【摘要】：目的:本研究通過(guò)對(duì)原發(fā)性失眠患者治療前后主癥各項(xiàng)癥狀評(píng)分及總評(píng)分臨床療效的觀察,探討穴位埋線配合認(rèn)知行為療法治療失眠的臨床療效,并與艾司唑侖片治療比較,為穴位埋線配合認(rèn)知行為療法提供臨床依據(jù),為原發(fā)性失眠的臨床治療提供新的思路,為臨床應(yīng)用的推廣提供依據(jù)。方法:采用隨機(jī)化研究方法,將符合入選標(biāo)準(zhǔn)的原發(fā)性失眠患者60例隨機(jī)分為治療組和對(duì)照組,每組30例。兩組均進(jìn)行認(rèn)知行為療法支持治療,治療組采用穴位埋線治療,于入組后第0周、第2周、第4周進(jìn)行治療,1次為1療程,共3個(gè)療程。對(duì)照組采用艾司唑侖片治療,且予以“按需服藥”原則,療程與治療組一致。于治療前、治療2周后、治療4周后、隨訪第2周以及隨訪第6周后隨訪行癥狀評(píng)估。結(jié)果:(1)治療2周后、治療4周后、隨訪第2周、隨訪第6周兩組PSQI總評(píng)分及各項(xiàng)評(píng)分與治療前相比,差異均有統(tǒng)計(jì)學(xué)意義(p0.05),且隨治療時(shí)間的延長(zhǎng)均呈下降趨勢(shì)。(2)治療后兩組間PSQI總評(píng)分及各項(xiàng)評(píng)分相比較,差異均無(wú)統(tǒng)計(jì)學(xué)意義(p0.05)。(3)隨訪第6周兩組PSQI總評(píng)分及各項(xiàng)評(píng)分與治療前相比,差異均有統(tǒng)計(jì)學(xué)意義(p0.05)。兩組間比較差異有統(tǒng)計(jì)學(xué)意義。結(jié)論:(1)穴位埋線配合認(rèn)知行為療法治療原發(fā)性失眠有一定的治療作用,且療效與對(duì)照組相當(dāng);穴位埋線配合認(rèn)知行為療法具有鎮(zhèn)靜安神,改善睡眠,能夠減少入睡時(shí)間,增加睡眠時(shí)間,有效地提高患者睡眠質(zhì)量,提高睡眠效率,改善患者入睡困難,日間疲乏;(2)穴位埋線配合認(rèn)知行為療法不僅有很好的近期療效,也有不錯(cuò)的遠(yuǎn)期療效;(3)隨訪期間,兩組治療方法雖未能維持治療后的效果,但與治療前相比,穴位埋線組配合認(rèn)知行為療法和艾司唑侖組仍有一定療效,且穴位埋線配合認(rèn)知行為療法優(yōu)于西藥組。
[Abstract]:Objective: to investigate the clinical efficacy of acupoint catgut embedding combined with cognitive behavioral therapy in the treatment of insomnia by observing the clinical efficacy of the patients with primary insomnia before and after treatment. To provide clinical basis for acupoint catgut embedding combined with cognitive behavioral therapy, to provide new ideas for clinical treatment of primary insomnia, and to provide basis for clinical application. Methods: 60 patients with primary insomnia were randomly divided into treatment group (n = 30) and control group (n = 30). Both groups were treated with cognitive behavior therapy. The treatment group was treated with catgut embedding at acupoint, and was treated at 0 week, 2 week and 4 week after entering the group, once as a course of treatment, for 3 courses of treatment. The control group was treated with Estrazolam tablets and was treated with the principle of "taking medicine on demand". The course of treatment was the same as that of the treatment group. Symptoms were evaluated before, 2 weeks, 4 weeks, 2 weeks and 6 weeks. Results: (1) after 2 weeks of treatment, 4 weeks of treatment, 2 weeks of follow-up, 6 weeks of follow-up, there were significant differences between the two groups in the total score of PSQI and the scores before treatment (p0. 05). With the prolongation of treatment time, there was a downward trend. (2) after treatment, the total PSQI score and the scores were compared between the two groups. There was no significant difference (p0. 05). (3) between the two groups in the total PSQI score and the scores before treatment (p0. 05). The difference between the two groups was statistically significant. Conclusion: (1) Acupoint catgut implantation combined with cognitive behavioral therapy has a certain therapeutic effect on primary insomnia, and the curative effect is similar to that of the control group. Acupoint catgut embedding combined with cognitive behavior therapy can calm and calm the mind, improve sleep, reduce the time of falling asleep, increase the time of sleep, improve the quality of sleep, improve the efficiency of sleep, improve the difficulty of falling asleep, and improve the daytime fatigue. (2) Acupoint catgut implantation combined with cognitive behavioral therapy not only has a good short-term effect, but also has a good long-term effect; (3) during the follow-up period, although the two treatment methods could not maintain the effect after treatment, the acupoint embedding group combined with cognitive behavioral therapy and eszolam group still had some curative effects compared with those before treatment. And acupoint catgut embedding combined with cognitive behavior therapy was superior to western medicine group.
【學(xué)位授予單位】：湖南中醫(yī)藥大學(xué)
【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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