【摘要】：目的通過(guò)以捻轉(zhuǎn)瀉法針刺申脈和捻轉(zhuǎn)補(bǔ)法針刺照海為主治療原發(fā)性失眠,觀察其臨床療效。探討傳統(tǒng)中醫(yī)對(duì)失眠癥發(fā)病機(jī)制的準(zhǔn)確性,驗(yàn)證穴位效應(yīng)的實(shí)際可靠性,同時(shí)也為臨床治療失眠提供另一個(gè)更簡(jiǎn)單、安全、有效的治療方案。方法將臨床選取符合標(biāo)準(zhǔn)的60例患者,按照1:1原則,采用隨機(jī)分組的方法分為治療組30例,通過(guò)針刺申脈照海,并配以補(bǔ)瀉手法進(jìn)行治療;對(duì)照組30例,采取常規(guī)針刺操作,并配合平補(bǔ)平瀉手法。并對(duì)各組別患者的性別、年齡等一般資料進(jìn)行統(tǒng)計(jì)學(xué)處理,統(tǒng)計(jì)結(jié)果無(wú)顯著差異性為基本條件。分別在治療前,治療結(jié)束后一個(gè)月左右,應(yīng)用匹茲堡睡眠質(zhì)量(PSQI)評(píng)定量表進(jìn)行評(píng)分,以評(píng)價(jià)療效,并隨訪患者健康狀態(tài)的自我評(píng)定情況。同時(shí)在治療前后拍攝患者面部及頸項(xiàng)部遠(yuǎn)紅外熱成像照片,觀察治療前后兩組患者面部、頸項(xiàng)部的體表皮膚溫度的變化,間接反映頭部溫度的變化和微循環(huán)的改善情況。結(jié)果1.兩組患者在治療后,睡眠狀況都有所改善,且兩種方法療效相當(dāng)。2.兩組患者在治療后,經(jīng)PSQI評(píng)分量表檢測(cè)得出,捻轉(zhuǎn)補(bǔ)法針刺照海配合捻轉(zhuǎn)瀉法針刺申脈對(duì)原發(fā)性失眠癥患者僅在入睡時(shí)間、睡眠障礙和日間功能方面,以及所測(cè)總分的比較上(P0.05),效果優(yōu)于常規(guī)針刺組;其余各項(xiàng)的得分比較上均無(wú)顯著性差異(P0.05),無(wú)統(tǒng)計(jì)學(xué)意義。3.以照海、申脈并配合相應(yīng)的補(bǔ)瀉手法治療原發(fā)性失眠癥患者相比于普通針刺方法療效相當(dāng),且取穴少,操作簡(jiǎn)便,避免針刺頭面部穴位,較少患者的恐懼感,患者更容易接受,值得推廣應(yīng)用。結(jié)論兩種治療方法均有效,且療效相當(dāng),差別不大。傳統(tǒng)醫(yī)學(xué)中以營(yíng)衛(wèi)理論和陰陽(yáng)蹺脈為依據(jù)的指導(dǎo),對(duì)于失眠的分析,是很有臨床實(shí)用價(jià)值的。且以照海、申脈為主穴相比于普通取穴治療原發(fā)性失眠癥,選穴較少,患者所受痛苦少,值得推廣。
[Abstract]:Objective to observe the clinical curative effect of treating primary insomnia by twirling and reducing acupuncture on Shenchai and twisting and reinforcing acupuncture on Zhaohai. To explore the accuracy of traditional Chinese medicine in the pathogenesis of insomnia, to verify the actual reliability of acupoint effect, and to provide another simple, safe and effective treatment for insomnia. Methods according to the 1:1 principle, 60 patients were selected and randomly divided into treatment group (30 cases) and control group (30 cases), which were treated by acupuncture of Shenchaizhaohai and combined with reinforcing and reducing manipulation, while those of control group (30 cases) were treated with routine acupuncture, and the control group (30 cases) was treated with routine acupuncture. And cooperate with flat tonifying and reducing manipulation. The data of gender and age were statistically analyzed. No significant difference was found in the statistical results. The Pittsburgh Sleep quality scale (PSQI) was used to evaluate the curative effect before and one month after the treatment, and the self-assessment of the health status of the patients was followed up. At the same time, the far-infrared thermal images of face and neck were taken before and after treatment. The changes of skin temperature on the face and neck of the two groups were observed before and after treatment, which indirectly reflected the change of head temperature and the improvement of microcirculation. Result 1. The two groups of patients in the treatment, sleep conditions have improved, and the efficacy of the two methods. 2. 2. After treatment, the patients in the two groups were tested by PSQI score scale. The results showed that the patients with primary insomnia only had sleep time, sleep disorder and daytime function after twirling and reinforcing acupuncture in Zhaohai combined with twisting and reducing acupuncture in Shenmai. As well as the total score measured on the comparison (P0.05), the effect is better than the conventional acupuncture group, the other items were no significant difference in comparison (P0.05), no statistical significance. The patients with primary insomnia treated by Zhaohai, Shenmai and the corresponding reinforcing and reducing manipulation have the same curative effect compared with the common acupuncture method, and have fewer points taken, easy to operate, avoid needling points on the face, less fear of the patients, and more easily accepted by the patients. It is worth popularizing and applying. Conclusion the two methods are effective, and the curative effect is similar, the difference is not obvious. The guidance of traditional medicine based on the theory of Ying Wei and Yin and Yang is of great clinical value for the analysis of insomnia. Compared with the common point extraction, the main points of Zhaohai and Shenmai are less to select points and less pain to the patients, so it is worth popularizing.
【學(xué)位授予單位】：山西中醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R246.6

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