【摘要】：目的:觀察心膽同治針刺結(jié)合刺血療法治療頸源性失眠的臨床療效。方法:選擇符合納入標(biāo)準(zhǔn)的頸源性失眠患者60例,按PEMS3.1統(tǒng)計軟件隨機平均分為觀察組與對照組各30例。觀察組采用針刺結(jié)合刺血療法治療,對照組采用常規(guī)針刺治療。1、觀察組:(1)針刺主穴:頸夾脊、風(fēng)池、神門、列缺、照海、百會;(2)刺法:患者取仰臥位,穴位直刺10-30mm,行小幅度提插捻轉(zhuǎn)致得氣,留針30分鐘,期間每10分鐘行針1次;(3)刺血療法取穴及操作:心俞、膽俞、頸百勞、大椎,操作時充分暴露患者項背部,先在刺血點行推、按、揉、捋等手法,使局部充血,皮膚做常規(guī)消毒,以左手拇指、食指固定腧穴周圍皮膚,右手持三棱針快速點刺2-3針,刺入深約0.5-0.8cm,選擇適當(dāng)大小的火罐迅速叩在刺血部位,放血量為自然出血停止量,留罐10-15分鐘,起罐后用無菌棉簽擦拭,再做常規(guī)消毒。2、對照組:(1)針刺主穴參考新世紀(jì)(第二版)全國高等中醫(yī)藥院校規(guī)劃教材《針灸治療學(xué)》取穴:神門、內(nèi)關(guān)、百會、安眠、頸夾脊、大椎。(2)針具、配穴及針刺刺法同觀察組。3、療程及評價方法:每周進(jìn)行2次治療,分別于周二、周五進(jìn)行1次,連續(xù)治療10次,于治療前與10次治療結(jié)束后采用匹茲堡睡眠質(zhì)量指數(shù)(PSQI)、SF-36生活質(zhì)量量表評分進(jìn)行療效評價。采用統(tǒng)計軟件PEMS3.1對數(shù)據(jù)進(jìn)行統(tǒng)計分析。結(jié)果:1.治療前兩組患者性別、年齡、病程等一般資料差異無統(tǒng)計學(xué)意義(P0.05)。2.治療后,觀察組在改善總體臨床療效方面優(yōu)于對照組(P0.05)。3.治療前后PSQI評分比較,觀察組在睡眠質(zhì)量、入睡時間、睡眠時間、睡眠效率、睡眠障礙、PSQI總分方面具有顯著性差異(P0.01),在催眠藥物、日間功能障礙方面具有顯著性差異(P0.05);對照組在睡眠質(zhì)量、入睡時間、睡眠時間、睡眠效率、睡眠障礙、日間功能障礙方面具有顯著性差異(P0.01),在PSQI總分方面具有顯著性差異(P0.05)。治療后兩組頸源性失眠患者的生活質(zhì)量較前有所改善。4.治療前后比較,SF-36生活質(zhì)量量表各因子評分,觀察組在生理機能、生理職能、軀體疼痛、精力、精神健康方面具有顯著性差異(P0.01),在一般健康狀況、社會功能方面具有顯著性差異(P0.05);對照組在精力方面具有顯著性差異(P0.01),在生理機能、精神健康方面具有顯著性差異(P0.05)。治療后兩組頸源性失眠患者的生活質(zhì)量較前有所改善。5.治療后,兩組PSQI評分比較,在睡眠質(zhì)量、入睡時間、睡眠效率、睡眠障礙、催眠藥物、日間功能障礙、總分方面具有顯著性差異(P0.05)。觀察組在改善頸源性失眠患者睡眠質(zhì)量方面優(yōu)于對照組。6.治療后,兩組SF-36生活質(zhì)量量表各因子評分比較,在生理機能、生理職能、精力方面具有顯著性差異(P0.01),在一般健康狀況、社會功能、情感職能、精神健康方面具有顯著性差異(P0.05),觀察組在改善頸源性失眠患者生活質(zhì)量方面優(yōu)于對照組。結(jié)論:基于心膽同治針刺結(jié)合刺血療法治療的觀察組與采用常規(guī)針刺治療的對照組均能有效治療頸源性失眠,但觀察組在改善頸源性失眠患者睡眠質(zhì)量與生活質(zhì)量方面均優(yōu)于對照組。
[Abstract]:Objective:To observe the clinical effect of acupuncture combined with blood-pricking therapy on cervical insomnia.Methods:60 cases of cervical insomnia were selected and randomly divided into observation group and control group according to PEMS 3.1 statistical software. Observation group: (1) Acupuncture the main points: cervical Jiaji, Fengchi, Shenmen, lie vacant, Zhaohai, Baihui; (2) Acupuncture: patients take supine position, acupoint straight 10-30 mm, twist to get gas by small amplitude lifting and inserting, needle retained for 30 minutes, needle every 10 minutes during the needle 1 time; (3) Acupuncture and operation of blood therapy: Xinshu, Danshu, Bailao, Dazhui, fully expose the patient's back during operation, first Push, press, knead and rub at the puncture point to make the local congestion, and disinfect the skin routinely. Fix the skin around the acupoint with the left thumb and index finger. Puncture 2-3 needles quickly with the right hand trigonometric needle. Push into the puncture point about 0.5-0.8 cm deep. Choose the appropriate size of the cup and tap the puncture site quickly. The amount of bleeding stops naturally. Keep the cup for 10-15 minutes. Wipe with sterile cotton swab, and then do routine disinfection. 2, control group: (1) Acupuncture the main points reference to the new century (second edition) National College of Traditional Chinese Medicine planning textbook < Acupuncture Therapy > Acupoints: Shenmen, Neiguan, Baihui, sleeping, cervical Jiaji, Dazhui. (2) Acupuncture, acupoints and acupuncture methods with the observation group. 3, treatment course and evaluation method: twice a week, respectively, treatment. Pittsburgh Sleep Quality Index (PSQI) and SF-36 Quality of Life Scale (SF-36) were used to evaluate the efficacy before and after 10 consecutive treatments. The data were analyzed by statistical software PEMS 3.1. Results: 1. There was no significant difference in the general data of gender, age and course of disease between the two groups before treatment. After treatment, the observation group in improving the overall clinical efficacy is better than the control group (P 0.05). 3. Before and after treatment PSQI score comparison, the observation group in sleep quality, sleep time, sleep efficiency, sleep disorders, PSQI total score has a significant difference (P 0.01), in hypnotics, daytime dysfunction has a significant difference (P 0.01). There were significant differences in sleep quality, sleep time, sleep efficiency, sleep disorders and daytime dysfunction between the control group and the control group (P 0.01). There were significant differences in total PSQI scores between the two groups (P 0.05). After treatment, the quality of life of patients with cervical insomnia was improved. 4. Before and after treatment, SF-36 was born. There were significant differences in physical function, physiological function, physical pain, energy and mental health in the observation group (P 0.01), and significant differences in general health status and social function (P 0.05); there were significant differences in energy in the control group (P 0.01), physiological function and mental health. After treatment, the quality of life of the two groups of cervical insomnia patients was improved. 5. After treatment, PSQI scores of the two groups in sleep quality, sleep time, sleep efficiency, sleep disorders, hypnotics, daytime dysfunction, the total score was significantly different (P 0.05). Sleep quality was better than that of the control group. 6. After treatment, there were significant differences in physiological function, physiological function and energy between the two groups (P 0.01). There were significant differences in general health, social function, emotional function and mental health (P 0.05). The observation group improved cervical insomnia patients. Conclusion: Both the observation group and the control group with routine acupuncture can effectively treat cervical insomnia, but the observation group is better than the control group in improving the quality of sleep and life of patients with cervical insomnia.
【學(xué)位授予單位】：廣西中醫(yī)藥大學(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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