group(P<0.05),while there was no significant difference between the decoction group and the acupuncture group(P>0.05).After treatment,the scores for symptoms such as sleeplessness,easy awakening,five-center heat,and soreness and weakness of the waist and knees in the combined group were significantly lower than those in the decoction group and the acupuncture group(P<0.05).The levels of DA and 5-HT in the combined group were significantly lower than those in the decoction group and the acupuncture group,while the level of NPY was signifi-cantly higher(P<0.05).The HAMA and PSQI scores in the combined group were significantly lower than those in the decoction group and t

关 键 词：心肾不交型失眠 督安神针刺疗法 交泰汤 临床疗效 中医证候 神经递质 睡眠质量 

分 类 号：R256.23[医药卫生—中医内科学]