發(fā)布時(shí)間：2018-01-05 20:03

  本文關(guān)鍵詞：調(diào)神針法治療失眠的臨床療效觀察　出處：《廣州中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 失眠 調(diào)神針法 安神補(bǔ)心膠囊 臨床療效

【摘要】：目的:失眠是臨床的多發(fā)病、常見病,目前西醫(yī)主要是以藥物治療,但其易產(chǎn)生依賴性和不良反應(yīng)。本次研究通過分析比較調(diào)神針法與安神補(bǔ)心膠囊治療失眠的臨床療效,客觀評價(jià)調(diào)神針法對失眠的療效,并為其在臨床治療失眠,增加睡眠時(shí)間、提高睡眠質(zhì)量的應(yīng)用及推廣提供參考依據(jù)。方法:選取廣州中醫(yī)藥大學(xué)第一附屬醫(yī)院針灸科及推拿科門診2016年3月至2016年12月符合研究納入標(biāo)準(zhǔn)且自愿參加本研究的患者90例。隨機(jī)分為針刺組(30例)、藥物組(30例)、針刺加藥物組(30例)。針刺組采取調(diào)神針法治療,主要選穴:四神針、神庭、印堂、神門、三陰交、申脈、照海,隨癥加減。針刺組治療每天1次,每次留針30分鐘,治療4周。藥物組口服安神補(bǔ)心膠囊(聚協(xié)昌(北京)藥業(yè)有限公司,批號:Z10960053),一次4粒,一日3次,治療4周后觀察療效。針刺加藥物組則同時(shí)接受調(diào)神針法及口服安神補(bǔ)心膠囊治療。分別于首次就診當(dāng)日(治療前)及治療4周后(治療后)對患者進(jìn)行匹茲堡睡眠質(zhì)量指數(shù)(PSQI)及睡眠狀況自評量表(SRSS)的評估。完成數(shù)據(jù)收集及整理工作后,使用SPSS20.0軟件進(jìn)行數(shù)據(jù)統(tǒng)計(jì)學(xué)分析,評價(jià)調(diào)神針法對原發(fā)性失眠的臨床療效。結(jié)果:本研究對三組患者進(jìn)行兩次數(shù)據(jù)采集,分別在首次治療前、治療4周后,以P0.05,(進(jìn)一步作兩兩比較,其校正檢驗(yàn)水準(zhǔn)取α'=0.017)為差異具有統(tǒng)計(jì)學(xué)意義。1.治療前,三組患者一般資料(性別、年齡、病程、職業(yè)分布、睡眠質(zhì)量、入睡時(shí)間、睡眠時(shí)間、日間功能障礙、PSQI評分及SRSS評分)經(jīng)統(tǒng)計(jì)學(xué)分析,差異均無統(tǒng)計(jì)學(xué)意義(P0.05),表明組間具有可比性。2.治療后三組患者睡眠質(zhì)量、入睡時(shí)間、睡眠時(shí)間、日間功能障礙、PSQI評分及SRSS評分較治療前均有所改善(P0.05),表明三組治療均有顯著療效。3.臨床療效:針刺組、藥物組、針刺加藥物組的總有效率分別為93.3%、73.3%、96.7%,經(jīng)等級秩和檢驗(yàn),P0.05,差異具有統(tǒng)計(jì)學(xué)意義。對治療后總有效率進(jìn)一步進(jìn)行兩兩比較,取校正檢驗(yàn)水準(zhǔn)取α' =0.017:針刺組與藥物組比較P0.017;針刺組與針?biāo)幗M比較:P0.017;藥物組與針?biāo)幗M比較:P0.017;說明:三組臨床療效比較具有顯著的統(tǒng)計(jì)學(xué)意義,針刺組與針?biāo)幗M總有效率均優(yōu)于藥物組,但針?biāo)幗M與針刺組效果相仿。4.三組患者治療后的睡眠質(zhì)量評分經(jīng)秩和檢驗(yàn),P0.05,三組患者治療后睡眠質(zhì)量評分比較有統(tǒng)計(jì)學(xué)意義。進(jìn)一步做兩兩比較,校正的α' =0.017,進(jìn)行χ2分割算法,其中針刺組與藥物組比較,P0.017;針刺組與針?biāo)幗M比較P0.017;藥物組與針?biāo)幗M比較,P0.017;說明改善睡眠質(zhì)量方面,針刺組與針?biāo)幗M均優(yōu)于藥物組,但針?biāo)幗M與針刺組效果相仿。5.三組患者治療后的入睡時(shí)間經(jīng)單因素的方差分析,P0.05,說明三組治療后的入睡時(shí)間有統(tǒng)計(jì)學(xué)意義。進(jìn)一步用SNK法和LSD法對均數(shù)進(jìn)行兩兩比較,其中:針刺組與藥物組比較P0.05;針刺組與針?biāo)幗M比較P0.05;藥物組與針?biāo)幗M比較P0.05;說明改善入睡時(shí)間方面,針刺組與針?biāo)幗M均優(yōu)于藥物組,但針?biāo)幗M與針刺組效果相仿。6.三組患者治療后的睡眠時(shí)間經(jīng)單因素的方差分析,P0.05,說明三組治療后的入睡時(shí)間有統(tǒng)計(jì)學(xué)意義。進(jìn)一步用SNK法和LSD法對均數(shù)進(jìn)行兩兩比較,其中:針刺組與藥物組比較P0.05;針刺組與針?biāo)幗M比較P0.05;藥物組與針?biāo)幗M比較P0.05;說明改善睡眠時(shí)間方面,針刺組與針?biāo)幗M均優(yōu)于藥物組,但針刺組與針?biāo)幗M效果相仿。7.三組患者治療后的日間功能障礙評分經(jīng)秩和檢驗(yàn),P0.05,三組患者治療后日間功能障礙評分比較有統(tǒng)計(jì)學(xué)意義。進(jìn)一步做兩兩比較,校正的α' =0.017,進(jìn)行χ2分割算法,其中針刺組與藥物組比較P0.017;針刺組與針?biāo)幗M比較P0.017;藥物組與針?biāo)幗M比較,P0.017;說明改善日間功能障礙評分,針刺組與藥物、針?biāo)幗M效果相仿,但針?biāo)幗M優(yōu)于藥物組。8.三組患者治療后的PSQI、SRSS評分經(jīng)單因素的方差分析,P0.05,說明三組治療后的睡眠總體質(zhì)量有統(tǒng)計(jì)學(xué)意義。進(jìn)一步用SNK法和LSD法對均數(shù)進(jìn)行兩兩比較,其中:針刺組與藥物組比較P0.05;針刺組與針?biāo)幗M比較P0.05;藥物組與針?biāo)幗M比較P0.05;說明改善總體睡眠質(zhì)量方面,針刺組與針?biāo)幗M均優(yōu)于藥物組,但針刺組與針?biāo)幗M效果相仿。結(jié)論:本研究提示調(diào)神針法、安神補(bǔ)心膠囊及調(diào)神針法加安神補(bǔ)心膠囊對治療失眠的療效均具有顯著性,并且均能改善入睡質(zhì)量、縮短入睡時(shí)間、延長睡眠時(shí)間、改善日間功能,但三組間具有差異性。三組臨床療效相比較:針刺組與針?biāo)幗M均優(yōu)于藥物組,但針刺組與針?biāo)幗M效果相仿;改善入睡眠質(zhì)量、縮短入睡時(shí)間、延長睡眠時(shí)間方面:針刺組與針?biāo)幗M均優(yōu)于藥物組,但針刺組與針?biāo)幗M效果相仿;改善入日間功能障礙評分方面:針刺組與藥物、針?biāo)幗M效果相仿,但針?biāo)幗M優(yōu)于藥物組。
[Abstract]:Objective: insomnia is a frequently occurring disease, clinical common disease, western medicine is mainly to drug treatment, but it is easy to produce dependence and adverse reactions. This study by comparing the clinical effect of mind regulating acupuncture and Anshenbuxin capsules in the treatment of insomnia, objectively evaluate the effect of regulating acupuncture for insomnia, and for its clinical treatment of insomnia, increase sleep time, to provide reference for the application and promotion of improving sleep quality. Methods: the First Affiliated Hospital of Guangzhou University of Chinese Medicine Department of acupuncture and massage department from March 2016 to December 2016 with a total of 90 patients were analyzed in this study and voluntary. Randomly divided into acupuncture group (30 cases), treatment group (30 cases), acupuncture plus drug group (30 cases). The acupuncture group take regulating acupuncture therapy, the main acupoints: Sishen needle, shenting, Yintang, Shenmen, Sanyinjiao, Shen Mai, Zhao Hai, with disease. Acupuncture treatment 1 times a day, every time For 30 minutes, for 4 weeks. Oral drug group Anshenbuxin capsules (poly Xiechang (Beijing) Pharmaceutical Co. Ltd., batch number: Z10960053), 4 tablets each time, 3 times a day, to observe the curative effect after 4 weeks of treatment. Acupuncture plus drug group received both regulating acupuncture and oral Anshenbuxin capsules in the treatment respectively. For the first time on the first day (before treatment) and after 4 weeks of treatment (after treatment) of Pittsburgh sleep quality index of patients (PSQI) and self rating scale of sleep (SRSS). The assessment data collection and collation, use SPSS20.0 software for data statistics, analysis and evaluation of the clinical curative effect of regulating acupuncture for primary insomnia. Results: in this study, two data acquisition of three groups of patients, respectively, at first before treatment, after 4 weeks of treatment with P0.05 (22 for further comparison, the calibration of inspection standard a'=0.017) has significant difference before.1. treatment, the three groups General data of patients (gender, age, duration, occupation distribution, sleep quality, sleep time, sleep time, daytime dysfunction, PSQI score and SRSS score) by statistical analysis, there were no significant differences (P0.05), that is comparable to that of.2. in three groups after treatment between groups of sleep quality, sleep time, sleep time, daytime dysfunction, PSQI score and SRSS score were improved than before treatment (P0.05), showed that the clinical curative effect of the treatment of the three groups had significant effect.3. acupuncture group, drug group, the total effective rate of acupuncture plus drug group were 93.3%, 73.3%, 96.7%, by rank sum test, P0.05, with statistical significance the difference of total effective rate after treatment further compare the 22, take the calibration of inspection standard a '=0.017: acupuncture group and medicine group P0.017; acupuncture group compared with the acupuncture group: P0.017; drug group and acupuncture group: P0.017 group: three; Comparison of the clinical efficacy was statistically significant, acupuncture group and acupuncture group, the total effective rate was better than the drug group, but the acupuncture group and the acupuncture group had a similar effect with.4. three groups of patients after treatment, sleep quality score of the rank and inspection, P0.05, three groups of patients after treatment, the sleep quality score is statistically significant further. 22, the correction for x 2 'alpha =0.017 segmentation algorithm, which compared with the drug group P0.017; acupuncture group and acupuncture group P0.017; drug group and acupuncture group P0.017; instructions to improve sleep quality, acupuncture group and acupuncture group was better than the drug group, but the needle the medicine group and the acupuncture group had a similar effect with.5. three groups of patients after treatment of sleep time by single factor variance analysis, P0.05, shows that the three groups had statistical significance after treatment of sleep time. Further on average 22 compared with SNK method and LSD method: Acupuncture Group and drug group P0.05; acupuncture group and acupuncture group P0.05; drug group and acupuncture group P0.05; instructions to improve the sleep time, the acupuncture group and the acupuncture group was better than the drug group, but the acupuncture group and the acupuncture group had a similar effect with.6. three groups of patients after treatment of sleep time by variance analysis, the single factor P0.05, that the three groups had statistical significance after treatment of sleep time. Further on average 22 comparison, using SNK method and LSD method of acupuncture group and medicine group P0.05; acupuncture group and acupuncture group P0.05; drug group and acupuncture group P0.05; that improving sleep time the acupuncture group, and acupuncture group was better than the drug group, but the acupuncture group and the acupuncture group had a similar effect with.7. three groups of patients after treatment of daytime dysfunction score by rank sum test, P0.05, three groups of patients after treatment of daytime dysfunction score was statistically significant further. 22, the correction for x 2 'alpha =0.017 segmentation algorithm, which compared with the drug group P0.017; acupuncture group and acupuncture group P0.017; drug group and acupuncture group P0.017; the improvement of daytime dysfunction score, acupuncture group and drug group, acupuncture effect is similar, but the needle the medicine group is better than the drug group.8. of the three groups after treatment of PSQI, the single factor variance analysis, the SRSS score of P0.05, indicating that three groups after treatment was statistically significant. The overall quality of sleep on average for 22 further compared with SNK method and LSD method of acupuncture group and medicine group P0.05 acupuncture group; with the needle medicine group P0.05; drug group and acupuncture group P0.05; that improving sleep quality overall, acupuncture group and acupuncture group was better than the drug group, but the acupuncture group and the acupuncture group had a similar effect. Conclusion: This study suggests that regulating acupuncture, Anshenbuxin capsule and metality needle The curative effect with Anshenbuxin capsules on the treatment of insomnia were significant, and can improve sleep quality, shorten sleep time, prolong the sleep time, improve daytime function, but has the difference between the three groups. The clinical curative effect of the comparison of the three groups: acupuncture group and acupuncture group was better than the drug group, but the acupuncture group and acupuncture the medicine group had a similar effect; improve the quality of sleep, shorten the sleep time, extended sleep time: acupuncture group and acupuncture group was better than the drug group, but the acupuncture group and the acupuncture group had a similar effect; the improvement in daytime dysfunction score: Acupuncture group and drug group, acupuncture effect is similar, but the acupuncture medicine group is better than that of drug group.

【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R246.6

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