【摘要】：目的:通過觀察俞募配穴法(肝俞、期門)及表里經配穴法(行間、俠溪)治療廣泛性焦慮癥睡眠障礙(失眠)的臨床療效,并對比兩種配穴法改善睡眠、焦慮、不同的中醫(yī)證候有何差別。方法:從就診的患者中選取符合診斷和納入標準的患者62例,用隨機的方法分為兩組:治療組(俞募配穴組)、對照組(表里經配穴組)兩組基礎選穴均為四神聰、印堂、安眠、神門、照海、申脈,治療組配取肝俞、期門,對照組配取行間、俠溪,兩組干預方法均為毫針針刺,療程均為15天。兩組分別在治療前后進行匹茲堡睡眠質量指數量表(PSQI)、漢密爾頓焦慮量表(HAMA)及中醫(yī)證候量表評分,納入病例的一般資料及試驗數據通過SPSS22.0軟件進行統(tǒng)計,觀察兩種方法治療焦慮癥睡眠障礙臨床療效及對三個量表改善程度的差異。結果:試驗結束共56例患者完成治療,每組各28例,試驗數據經統(tǒng)計分析后,兩組總有效率均為96.4%,但治療組的顯效率高于對照組。在量表評分方面,治療組改善PSQI總分、睡眠質量、入睡時間、睡眠時間、日間功能障礙方面優(yōu)于對照組,差異有統(tǒng)計學意義(P0.05)。HAMA評分兩組改善總分與精神性焦慮部分差異無統(tǒng)計學意義(P0.05),在軀體性焦慮部分治療組改善程度優(yōu)于對照組,差異具有統(tǒng)計學意義(P0.05)。在中醫(yī)證候量表各項評分上,治療組對改善總分、情緒、心悸、口干口苦、胸脅脹痛優(yōu)于對照組,差異具有統(tǒng)計學意義(P0.05),兩組在失眠、倦怠乏力、頭暈目眩這幾項上改善程度相當,差異無統(tǒng)計學意義(P0.05)。結論:1、兩種配穴法治療焦慮相關睡眠障礙療效相當,均能改善PSQI、HAMA、中醫(yī)證候量表評分。2、本研究中的俞募配穴法相比表里經配穴法能更好的改善睡眠質量,縮短入睡時間,延長睡眠時間,減少因失眠引起的日間功能障礙,改善軀體性焦慮癥狀,在中醫(yī)證候上能更有效的改善煩躁情緒,減少心悸、口干口苦等癥狀,緩解局部胸脅脹痛。3.俞募配穴法可用于治療焦慮相關睡眠障礙,能有效調節(jié)臟腑功能緩解相關癥狀。
[Abstract]:Objective: to observe the clinical effect of Shu-fu-combined acupoint (Ganshu, Yimen) and epidermal meridian (Xingjian, Xiaxi) in the treatment of sleep disorder (insomnia) with generalized anxiety disorder, and to compare the two methods to improve sleep and anxiety. What is the difference between different TCM syndromes. Methods: Sixty-two patients who met the criteria of diagnosis and inclusion were randomly divided into two groups: the treatment group (Shu-Fu points group) and the control group (epidermal meridian plus acupoint group). Shenmen, Zhaohai, Shenmai, combination of treatment Ganshu, phase gate, control group matched with interline, Xiaxi, the two groups intervention methods are acupuncture, the course of treatment is 15 days. The Pittsburgh Sleep quality Index scale (PSQI), Hamilton anxiety scale (HAMA) and TCM Syndrome scale (TCM) were scored before and after treatment, and the general data and experimental data were collected by SPSS22.0 software. To observe the clinical effect of the two methods in the treatment of sleep disorders in anxiety disorder and the difference in the improvement of the three scales. Results: a total of 56 patients completed the treatment in each group, 28 cases in each group. After statistical analysis, the total effective rate of the two groups was 96.4, but the effective rate of the treatment group was higher than that of the control group. In the score of the scale, the treatment group was superior to the control group in improving the total score of PSQI, sleep quality, sleep time, sleep time and daytime dysfunction. Hama score improvement total score and mental anxiety part of the difference was not statistically significant (P0.05), in the somatic anxiety part of the treatment group than the control group, the difference was statistically significant (P0.05). In TCM syndrome scale scores, the treatment group improved the total score, mood, palpitations, dry mouth bitter, chest and flank pain than the control group, the difference was statistically significant (P0.05), the two groups in insomnia, fatigue, fatigue, The improvement degree of dizziness on these items was similar, the difference was not statistically significant (P0.05). Conclusion the two methods have the same therapeutic effect on anxiety related sleep disorders, both of which can improve PSQI Hama and TCM syndrome scale score. Compared with the method of acupoint matching in the study, the two methods can improve the sleep quality and shorten the time to fall asleep. Prolonging sleep time, reducing daytime dysfunction caused by insomnia, improving somatic anxiety symptoms, can effectively improve irritability, reduce palpitation, dry mouth pain and other symptoms in traditional Chinese medicine syndrome, and relieve local chest distending and hypochondriac pain .3. Shu-Fu-combined acupoint therapy can be used to treat anxiety-related sleep disorders and can effectively regulate the function of viscera to alleviate related symptoms.
【學位授予單位】：新疆醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R246.6

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