【摘要】：目的:運(yùn)用緩慢捻進(jìn)針法治療肝郁脾虛型不寐,以西藥口服為對照組,根據(jù)不寐的臨床療效標(biāo)準(zhǔn)、匹茲堡睡眠質(zhì)量指數(shù)(PSQI)以及肝郁脾虛型不寐主要癥狀評分表來進(jìn)行療效評價(jià),探討該法治療本病的療效和優(yōu)勢。方法:收集廣西中醫(yī)藥大學(xué)第一附屬醫(yī)院仁愛分院針灸門診的60例肝郁脾虛型不寐患者,并按就診先后順序隨機(jī)分為兩組,即緩慢捻進(jìn)針法治療組30例、西藥對照組30例。緩慢捻進(jìn)針法治療組取穴:神門(雙)、足三里(雙)、三陰交(雙)、太沖(雙)、百會(只灸),通過緩慢捻進(jìn)針法進(jìn)行治療。西藥對照組予艾司唑侖片口服治療。二者均治療10天為1療程,間隔休息2天后繼續(xù)下一個(gè)療程,共治療2個(gè)療程。分別于治療前、治療第一個(gè)療程后和治療第二個(gè)療程后這3個(gè)時(shí)間點(diǎn)采集數(shù)據(jù),根據(jù)不寐的臨床療效標(biāo)準(zhǔn)、匹茲堡睡眠質(zhì)量指數(shù)(PSQI)以及肝郁脾虛型不寐主要癥狀評分表來進(jìn)行療效評價(jià)。采用SPSS17.0版統(tǒng)計(jì)軟件進(jìn)行統(tǒng)計(jì)分析。結(jié)果:治療第一個(gè)療程后,兩組療效相比,緩慢捻進(jìn)針法治療組總有效率為63.33%,西藥對照組總有效率為66.67%,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。兩組PSQI量表總分相比,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。兩組癥狀評分總分相比,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。治療第二個(gè)療程后,兩組療效相比,緩慢捻進(jìn)針法治療組總有效率為86.67%,西藥對照組總有效率為80.00%,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。兩組PSQI量表總分相比,治療組PSQI量表總分低于對照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組癥狀評分總分相比,治療組癥狀評分總分低于對照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:(1)緩慢捻進(jìn)針法治療與西藥治療均可以改善睡眠。(2)緩慢捻進(jìn)針法治療與西藥治療臨床療效兩者相當(dāng),無明顯差異性。兩組在第一個(gè)療程后改善肝郁脾虛癥狀無明顯差異,而在第二個(gè)療程后緩慢捻進(jìn)針法治療組改善肝郁脾虛癥狀明顯優(yōu)于西藥對照組。
[Abstract]:Objective: to evaluate the curative effect of slow twisting acupuncture in the treatment of insomnia of liver depression and spleen deficiency type, and to explore the curative effect and advantage of this method according to the clinical curative effect standard of insomnia, Pittsburgh sleep quality index (PSQI) and the main symptom score table of liver depression and spleen deficiency type. Methods: sixty patients with insomnia of liver depression and spleen deficiency type were collected from the acupuncture clinic of Renai Branch Hospital, the first affiliated Hospital of Guangxi University of traditional Chinese Medicine. According to the order of treatment, they were randomly divided into two groups: slow twisting acupuncture treatment group (n = 30) and western medicine control group (n = 30). In the treatment group, Shenmen (Shuang), Zusanli (Shuang), Sanyinjiao (Shuang), Taichong (Shuang) and Baihui (moxibustion only) were treated by slow twisting acupuncture. The western medicine control group was treated with eszolam tablets. Both of them were treated for 10 days as a course of treatment, and the next course of treatment was continued after 2 days of rest, for a total of 2 courses of treatment. Before treatment, after the first course of treatment and after the second course of treatment, the data were collected at these three time points. According to the clinical efficacy standard of insomnia, Pittsburgh sleep quality index (PSQI) and the main symptoms score table of liver depression and spleen deficiency type, the curative effect was evaluated. The statistical analysis was carried out by using SPSS17.0 statistical software. Results: after the first course of treatment, the total effective rate was 63.33% in the slow twisting acupuncture group and 66.67% in the western medicine control group, there was no significant difference between the two groups (P 0.05). There was no significant difference in the total score of PSQI between the two groups (P 0.05). There was no significant difference in the total score of symptom score between the two groups (P 0.05). After the second course of treatment, the total effective rate was 86.67% in the slow twisting acupuncture group and 80.00% in the western medicine control group, there was no significant difference between the two groups (P 0.05). Compared with the total score of PSQI scale in the two groups, the total score of PSQI scale in the treatment group was lower than that in the control group, the difference was statistically significant (P 0.05). Compared with the total score of symptom score in the two groups, the total score of symptom score in the treatment group was lower than that in the control group, and the difference was statistically significant (P 0.05). Conclusion: (1) both slow twisting acupuncture and western medicine can improve sleep. (2) there is no significant difference between slow twisting acupuncture and western medicine. There was no significant difference between the two groups in improving the symptoms of liver depression and spleen deficiency after the first course of treatment, but the symptoms of liver depression and spleen deficiency in the treatment group were significantly better than those in the western medicine control group after the second course of treatment.
【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】：2017
【分類號】：R246.6

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