针药并用治疗阴虚火旺型失眠的疗效观察及对脑功能密度的影响  

Therapeutic observation of acupuncture plus medication for insomnia due to Yin deficiency leading to fire hyperactivity and the effect on brain functional connectivity density

作　　者：钱焕萍 陈雪 许建峰[1,2,3] QIAN Huanping;CHEN Xue;XU Jianfeng(School of Traditional Chinese Medicine,Ningxia Medical University,Yinchuan 750004,China;General Hospital of Ningxia Medical University,Yinchuan 750004,China;Key Laboratory of Ningxia Ethnomedicine Modernization,Ministry of Education,Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学中医学院,银川750004 [2]宁夏医科大学总医院,银川750004 [3]宁夏医科大学宁夏少数民族医药现代化教育部重点实验室,银川750004

出　　处：《上海针灸杂志》2025年第4期396-401,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：国家自然科学基金项目(82260984);宁夏自然科学基金项目(2022AAC03533)。

摘　　要：目的 观察治神针法联合黄连阿胶汤治疗阴虚火旺型失眠的疗效,并利用静息状态功能磁共振成像(resting-state functional magnetic resonance imaging, rs-fMRI)检查全脑功能连接密度的变化。方法 选取阴虚火旺型失眠患者60例,采用抽样法随机分为对照组和观察组,每组30例。对照组单独用黄连阿胶汤治疗,观察组采用治神针法联合口服黄连阿胶汤治疗。治疗4周后,比较两组患者各脑区功能连接密度(functional connectivity density,FCD)值,比较匹兹堡睡眠质量指数(Pittsburgh sleep quality index, PSQI)和临床有效率。结果 与对照组比较,观察组左小脑和左脑干FCD值升高(P<0.05)。左侧中央前回、左侧额上回、左侧中央旁小叶和左侧中央后回的FCD值降低(GRF校正,体素水平P<0.005,质量水平P<0.05)。对照组总有效率显著低于观察组(P<0.05),PSQI评分显著高于观察组(P<0.05)。结论 治神针法联合黄连阿胶汤治疗阴虚火旺型失眠的疗效明显优于单独用黄连阿胶汤治疗,联合方法有效地调节了与睡眠相关的大脑区域的功能连接密度。Objective To observe the therapeutic efficacy of Zhi Shen Zhen Fa plus Huang Lian E Jiao decoction in treating insomnia due to Yin deficiency leading to fire hyperactivity and check the changes in brain functional connectivity density(FCD)using the resting-state functional magnetic resonance imaging(rs-fMRI).Method Sixty patients with insomnia due to Yin deficiency leading to fire hyperactivity were randomized into a control group and an observation group using the sampling method,with 30 participants in each group.The control group was offered treatment with Huang Lian E Jiao decoction,and the observation group was treated with Zhi Shen Zhen Fa plus oral administration of Huang Lian E Jiao decoction.After 4 weeks of treatment,the FCD value,Pittsburgh sleep quality index(PSQI),and clinical effective rate were compared between the two groups.Result Compared to the control group,the observation group showed increased FCD values in the left cerebellum and the left side of the brain stem(P<0.05)and decreased FCD values in the left precentral gyrus,left superior frontal gyrus,left paracentral lobule,and left postcentral gyrus(GRF correction,voxel-level P<0.05,mass-level P<0.05).The total effective rate was significantly lower in the control group than in the observation group(P<0.05),and the PSQI score was notably higher in the control group(P<0.05).Conclusion Zhi Shen Zhen Fa plus Huang Lian E Jiao decoction produces more significant efficacy than Huang Lian E Jiao decoction alone in treating insomnia due to Yin deficiency leading to fire hyperactivity.Further,this combined approach can effectively regulate the FCD in sleep-related brain regions.

关 键 词：针刺疗法 针药并用 失眠 黄连阿胶汤 功能连接密度 

分 类 号：R246.6[医药卫生—针灸推拿学]