针刺治疗失眠选穴优化方案的临床研究

Clinical Observation to Optimize Acupuncture Prescription for Insomnia

目的:在总结古今医家临床经验的基础上,对调卫健脑法和养心安神法进行临床疗效观察对比,为提高针刺治疗失眠疗效及优化选穴组方提供一定参考。方法:60例患者随机纳入调卫健脑组和养心安神组,每组30例,对临床疗效及匹兹堡睡眠质量指数(PSQI)、Epworth困倦量表(ESS)、焦虑自评量表(SAS)和抑郁自评量表(SDS)进行观察。结果:(1)调卫健脑组痊愈48.3%,显效34.5%,有效10.3%,无效6.9%,总有效率为93.1%;养心安神组痊愈28.6%,显效35.7%,有效17.9%,无效17.9%,总有效率为82.1%。调卫健脑组疗效与养心安神组比较有显著性差异(P<0.05)。(2)调卫健脑组和养心安神组PSQI总分对比有极显著性差异(P<0.01);两组间ESS与SAS积分比较有显著性差异(P<0.05)。结论:调卫健脑法临床疗效优于养心安神法,其疗效可靠稳定,便于临床推广应用。

Objective： Based on summarizing experiences of ancient and modern medical experts, to compare the clinical effect of the needling method of ＂regulating wei and strengthening brain＂ and the needling method of ＂nourishing heart for tranquillization＂, to promote the clinical effect for insomnia and to optimize acupuncture prescription. Methods： 60 patients were randomly divided into ＂regulating wei and strengthening brain＂ group and ＂nourishing heart for tranquillization＂ group. To investigate the patient＇s clinical therapeutic effect according to the standard clinical judgment after the treatment. And a few tables such as Pinsburgh sleep quality index （PSQI） , Epworth sleepiness scale（ESS）, self- rating anxiety scale （SAS） and self- rating depression scale （SDS） were made to compare the effect before and after the treatment. Results： （ 1 ） The clinical recover rate was 48.3% , excellence rate 34.5% , effective rate 10.3%, ineffective rate 6.9% and total effective rate 93.1% in ＂regulating wei and strengthening brain＂ group. While in ＂nourishing heart for tranquillization＂ group, the clinical recover rate was 28.6% , excellence rate 35.7% , effective rate 17.9% , ineffective rate 17.9% and total effective rate 82.1%. The statistics result showed that the clinical effect of ＂regulating wei and strengthening brain＂ group is obviously better than the ＂nourishing heart for tranquillization＂ group （P 〈 0.05 ）. （2） The comparison of the total scores of PSQI between two groups had significant difference （ P 〈 0.01 ）. And there was significant difference between two groups on reducing the scores of ESS and SAS （ P 〈 0.05 ）. Conclusion ： The clinical effect of the needling method of ＂regulating wei and strengthening brain＂ is better than ＂nourishing heart for tranquillization＂ needling method and its effect is reliable. It is easy for the clinic to popularize.