本文關鍵詞： 針藥結(jié)合 普通針剌 失眠　出處：《遼寧中醫(yī)藥大學》2016年碩士論文　論文類型：學位論文

【摘要】：目的:研究針藥結(jié)合治療心膽氣虛型失眠的療效和作用機制。并嘗試與單純針刺組作對照,通過治療前后兩組患者的PSQI評分比較,評價其臨床療效。材料與方法:根據(jù)符合失眠診斷標準、納入標準和排除標準臨床選擇48例患者,按照統(tǒng)計學隨機數(shù)字表法分為兩組,治療組(針刺結(jié)合酸棗仁湯加減療法)24例,對照組(單純針刺療法)24例。治療組采用針刺治療:取百會、大陵、神門、三陰交、丘虛、心俞、膽俞。每日1次。并予酸棗仁湯加減口服,每日2次。對照組采用常規(guī)針刺療法:取百會、大陵、神門、三陰交、丘虛、心俞、膽俞。每日一次。每周連續(xù)治療6日,治療2周。兩組患者治療2周后,于總療程前后進行匹茲堡睡眠質(zhì)量指數(shù)(PSQI)評分進行睡眠評估;臨床療效評定采用《中藥新藥治療失眠的臨床研究指導原則》進行評定。數(shù)據(jù)結(jié)果采用SPSS17.0進行統(tǒng)計分析。結(jié)果:PSQI評分比較:治療前,兩組患者PSQI評分比較,P0.05,差異無統(tǒng)計學意義,具有可比性。治療2周后,兩組患者PSQI評分均有降低,經(jīng)統(tǒng)計學分析,P0.05,差異有統(tǒng)計學意義,表明二者均能改善評分,即對失眠均有確切療效。組間比較,治療2周后,兩組患者PSQI評分組間比較,P0.05,差異有統(tǒng)計學意義,表明針藥結(jié)合治療組較單純針刺治療組更能改善評分。兩組治療后組間比較,入睡時間、睡眠效率、睡眠障礙的評分數(shù)據(jù)經(jīng)統(tǒng)計學分析,P0.01,差異有統(tǒng)計學意義,表明針藥結(jié)合組的入睡時間、睡眠效率、睡眠障礙療效顯著優(yōu)于單純針刺組。臨床療效比較:兩組患者治療2周后最終臨床療效比較,治療組痊愈5例,顯效11例,有效5例,無效3例,總有效率87%;對照組痊愈4例,顯效8例,有效10例,無效6例,總有效率75%。經(jīng)統(tǒng)計學分析,P0.05,差異有統(tǒng)計學意義,表明針藥結(jié)合療法治療失眠較單純針刺療法治療失眠更具有臨床療效。結(jié)論:1.針刺結(jié)合酸棗仁湯及單純針刺對治療心膽氣虛型失眠的患者均有較好的臨床療效。針刺結(jié)合酸棗仁湯治療組的入睡時間、睡眠效率、睡眠障礙療效優(yōu)于單純針刺組,表明針刺結(jié)合酸棗仁湯對失眠患者臨床癥狀有較全面的改善。2.針刺結(jié)合方藥治療失眠,充分發(fā)揮出針刺疏通經(jīng)脈氣血,中藥調(diào)和氣血的效用,有效提高失眠患者的生活質(zhì)量,減輕臨床癥狀。
[Abstract]:Objective: to study the curative effect and mechanism of acupuncture combined with medicine in treating insomnia of heart and gallbladder qi deficiency type, and to compare the PSQI score between the two groups before and after treatment. Materials and methods: according to the diagnostic criteria of insomnia, inclusion criteria and exclusion criteria, 48 patients were selected and divided into two groups according to the statistical random digital table method. The treatment group (acupuncture combined with Suanzaoren decoction, 24 cases) and the control group (24 cases) were treated with acupuncture: Baihui, Daling, Shenmen, Sanyinjiao, Qiu deficiency, Xinshu, Danshu. 1 times a day, 2 times a day. The control group was treated with routine acupuncture therapy: Baihui, Daling, Shenmen, Sanyinjiao, Qiu Xu, Xinshu, Danyu. After 2 weeks of treatment, the patients in both groups were evaluated with Pittsburgh Sleep quality Index (PSQI) score before and after the total course of treatment. The clinical curative effect was evaluated by "guiding principles of Clinical Research on the treatment of Insomnia with traditional Chinese Medicine". The data were statistically analyzed by SPSS17.0. Results: before treatment, the PSQI scores of the two groups were compared with that of the two groups (P 0.05), the difference was not statistically significant. After 2 weeks of treatment, the PSQI scores of the two groups were decreased, and the difference was statistically significant (P 0.05), which indicated that both of them could improve the score, that is, there was a definite curative effect on insomnia. The comparison between the two groups, after 2 weeks of treatment, showed that there was no significant difference between the two groups. The difference of PSQI score between the two groups was statistically significant, indicating that the acupuncture and medicine combined treatment group could improve the score better than that of the simple acupuncture treatment group, the sleep time, sleep efficiency and sleep time of the two groups after treatment were better than those in the simple acupuncture treatment group. The score data of sleep disorder were statistically analyzed (P 0.01), the difference was statistically significant, which indicated that the time of falling asleep and sleep efficiency of acupuncture and medicine combination group, The curative effect of sleep disorder was significantly better than that of simple acupuncture group. Comparison of clinical efficacy: after 2 weeks of treatment, 5 cases were cured, 11 cases were markedly effective, 5 cases were effective, 3 cases were ineffective, the total effective rate was 87% in the treatment group, 4 cases in the control group, 4 cases in the control group, and 4 cases in the control group. There were 8 cases of remarkable effect, 10 cases of effective and 6 cases of failure. The total effective rate was 750.The difference was statistically significant (P 0.05). The results showed that acupuncture combined with medicine therapy was more effective than simple acupuncture therapy in the treatment of insomnia. Conclusion the combination of acupuncture and Suanzaoren decoction and simple acupuncture have better clinical effect on insomnia of heart and gallbladder qi deficiency type. The time of falling asleep in the treatment group of acupuncture combined with Suanzaoren decoction, Sleep efficiency and sleep disorder were better than simple acupuncture group, indicating that acupuncture combined with Suanzaoren decoction could improve the clinical symptoms of insomnia patients. 2.Acupuncture combined with prescription medicine was used to treat insomnia and give full play to acupuncture to dredge the meridians and qi and blood. The effect of Chinese medicine to harmonize qi and blood, effectively improve the quality of life of insomnia patients, alleviate clinical symptoms.
【學位授予單位】：遼寧中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R256.23

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