本文選題：失眠 + 心脾兩虛��； 參考：《廣州中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:觀察壓灸百會(huì)穴治療心脾兩虛型失眠的臨床療效,比較壓灸百會(huì)穴結(jié)合傳統(tǒng)針刺,與單純常規(guī)針刺,兩者對(duì)比于心脾兩虛型失眠的療效差異。旨在評(píng)估和探討壓灸百會(huì)穴結(jié)合針刺治療心脾兩虛型失眠有效性,為臨床針灸療法治療心脾兩虛型失眠提供新的臨床研究思路和資料。方法:本研究課題嚴(yán)格按照納入標(biāo)準(zhǔn)選取心脾兩虛型患者76例,按照隨機(jī)數(shù)字表法分為治療組(壓灸百會(huì)穴結(jié)合常規(guī)針刺)和對(duì)照組(常規(guī)針刺),每組各38例。治療組百會(huì)穴壓灸五壯,接著待余熱自頭皮入腦或向四神聰方向穴位傳導(dǎo),休息五分鐘后進(jìn)行同對(duì)照組同樣穴位常規(guī)針刺,而對(duì)照組為單純進(jìn)行常規(guī)針刺,然后進(jìn)行臨床治療效果的觀察。所有患者按既定方案進(jìn)行治療,隔1天治療1次,10天為一個(gè)療程,共治療兩個(gè)療程。觀察記錄兩組受試者治療前后的總有效率、中醫(yī)癥候積分和匹茲堡睡眠質(zhì)量指數(shù)(PSQI)積分的變化水平,以及治療后比較兩組的臨床療效差異。并在療程結(jié)束后,根據(jù)各項(xiàng)指標(biāo)及臨床療效對(duì)治療后與治療前的評(píng)分進(jìn)行對(duì)比比較,再運(yùn)用SPSS 22.0進(jìn)行統(tǒng)計(jì)學(xué)分析,得出最后的量化結(jié)果。結(jié)果:本課題根據(jù)病例納入標(biāo)準(zhǔn)篩取了心脾兩虛型失眠患者76例,研究實(shí)行過程中,治療組出現(xiàn)脫落3例(均因治療期間服用干擾藥物自行退出),對(duì)照組脫落3例(2例因依從性差中斷治療,1例中途無故中斷治療),故實(shí)際共觀察患者例數(shù)70例。1.經(jīng)2個(gè)療程治療后比較兩組治療結(jié)果,對(duì)照組治療總有效率為80%,治療組的總有效率為94.29%,壓灸百會(huì)穴結(jié)合針刺治療組在臨床有效率方面要優(yōu)于常規(guī)針刺對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。2.中醫(yī)癥候積分比較:兩組治療后結(jié)果相較治療前均發(fā)生明顯改善,且差異顯著(P0.05);治療組與對(duì)照組治療效果相比,治療組結(jié)果要優(yōu)于對(duì)照組,且差異顯著,有統(tǒng)計(jì)學(xué)意義(P0.05)。3.匹茲堡失眠質(zhì)量指數(shù)(PSQI)量表積分對(duì)比:治療后,兩組在積分變化上比較,壓灸百會(huì)穴治療組在量表總分、睡眠質(zhì)量、睡眠時(shí)間及入睡時(shí)間上效果均優(yōu)于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05),在日間功能和睡眠效率方面,兩組臨床治療效果相當(dāng),比較未見明顯差異,無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:1.壓灸百會(huì)穴結(jié)合傳統(tǒng)針刺治療心脾兩虛型失眠臨床療效在總有效率方面,要高于單純傳統(tǒng)針刺組,表明將百會(huì)穴壓灸與針刺相結(jié)合治療心脾兩虛型失眠不寐在臨床中會(huì)有產(chǎn)生更好的治療效果。2.壓灸百會(huì)穴治療心脾兩虛型失眠對(duì)中醫(yī)癥狀方面和PSQI減分率的影響明顯均優(yōu)于傳統(tǒng)針刺組,表明運(yùn)用本治法可改善患者失眠的伴隨癥狀,提高患者生活質(zhì)量,是一種結(jié)合中醫(yī)理念且無副作用的治療手段,具有相當(dāng)大的優(yōu)勢(shì)與前景,值得臨床推廣和更多學(xué)者進(jìn)一步研究。
[Abstract]:Objective: to observe the clinical effect of pressing moxibustion on insomnia with deficiency of heart and spleen, compare the curative effect of compression moxibustion with traditional acupuncture and simple routine acupuncture, and compare the curative effect of pressure moxibustion with traditional acupuncture in treating insomnia with deficiency of heart and spleen. The purpose of this study was to evaluate the efficacy of moxibustion at Baihui point combined with acupuncture in the treatment of insomnia with deficiency of both heart and spleen, and to provide new clinical research ideas and data for clinical acupuncture therapy in treating insomnia with deficiency of both heart and spleen. Methods: 76 patients with deficiency of both heart and spleen were selected according to the inclusion criteria. According to the random number table, they were divided into treatment group (moxibustion combined with routine acupuncture) and control group (38 cases in each group). The treatment group was treated with moxibustion at Baihui point, followed by heat from scalp into the brain or point conduction to Sishencong. After five minutes of rest, the treatment group was treated with routine acupuncture at the same acupoint as the control group, while the control group was treated with simple routine acupuncture. Then the effect of clinical treatment was observed. All patients were treated in accordance with the established program, once a day for 10 days as a course of treatment, a total of two courses of treatment. The changes of total effective rate, TCM symptom score and Pittsburgh Sleep quality Index (PSQI) score before and after treatment were observed and recorded. At the end of the course of treatment, the scores after treatment and before treatment were compared and compared according to the indexes and clinical efficacy, and then SPSS 22.0 was used for statistical analysis, and the final quantitative results were obtained. Results: 76 cases of insomnia with deficiency of both heart and spleen were selected according to the standard of inclusion of the case, and the course of the study was carried out. There were 3 cases of shedding in the treatment group (all due to the withdrawal of interference drugs during the treatment, 2 cases of the control group due to poor compliance and 1 case of interruption of treatment for no reason), so 70 cases were observed. After two courses of treatment, the results of the two groups were compared. The total effective rate of the control group was 80 and the total effective rate of the treatment group was 94.29. The clinical effective rate of the moxibustion combined with acupuncture treatment group was better than that of the conventional acupuncture control group. The difference was statistically significant (P 0.05). Comparison of TCM symptom score: the results of the two groups were obviously improved after treatment, and the difference was significant (P 0.05), the results of the treatment group were better than the control group, and the difference was significant (P 0.05 路3), compared with the control group, the results of the treatment group were better than that of the control group, and there was significant difference between the treatment group and the control group. Comparison of Pittsburgh Insomnia quality Index (PSQI) scale: after treatment, the score changes of the two groups were compared. The effect of moxibustion on the total score, sleep quality, sleep time and sleep time of the treatment group was better than that of the control group. The difference was statistically significant (P 0.05). In the aspects of daytime function and sleep efficiency, the two groups had the same therapeutic effect, but there was no significant difference between the two groups, and there was no significant difference between the two groups in terms of daytime function and sleep efficiency. Conclusion 1. The total effective rate of moxibustion on Baihui point combined with traditional acupuncture in treating insomnia with deficiency of both heart and spleen was higher than that in simple traditional acupuncture group. The results showed that the combination of moxibustion at Baihui point and acupuncture in treating insomnia with deficiency of heart and spleen could produce better therapeutic effect in clinic. The effect of moxibustion on insomnia of deficiency of both heart and spleen was better than that of the traditional acupuncture group, which indicated that this method could improve the accompanying symptoms of insomnia and improve the quality of life of the patients. It is a kind of treatment method which combines the concept of traditional Chinese medicine and has no side effects, and has considerable advantages and prospects, which is worthy of clinical promotion and further research by more scholars.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R246.6

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