浮针联合柴胡加龙骨牡蛎汤加减治疗肝郁化火型原发性失眠疗效观察

Therapeutic Observation of Superficial Needling Combined with Modified Chaihu Jia Longgu Muli Decoction for Primary Insomnia Due to Liver Depression Transforming into Fire

目的观察浮针联合柴胡加龙骨牡蛎汤加减治疗肝郁化火型原发性失眠的临床疗效。方法将肝郁化火型原发性失眠患者90例,随机分为浮针+中药组、中药组、西药组,每组30例。中药组给予口服柴胡加龙骨牡蛎汤加减;西药组给予口服酒石酸唑吡坦片,浮针+中药组给予浮针联合中药治疗。选择匹兹堡睡眠质量指数(PSQI)评分分别评价各组治疗前后的失眠症状,并比较各组临床疗效。结果3组治疗后PSQI总评分显著低于同组治疗前(P<0.05);浮针+中药组显著低于中药组、西药组(P<0.05);中药组与西药组比较,差异无统计学意义(P>0.05)。浮针+中药组治疗后睡眠质量、入睡时间、睡眠效率评分最优(P<0.05),西药组治疗后睡眠时间评分最优(P<0.05),浮针+中药组优于中药组(P<0.05)。3组治疗后睡眠障碍评分比较,差异无统计学意义(P>0.05)。浮针+中药组与中药组治疗后催眠药物使用、日间功能评分比较,差异无统计学意义(P>0.05),但均优于西药组(P<0.05)。浮针+中药组愈显率显著高于中药组、西药组(P<0.05);中药组、西药组比较,差异无统计学意义(P>0.05)。结论浮针联合柴胡加龙骨牡蛎汤加减、单用中药、单用西药,均能有效改善肝郁化火型原发性失眠临床症状,浮针联合中药在改善睡眠质量、入睡时间、睡眠效率、催眠药物使用、日间功能方面,疗效优于单用中药或单用西药。

Objective To observe the clinical efficacy of superficial needling plus modified Chaihu Jia Longgu Mulidecoction in treating primary insomnia due to liver depression transforming into fire.Method Ninety patients withprimary insomnia due to liver depression transforming into fire were randomized into a superficial needling plusChinese medication group,a Chinese medication group and a Western medication group,with 30 cases in each group.The Chinese medication group was given oral administration of modified Chaihu Jia Longgu Muli decoction;theWestern medication group was given oral Zolpidem tartrate tablets,and the superficial needling plus Chinesemedication group was intervened by superficial needling and Chinese medication.The insomnia symptoms of the threegroups were evaluated using the Pittsburgh Sleep Quality Index(PSQI)before and after treatment,and the clinicalefficacy was compared among the three groups.Result The PSQI score decreased significantly after treatment in the three groups(P<0.05);the score in the superficial needling plus Chinese medication group was significantly lower than that in the Chinese medication group and the Western medication group(P<0.05);there was no significant difference between the Chinese medication group and the Western medication group(P>0.05).After treatment,the superficial needling plus Chinese medication group achieved the best scores in sleep quality,sleep latency and sleep efficiency(P<0.05);the Western medication group obtained the best score in sleep duration after treatment(P<0.05),and the score in the superficial needling plus Chinese medication group was better than that in the Chinese medication group(P<0.05);there was no statistical significance comparing the score of sleep disturbance among the three groups(P>0.05);there was no statistical significance comparing the scores of use of sleeping pills and daytime function between the superficial needling plus Chinese medication group and the Chinese medication group(P>0.05),but the scores were better in these two groups than in the Western medication group(P<0.05).The markedly effective rate in the superficial needling plus Chinese medication group was significantly higher than that in the Chinese medication group and the Western medication group(P<0.05);there was no significant difference between the Chinese medication group and the Western medication group(P>0.05).Conclusion Superficial needling plus modified Chaihu Jia Longgu Muli decoction,or using the Chinese medication or Western medication alone can effectively improve the clinical symptoms in primary insomnia due to liver depression transforming into fire.Superficial needling plus Chinese medication can produce more significant efficacy in improving sleep quality,sleep latency,sleep efficiency,use of sleeping pills and daytime function compared with using the Chinese medication or Western medication alone.