针刺疗法结合生物反馈放松疗法治疗老年慢性失眠的长期疗效观察

Long-term effect study of acupuncture therapy combining with biofeedback relaxation therapy on senile chronic insomnia patients

目的:探讨针刺疗法结合生物反馈放松疗法治疗老年慢性失眠的长期临床疗效。方法:150名老年慢性失眠症患者,随机分成3组,A组单纯接受针刺加耳穴贴磁珠治疗,B组单纯接受生物反馈放松疗法,C组接受上述两种疗法联合治疗。记录3组患者在治疗前、治疗后8周末、随访6个月末的匹兹堡睡眠质量指数(PSQI)、汉密顿焦虑量表(HAMA)总分、汉密顿抑郁量表(HAMD-17)总分及副反应观察。结果:治疗结束后6个月末随访患者,C组的PSQI总分、HAMA总分及HAMD总分和治疗前相比仍有改善(P<0.01),但和8周末相关指标比较,PSQI总分无明显差异,HAMA总分和HAMD总分均较8周末升高(P<0.05)。组间比较,C组6个月末的PSQI总分、HAMA总分及HAMD总分均优于其他两组同期得分(P<0.01)。结论:针刺疗法结合生物反馈放松疗法能显著改善老年人慢性失眠的睡眠质量,并能保持一定的远期疗效,而单一疗法改善睡眠质量的远期疗效均较差。在改善失眠患者焦虑、抑郁不良心理状态方面无论单一疗法或是联合疗法均未有稳定的远期疗效,建议患者需要更长的疗程才可能获得较好的稳定疗效,否则容易复发。

Objective：To study the long-term effect of acupuncture therapy combining with biofeedback relaxation therapy on senile chronic insomnia patients.Methods：150 cases of senile chronic insomnia were divided into 3 groups randomly：group A received acupuncture therapy only,group B received biofeedback relaxation therapy only,and group C received both therapies.The scores of Pittsburgh Sleep Quality Index（PSQI）,the scores of Hamilton Anxiety Scale（HAMA） and Hamilton Depression Scale（HAMD） were recorded before the treatment and at the end of the 8th week during the treatment and at the end of the 6th month after the treatment.Results：At the end of the 6th month follow-up after the treatment,the scores of PSQI（8.33±2.03）,the scores of HAMA（11.95±3.61） and HAMD-17（12.44±3.37） of group C were also better than that of before the treatment（P〈0.01）.But the group C showed no significant difference in the scores of PSQI and showed more difference in the scores of HAMA and HAMD-17 compared with that of at the end of the 8th week.At the same time,among the three groups,the scores of PSQI,the scores of HAMA and HAMD-17 of group C were all better than that of group A [（12.17±2.53）,（16.80±4.55）,（15.89±4.08）] and group B [（13.20±2.58）,（14.18±4.04）,（14.16±4.38）] significantly（P〈0.01）.Conclusion：The therapy of acupuncture combining with biofeedback relaxation is benefit to improve the sleep quality of senile chronic insomnia patients which can maintain a long-term efficacy.But single therapy to improve sleep quality was poor in long-term efficacy.Meanwhile,neither single nor combining therapy has a stable long-term efficacy on releasing the anxiety and depression of insomnia patients.It suggests that insomnia patients need a longer course of treatment to get a better effect,or likely to relapse.