本文關鍵詞：綜合療法對心脾兩虛型不寐患者多導睡眠圖干預的相關性研究　出處：《長春中醫(yī)藥大學》2015年碩士論文　論文類型：學位論文

  更多相關文章： 心脾兩虛 不寐 多導睡眠圖

【摘要】：目的:觀察綜合療法治療心脾兩虛型不寐證的臨床療效,并探討其對多導睡眠圖干預的相關性研究。方法:研究選取于長春中醫(yī)藥大學附屬醫(yī)院中西醫(yī)結合睡眠中心就診的心脾兩虛型不寐證患者72例,采用隨機表法分為綜合療法治療組36例,單純中藥治療組36例,其中單純中藥治療組患者應用歸脾湯加減,綜合療法治療組在對照組中藥治療基礎上,配合耳穴貼敷療法,7天為1療程,共4療程。應用多導睡眠監(jiān)測系統(tǒng)檢測不寐患者的睡眠變化情況,對兩組監(jiān)測結果進行評估和比較。結果:①綜合療法和單純中藥治療均可有效延長不寐患者的總睡眠時間,縮短睡眠潛伏期、REM潛伏期,提高睡眠效率,但綜合療法治療組總睡眠時間、睡眠潛伏期、睡眠效率水平的改善明顯要優(yōu)于單純中藥組(P0.05),但是REM潛伏期的改善方面兩組比較無顯著性差異(P0.05),提示對REM潛伏期的縮短方面療效相近;②兩組治療均可明顯增加不寐患者的NREM睡眠時間及REM睡眠時間(P0.05),但綜合治療組對NREM期睡眠時間和REM期睡眠時間的延長的作用優(yōu)于單純中藥組(P0.05),在覺醒次數(shù)方面,兩組治療后覺醒次數(shù)均明顯減少,綜合治療組對覺醒次數(shù)的減少方面要優(yōu)于單純中藥組(P0.05),說明綜合治療組可有效減少覺醒事件在整體睡眠過程中的發(fā)生次數(shù);③綜合治療組NREM睡眠期S1期、S2期、S3期時間在治療前后均具有極顯著性差異(P0.01),提示綜合治療通過縮短不寐患者的淺睡眠時間,延長深睡眠時間,實現(xiàn)對NREM睡眠的調節(jié)作用;單純中藥組NREM睡眠S1期、S2期在治療前后具有極顯著性差異(P0.01),S3期比較無顯著性差異(P0.05),提示單純中藥治療能夠增加S2期睡眠時間,縮短S1期睡眠時間,但對深睡眠時間無明顯影響。綜合治療對NREM睡眠的各期及總體的改善作用要優(yōu)于單純中藥組(P0.05);④綜合治療組的總有效率為86.11%,在總體療效方面臨床比較優(yōu)于單純中藥組(69.44%)(P0.05)。結論:中藥、耳穴綜合療法治療心脾兩虛型不寐證安全、有效,可以在根本上優(yōu)化失眠患者的睡眠結構,提高患者睡眠效率,增加REM、NREM睡眠時間,在改善睡眠質量方面具有顯著優(yōu)勢。
[Abstract]:Objective: to observe the clinical effect of comprehensive therapy on insomnia with deficiency of both heart and spleen. Methods: 72 patients with insomnia with deficiency of both heart and spleen were selected from sleep center of TCM and Western medicine affiliated hospital of Changchun University of traditional Chinese Medicine. Random list method was used to divide the treatment group into three groups: 36 cases in the combined therapy group and 36 cases in the traditional Chinese medicine treatment group, in which the patients in the traditional Chinese medicine treatment group were treated with Guipi decoction, and the treatment group was based on the traditional Chinese medicine treatment in the control group. Combined with auricular acupoint application therapy for 7 days as a course of treatment, a total of 4 courses. The use of polysomnography monitoring system to detect sleep changes in patients with insomnia. Results the total sleep time of the patients with insomnia was prolonged, the REM latency was shortened and the sleep efficiency was improved. However, the improvement of total sleep time, sleep latency and sleep efficiency in the treatment group was significantly better than that in the traditional Chinese medicine group (P0.05). However, there was no significant difference in the improvement of REM latency between the two groups, indicating that the effect of shortening the latency of REM was similar. 2 the NREM sleep time and REM sleep time of the patients with insomnia were significantly increased in both groups (P 0.05). But the effect of comprehensive treatment group on NREM sleep time and REM stage sleep time prolongation was better than that of traditional Chinese medicine group (P0.05A). In the arousal times, the two groups after treatment significantly decreased the arousal times. The reduction of arousal times in the comprehensive treatment group was better than that in the traditional Chinese medicine group, which indicated that the comprehensive treatment group could effectively reduce the number of arousal events occurring in the whole sleep process. 3There was a significant difference in the time of NREM sleep stage S1, S2 and S3 before and after treatment in the combined treatment group, indicating that comprehensive treatment could shorten the shallow sleep time of the patients with insomnia. Prolonging the time of deep sleep and realizing the regulation of NREM sleep; There was no significant difference in NREM sleep stage S _ 1 / S _ 2 stage before and after treatment in Chinese medicine group (P 0.05). It is suggested that Chinese medicine alone can increase sleep time in S2 stage and shorten sleep time in S1 stage. But there was no significant effect on the time of deep sleep. The effect of comprehensive therapy on the improvement of NREM sleep was better than that of traditional Chinese medicine group (P 0.05). 4 the total effective rate of the combined treatment group was 86.11, which was better than that of the traditional Chinese medicine group in the total curative effect. Conclusion: traditional Chinese medicine is better than the traditional Chinese medicine group. Auricular point therapy is safe and effective in treating insomnia with deficiency of both heart and spleen. It can fundamentally optimize sleep structure of insomnia patients, improve sleep efficiency of patients, and increase sleep time of REMN NREM patients. It has significant advantages in improving sleep quality.
【學位授予單位】：長春中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R740

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