本文選題：失眠 + 心腎不交型�。� 參考：《廣西中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:此課題旨在對(duì)穴位注射結(jié)合針刺療法治療失眠癥的療效進(jìn)行臨床觀察,以期對(duì)其療效進(jìn)行評(píng)定,從而研究治療心腎不交型失眠癥時(shí)穴位注射結(jié)合針刺療法對(duì)其的有效率;并總結(jié)過往臨床用于治療失眠的研究,以便于對(duì)比出在臨床治療中,穴位注射結(jié)合針刺療法治療失眠的獨(dú)特性。并在最后進(jìn)行相關(guān)的臨床經(jīng)驗(yàn)總結(jié),對(duì)此種療法的理論根據(jù)進(jìn)行梳理,以期對(duì)臨床治療心腎不交及其他類型的失眠有一定價(jià)值。方法:以2015年9月--2016年9月在廣西中醫(yī)藥大學(xué)附屬瑞康醫(yī)院針灸門診、瑞康醫(yī)院南寧市南棉社區(qū)衛(wèi)生服務(wù)中心針灸門診收集到符合本課題納入標(biāo)準(zhǔn)的失眠患者70例,通過隨機(jī)數(shù)字表隨機(jī)分為兩組,其中,治療組35例,對(duì)照組35例,治療組使用穴位注射維生素B12并結(jié)合瀉南補(bǔ)北針刺療法,而對(duì)照組僅單純使用瀉南補(bǔ)北針刺療法治療,治療周期為每周治療2次,每4次為一個(gè)療程,兩組的治療時(shí)間均為連續(xù)治療兩個(gè)療程。同時(shí)以匹茲堡睡眠質(zhì)量指數(shù)量表的評(píng)分作為參考的治療指標(biāo),最后分別在一個(gè)療程結(jié)束時(shí)以及兩個(gè)療程結(jié)束時(shí)做出療效的對(duì)比觀察,使用spss22.0軟件統(tǒng)計(jì)分析收集到的數(shù)據(jù),從而比較兩組療效的差異和可比性。結(jié)果:通過統(tǒng)計(jì)學(xué)數(shù)據(jù)和臨床研究有如下的結(jié)論:對(duì)治療組和對(duì)照組的性別、年齡、病程以及兩組治療前的PSQI評(píng)分進(jìn)行統(tǒng)計(jì)學(xué)比較,p0.05,即差異無統(tǒng)計(jì)學(xué)意義,兩組的數(shù)據(jù)具有可比性。通過臨床療效統(tǒng)計(jì)和對(duì)比顯示,治療組共患者35例,痊愈13例,顯效8例,有效19例,無效2例,脫落1例,總有效率為94.11%;對(duì)照組共35例,痊愈7例,顯效6例,有效21例,無效6例,脫落1例,總有效率為82.35%,經(jīng)過秩和檢驗(yàn)結(jié)果:w=1008.012,p0.05,治療組優(yōu)于對(duì)照組,差異有統(tǒng)計(jì)學(xué)的意義;比較PSQI評(píng)分方面,治療組在兩個(gè)療程的治療后得出的PSQI總分以及各成份評(píng)分較對(duì)照組有明顯減少,說明了治療組睡眠質(zhì)量高于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(t=2.54,p0.05)。結(jié)論:(1)穴位注射結(jié)合針刺治療心腎不交型失眠癥有很好的近期療效。(2)穴位注射結(jié)合針刺療法能夠滋陰潛陽、安神利眠,有效改善患者睡眠,在減少入睡時(shí)間的同時(shí)增加睡眠時(shí)間,并可以提高睡眠效率和睡眠質(zhì)量,改善患者的日間疲乏與夜間入睡困難。(3)穴位注射結(jié)合針刺治療治療失眠癥可以有效減少患者的就診頻率,并提高患者的依從性,節(jié)省患者不必要的就診費(fèi)用。同時(shí)還可以增強(qiáng)患者的自我調(diào)節(jié)能力,調(diào)整患者心理作用,適合生活節(jié)奏快的現(xiàn)代人用于治療失眠。(4)治療組在治療過程中未出現(xiàn)強(qiáng)烈的不良反應(yīng),其效果安全可靠。
[Abstract]:Objective: to observe the curative effect of acupoint injection combined with acupuncture therapy on insomnia in order to evaluate its curative effect, and to study the effective rate of acupoint injection combined with acupuncture therapy in the treatment of heart and kidney disjoint insomnia. In order to compare the uniqueness of acupoint injection combined with acupuncture therapy in the treatment of insomnia. In the end, the author summarized the relevant clinical experience and combed the theoretical basis of this therapy, hoping to have certain value for clinical treatment of heart and kidney disconnection and other types of insomnia. Methods: from September 2015 to September 2016, 70 patients with insomnia were collected from the clinic of acupuncture and moxibustion in Ruikang Hospital affiliated to Guangxi University of traditional Chinese Medicine. Among them, 35 cases in treatment group and 35 cases in control group were randomly divided into two groups. The treatment group was treated with acupoint injection of vitamin B12 and combined with Xionan Bubei acupuncture therapy, while the control group was only treated with Xionan Bubei acupuncture therapy. The treatment cycle was 2 times a week and every 4 times as a course of treatment. At the same time, the score of Pittsburgh Sleep quality Index scale was taken as the reference treatment index. At the end of one course of treatment and at the end of two courses of treatment, the curative effect was compared and observed, and the collected data were analyzed with spss22.0 software. Therefore, the difference and comparability of curative effect between the two groups were compared. Results: according to the statistical data and clinical study, there were no significant differences in sex, age, course of disease and PSQI score before treatment between treatment group and control group (P 0.05), which indicated that there was no significant difference between treatment group and control group in sex, age, course of disease and PSQI score before treatment. The two groups of data are comparable. According to the clinical curative effect statistics and comparison, 35 patients in the treatment group were cured, 13 cases were cured, 8 cases were effective, 19 cases were effective, 2 cases were ineffective, 1 case was lost, the total effective rate was 94.111.The control group consisted of 35 cases, 7 cases were cured, 6 cases were effective, 21 cases were effective. The total effective rate was 82.35. The results of rank sum test showed that the treatment group was superior to the control group (P 0.05), and the difference was statistically significant. After two courses of treatment, the total score of PSQI and the scores of each component in the treatment group were significantly reduced compared with the control group, which indicated that the sleep quality of the treatment group was higher than that of the control group, and the difference was statistically significant. Conclusion (1) Acupoint injection combined with acupuncture in the treatment of heart-kidney disjoint insomnia has a good short-term curative effect. (2) Acupoint injection combined with acupuncture therapy can nourish yin and latent yang, soothe the mind and rest sleep, and effectively improve the sleep of the patients. Reducing sleep time while increasing sleep time, and can improve sleep efficiency and sleep quality, Improvement of daytime fatigue and nocturnal difficulty in falling asleep.) Acupoint injection combined with acupuncture in the treatment of insomnia can effectively reduce the frequency of the patient visit and improve the patient's compliance and save the patient unnecessary expenses. At the same time, it can also enhance the self-regulation ability of patients, adjust the psychological role of patients, suitable for modern people with fast life rhythm for the treatment of insomnia. 4) in the treatment group, there is no strong adverse reaction in the treatment process, and the effect is safe and reliable.
【學(xué)位授予單位】：廣西中醫(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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