清肝安神法与镇脑安神法电针治疗原发性失眠症临床疗效对比观察

Comparative Study on Efficacy of Electroacupuncture with Liver-Clearing Spirit-Quieting Method and Brain-Settling Spirit-Quieting Method for Primary Insomnia

目的探讨清肝安神法与镇脑安神法电针治疗原发性失眠症(PI)的疗效及其对睡眠结构的影响。方法将82例患者随机分为清肝安神组(清肝组)、镇脑安神组(镇脑组)各41例。清肝组取穴太冲、足临泣、神门、内关,镇脑组取穴百会、四神聪、神庭、安眠。两组均治疗10次为1个疗程,治疗后及随访时(结束后2周)评价疗效并观察两组患者治疗前后匹兹堡睡眠质量指数(PSQI)各因子及总分评分。结果治疗后清肝组总有效率为97.4%,镇脑组为85.3%,两组比较差异无统计学意义(P>0.05);随访时清肝组总有效率为97.4%,镇脑组为70.7%,两组比较差异有统计学意义(P<0.01)。治疗后及随访时两组患者PSQI评分中睡眠质量、入睡时间、睡眠时间、睡眠效率、日间功能等因子积分均较治疗前明显下降(P<0.01);镇脑组睡眠障碍积分治疗后与治疗前比较亦明显减少(P<0.01)。在睡眠效率积分方面,清肝组在治疗后及随访时均明显低于镇脑组(P<0.01)。在PSQI总分方面,清肝组在随访时低于镇脑组(P<0.01)。结论清肝安神法与镇脑安神法电针治疗PI均安全有效,清肝安神法疗效更佳。

Objective To study the efficacy of electroacupuncture with liver-clearing spirit-quieting method and brain-settling spirit-quieting method for primary insomnia （PI） and the effect on sleep structure. Methods Eighty-two cases of PI were ran- domized into the liver-clearing spirit-quieting group （liver-clearing group） and brain-settling spirit-quieting group （brain-settling group）, with 41 in each. The liver-clearing group was given electroacupuncture on bilateral Taichong （LR3）, Zulinqi （GB41）, Shenmen （TF4） and Neiguan （PC6）. The brain-settling group was given electroacupuncture on Baihui （DU20）, Sishencong （EX-HN1）, Shenting （DU24） and bilateral Anmian （EX-HN）. Both groups were treated for 10 times as one treatment course. After treatment and in the follow-up period, the efficacy and scores of each factor and total score of the Pittsburgh Sleep Quality Index （PSQI） were evaluated in both groups. Results The total effective rate of the liver-clearing group and brain-settling group was 97.4% and 85.3% respectively, with no significant difference between groups （P〉0. 05）. In the fol- low-up period, the total effective rate of the liver-clearing group and brain-settling group was 97.4% and 70.7% respectively, with significant difference between groups （P〈0.01）. After treatment and in the follow-up period, the factor scores of PSQI such as sleep quality, sleep latency, sleep time, sleep efficiency and daytime function decreased significantly in both groups （P〈0.01）. After treatment, the scores of sleep disorders decreased significantly in the brain-settling group （P〈0.01）. After treatment and in the follow-up period, the scores of sleep efficacy in the liver-clearing spirit-quieting group were significantly lower than those in the brain-settling group （P〈 0.01）. Conclusion Electroacupuncture with liver-clearing spirit-quieting method or brain-settling spirit-quieting method for PI is safe and effective, especially with brain-settling spirit-quieting method.