發(fā)布時間：2018-08-15 16:35

【摘要】：目的觀察“眠十針”對原發(fā)性失眠癥患者的睡眠時間、質(zhì)量的改善及腦血流的影響,評價其臨床療效,并初步探討其作用機(jī)理,為治療原發(fā)性失眠癥探索一個施治方便、操作規(guī)范、標(biāo)本兼治、高效安全的臨床治療方法。方法從2014年5月-2016年2月中國人民解放軍第255醫(yī)院中醫(yī)科門診患者中選擇符合納入標(biāo)準(zhǔn)的原發(fā)性失眠癥患者70例,按就診順序分為“眠十針”治療組、口服艾司唑侖片對照組各35例,治療組針刺百會、神庭、神門(雙)、三陰交(雙)、太溪(雙)、太沖(雙),每日治療1次,10次為一個療程,連續(xù)治療3個療程,對照組每日睡前口服1次,每次1-2mg,連續(xù)服藥30天,治療結(jié)束后,觀察評價治療前后二組臨床療效、匹茲堡睡眠質(zhì)量指數(shù)、中醫(yī)癥狀積分及TCD的變化,1個月后評價復(fù)發(fā)情況。結(jié)果治療前兩組病人在性別、年齡、病程方面進(jìn)行比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05),具有可比性。治療組與對照組治療后在中醫(yī)癥狀積分,匹茲堡睡眠質(zhì)量指數(shù),入睡時間,睡眠質(zhì)量,睡眠時間,睡眠效率,日間功能方面評分均有明顯改善,差異有統(tǒng)計(jì)學(xué)意義(P0.01)。兩組治療后左側(cè)椎動脈、右側(cè)椎動脈、基底動脈TCD各指標(biāo)均有改善,差異有統(tǒng)計(jì)學(xué)意義(P0.05)�！懊呤槨敝委熃M臨床治愈10例,顯效14例,有效8例,無效3例,總有效率為91.42%,艾司唑侖片對照組臨床治愈5例,顯效10例,有效12例,無效8例,總有效率為77.14%,兩組臨床療效比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05),治療組療效優(yōu)于對照組。結(jié)論1“眠十針”治療原發(fā)性失眠癥能夠提高患者的睡眠質(zhì)量和睡眠效率,縮短入睡時間,減少噩夢次數(shù),使日間功能恢復(fù)正常。2“眠十針”治療原發(fā)性失眠癥療效優(yōu)于口服西藥艾司唑侖片。3“眠十針”能夠改善原發(fā)性失眠癥患者椎-基底動脈供血不足情況,增加腦血流量,從而有利于改善腦功能。4“眠十針”療效確切,施治方便,無副作用,適宜臨床推廣應(yīng)用。
[Abstract]:Objective to observe the effects of "Sleeping Ten Needles" on sleep time, quality improvement and cerebral blood flow in patients with primary insomnia, to evaluate its clinical efficacy, and to explore its mechanism, so as to explore a convenient treatment for primary insomnia. Standard operation, both symptoms and symptoms, effective and safe clinical treatment. Methods from May 2014 to February 2016, 70 patients with primary insomnia, who met the inclusion criteria, were selected from the outpatient clinic of TCM Department, 255 Hospital of the Chinese people's Liberation Army, and were divided into "Sleeping Ten Needle" treatment group according to the order of visit. The treatment group was treated with acupuncture, Shenting, Shenmen (double), Sanyinjiao (double), Taixi (double), Taichong (double), and treated once a day for 10 times as a course of treatment and 3 consecutive courses of treatment. The control group took orally once a day before bedtime, 1-2mgeach time for 30 days. After the treatment, the clinical effect, Pittsburgh sleep quality index, TCM symptom score and TCD were observed and evaluated before and after treatment, and the recurrence was evaluated after one month. Results there was no significant difference in sex, age and course of disease between the two groups before treatment (P0.05). The scores of TCM symptom score, Pittsburgh sleep quality index, sleep time, sleep quality, sleep time, sleep efficiency and daytime function were significantly improved in treatment group and control group (P0.01). After treatment, TCD of left vertebral artery, right vertebral artery and basilar artery were improved in two groups, the difference was statistically significant (P0.05). In the treatment group, 10 cases were cured, 14 cases were effective, 8 cases were effective, 3 cases were ineffective. The total effective rate was 91.42%. In the control group, 5 cases were cured, 10 cases were effective, 12 cases were effective, and 8 cases were ineffective. The total effective rate was 77.14. The difference between the two groups was statistically significant (P0.05). The curative effect of the treatment group was better than that of the control group. Conclusion 1Sleeping ten needles in the treatment of primary insomnia can improve the sleep quality and sleep efficiency, shorten the time to sleep and reduce the number of nightmares. The curative effect of "Sleeping Ten Needles" on the treatment of primary insomnia was better than that of "Sleeping Ten Needles" in the treatment of primary insomnia with oral eszolam tablet .3 "Sleeping Ten Needles", which could improve the blood supply of vertebrobasilar artery and increase cerebral blood flow in patients with primary insomnia. Therefore, it is beneficial to improve brain function. 4. "Sleeping Ten Needles" is effective, convenient and no side effect. It is suitable for clinical application.
【學(xué)位授予單位】：華北理工大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R246.6

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