本文選題：原發(fā)性失眠 + 淺針　； 參考：《福建中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：研究目的觀察淺針治療原發(fā)性失眠的臨床療效,分析其對(duì)腦內(nèi)神經(jīng)遞質(zhì)的影響,為淺針的臨床應(yīng)用提供理論依據(jù)。研究方法將60例原發(fā)性失眠患者隨機(jī)分為試驗(yàn)組與對(duì)照組,每組30例。試驗(yàn)組采用淺針干預(yù),每日一次,每次30分鐘;對(duì)照組給予艾司唑侖1mg,每日一次,臨睡前30分鐘服用。共干預(yù)20天。干預(yù)前后采用匹茲堡睡眠質(zhì)量指數(shù)量表(Pittsburgh sleep qu ality index,PSQI)和埃普沃思嗜睡量表(Epworth Sleepiness Scale,ESS)評(píng)估兩組的睡眠質(zhì)量及臨床療效,應(yīng)用腦漲落圖(Encephalofluctuograph,EFG)評(píng)定腦內(nèi)神經(jīng)遞質(zhì)的變化情況。研究結(jié)果1、試驗(yàn)組總有效率為78.5%,對(duì)照組為74.0%,兩組療效相當(dāng)(P0.05)。2、與干預(yù)前比較,干預(yù)后兩組的匹茲堡睡眠質(zhì)量指數(shù)(PSQI)評(píng)分均明顯低于干預(yù)前,差異有統(tǒng)計(jì)學(xué)意義(P0.05);干預(yù)后兩組PSQI評(píng)分組間比較,試驗(yàn)組略高于對(duì)照組;干預(yù)結(jié)束時(shí)治療組PSQI量表七個(gè)子項(xiàng)目治療前后的差值分別與對(duì)照組比較,入睡時(shí)間和催眠藥物兩項(xiàng)的差值評(píng)分高于對(duì)照組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05),睡眠障礙、睡眠質(zhì)量、睡眠時(shí)間、睡眠效率及日間功能障礙五項(xiàng)的差值分別與對(duì)照組比較,分值相當(dāng),差異無統(tǒng)計(jì)學(xué)意義(P0.05);干預(yù)結(jié)束一個(gè)月后隨訪,兩組的匹茲堡睡眠質(zhì)量指數(shù)(PSQI)與治療結(jié)束時(shí)比較,均略有提高,組間比較差異無統(tǒng)計(jì)學(xué)意義(P0.05)。3、與干預(yù)前比較,干預(yù)后兩組的埃普沃思嗜睡量表(ESS)評(píng)分均低于干預(yù)前,差異均有統(tǒng)計(jì)學(xué)意義(P0.05);干預(yù)結(jié)束時(shí)兩組(ESS)評(píng)分組間比較,試驗(yàn)組略高于對(duì)照組,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。4、干預(yù)后兩組患者腦內(nèi)神經(jīng)遞質(zhì)的相對(duì)功率與干預(yù)前比較,兩組γ-氨基丁酸(γ-aminobutyric acid,GABA)、五羥色胺(5-hydroxytryptamine,5-HT)、乙酰膽堿(Acetylcholine,Ach)及多巴胺(Dopamine,DA)均高于干預(yù)前,其中對(duì)照組5-HT、Ach和試驗(yàn)組的GABA、Ach在干預(yù)前后有統(tǒng)計(jì)學(xué)意義(P0.05);干預(yù)后組間比較,試驗(yàn)組GABA、5-HT高于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);干預(yù)后兩組的去甲腎上腺素(Norepinephrine,NE)、谷氨酸(Glutamate,Glu)均降低,對(duì)照組Glu、NE和試驗(yàn)組NE在干預(yù)前后差異有統(tǒng)計(jì)學(xué)意義(P0.05),干預(yù)后組間比較均無顯著差異(P0.05)。結(jié)論1、淺針治療原發(fā)性失眠癥臨床療效較好,不遜于艾司唑侖。2、淺針刺激鎮(zhèn)靜穴、山根穴能夠提高腦內(nèi)GABA和5-HT的相對(duì)功率。
[Abstract]:Objective to observe the clinical effect of superficial acupuncture on primary insomnia and to analyze its effect on neurotransmitters in brain, and to provide theoretical basis for clinical application of shallow acupuncture. Methods 60 patients with primary insomnia were randomly divided into experimental group and control group with 30 cases in each group. The experimental group was treated with shallow needle once a day for 30 minutes, while the control group was given 1 mg of oxazolam once a day for 30 minutes before bedtime. The intervention lasted 20 days. The sleep quality and clinical efficacy of the two groups were evaluated by Pittsburgh sleep qu ality Index (Pittsburgh sleep qu ality) and Epworth Sleepiness scale (ESSs) before and after intervention, and the changes of neurotransmitters in the brain were assessed by cerebral fluctuation map. Results 1. The total effective rate was 78.5 in the trial group and 74.0 in the control group. The efficacy of the two groups was similar to that before intervention. Compared with the pre-intervention, the Pittsburgh Sleep quality Index (PSQI) scores of the two groups were significantly lower than those before the intervention. After intervention, the difference of PSQI score between the two groups was slightly higher than that of the control group, and the difference between the seven sub-items of PSQI scale before and after treatment in the treatment group was compared with that in the control group at the end of the intervention. The difference scores of sleep time and hypnotic drugs were higher than those of the control group (P 0.05). The difference values of sleep disorder, sleep quality, sleep time, sleep efficiency and daytime dysfunction were similar to those of the control group. The Pittsburgh Sleep quality Index (PSQI) of the two groups was slightly higher than that at the end of the treatment, and there was no significant difference between the two groups. After the intervention, the ESS scores of the two groups were lower than those before the intervention, and the differences were statistically significant (P 0.05), and at the end of the intervention, the scores of ESSs in the two groups were slightly higher than those in the control group. The relative power of neurotransmitters in the brain of the two groups after intervention was higher than that before intervention. The levels of 緯 -aminobutyric acid (GABA), serotonin 5-hydroxytrypine (5-HT), acetylcholine Acetylcholine (Acetylcholine) and dopamine dopamineDAA (DAA) were higher than those before intervention. The 5-HT Ach in the control group and the GABA Ach in the experimental group before and after intervention were significantly higher than those in the control group (P 0.05), and the levels of norepinephrinene-glutamate (Glutamate) in the two groups were significantly lower than those in the control group (P 0.05). There was significant difference between the control group and the test group before and after intervention (P 0.05), but there was no significant difference between the control group and the test group before and after intervention (P 0.05). Conclusion 1. Shallow acupuncture can improve the relative power of GABA and 5-HT in the brain of patients with primary insomnia, which is not inferior to that of eszolam. 2. Shallow acupuncture can stimulate sedation points and Shangen acupoint can increase the relative power of GABA and 5-HT in the brain.
【學(xué)位授予單位】：福建中醫(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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