【摘要】：目的探討疏肝調神針刺法治療抑郁相關失眠的臨床療效。方法將80例患者隨機分為疏肝調神針刺組和非穴位淺刺組,每組40例。疏肝調神組取針刺雙側百會、印堂、合谷、太沖、神門、三陰交、安眠,肝俞、心俞埋針;非穴淺刺組取百會旁、印堂旁、合谷旁、太沖旁、神門旁、三陰交旁、安眠旁,均為各穴水平向左旁開0.5 cm,針身刺入穴位皮膚淺層0.2~0.3 cm,且進針后不行任何手法,心俞旁、肝俞旁埋王不留行籽;2次/w,持續(xù)8 w,共16次。觀察兩組針刺前、針刺4、8 w和隨訪4 w時的匹茲堡睡眠量表(PSQI)及漢密爾頓抑郁量表(HAMD)總分改善情況。結果疏肝調神組1例因針刺后頭痛、3例因療效不能達到預期退出研究,實際納入36例受試者;非穴淺刺組6例患者因療效未達預期值而退出,實際納入34例。疏肝調神針刺組PSQI在治療4、8 w較治療前降低(P0.05),并且在隨訪4 w時評分基本維持在治療8 w水平(P0.05);HAMD治療4、8 w較治療前顯著下降(P0.05),在隨訪4 w時有上升趨勢,但差異無統(tǒng)計學意義(P0.05)。非穴淺刺組PSQI在治療后8 w較治療前下降(P0.05),在隨訪4 w較治療8 w時有上升趨勢;HAMD在治療4、8 w時較治療前降低(P0.05),隨訪4 w時升高。疏肝調神組在治療各時點PSQI、HAMD總分均較非穴淺刺組降低顯著。基于PSQI和HAMD減分率的療效提示疏肝調神針法可提高睡眠效率和抗抑郁療效。結論疏肝調神針刺法和非穴淺刺組可改善抑郁相關失眠患者的PSQI、HAMD總分,但前者較后者起效更快更顯著更持久。
[Abstract]:Objective to explore the clinical effect of soothing the liver and regulating the spirit by acupuncture in the treatment of depression-related insomnia. Methods 80 patients were randomly divided into soothing liver-regulating acupuncture group and non-acupoint superficial acupuncture group, with 40 cases in each group. Shugan Tiaoshen group to acupuncture bilateral Baihui, Yintang, Hegu, Taichong, Shenmen, Sanyin Jiao, sleep, Ganyu, Xinshu buried needle; In the non-acupoint shallow prick group, the patients in the non-acupoint shallow acupuncture group were taken from the side of the hundred meeting, the printing hall, the Hegu side, the Taichong side, the Shenmen side, the side of the Sanyin intersection, the side of the sleeping side, and all the points were opened to the left for 0.5 cm, needle body puncture into the superficial layer of the acupoint skin 0.2 And after the needle can not be any manipulation, next to the heart, liver next to the king buried no seeds; 2 times / w, lasting 8 w. a total of 16 times. The total scores of Pittsburgh sleep scale (PSQI) and Hamilton depression scale (HAMD) were improved before acupuncture, at 4, 8 weeks after acupuncture and 4 weeks after follow-up. Results in the group of soothing liver and regulating mind, one case had headache after acupuncture, 3 cases had failed to achieve the expected curative effect, 36 cases had actually been enrolled in the study, and 6 cases in the group of non-acupoint shallow acupuncture had withdrawn because the curative effect did not reach the expected value, and 34 cases had actually been included in the group of non-acupoint shallow acupuncture. In the treatment group, PSQI was lower at 4 weeks and 8 weeks after treatment than that before treatment (P0.05), and the score was maintained at the level of 8 weeks after 4 weeks of follow-up (P0.05). HAMD treatment 4, 8 weeks than before treatment significantly decreased (P0.05), at 4 weeks follow-up trend increased, but there was no significant difference (P0.05). In the non-acupoint superficial acupuncture group, PSQI decreased at 8 weeks after treatment (P0.05), and increased at 4 weeks after treatment compared with 8 weeks after treatment, and HAMD decreased at 4 and 8 weeks after treatment (P0.05), and increased at 4 weeks after follow-up. The total score of PSQI,HAMD in the Shugan Tiaoshen group was significantly lower than that in the non-acupoint shallow acupuncture group at each time point. The results based on the reduction rate of PSQI and HAMD suggest that the method of soothing the liver and regulating the mind can improve the sleep efficiency and the antidepressant effect. Conclusion the total score of PSQI,HAMD in depression-related insomnia patients can be improved by soothing liver-regulating acupuncture and non-acupoint shallow acupuncture, but the effect of the former is faster and more lasting than that of the latter.
【作者單位】： 廣州中醫(yī)藥大學第二附屬醫(yī)院;湖南省長沙市第四醫(yī)院中醫(yī)科;
【基金】：廣東省科技項目(No.2013B032500008;2014A020221079)
【分類號】：R246.6
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本文編號：2435954