针灸联合中药内服辨治肝郁化火型失眠临床研究

Clinical Research on Acupuncture Associated with Traditional Chinese Medicine in Treatment of Insomnia with Liver Fire Retarding Type

目的:观察用针灸联合中药内服辨治肝郁化火型失眠患者的临床效果。方法:选取2011年2月—2013年3月于我院就诊的经中医临床辨证为肝郁化火型失眠患者123例,随机分为对照组60例和观察组63例。对照组患者于睡前半小时给予艾司唑仑片1 d 1 mg治疗;观察组患者给予针灸联合中药汤剂内服进行辨治,4周为1个疗程。治疗后观察两组患者睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍的改善情况,用不良反应症状量表(TESS)对治疗过程中的不良反应进行评价,比较睡眠各项积分的变化情况及两组治疗的有效率。结果:对照组有效率为78.3%,观察组有效率为90.4%,对照组的有效率明显低于观察组,两组有效率比较,差异有统计学意义(P<0.05)。两组患者经治疗后睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍等均较治疗前有所改善;证候积分均有所下降,以观察组的改变程度尤为明显,差异有统计学意义(P<0.05)。治疗过程中,观察组的不良反应率为4.76%,明显少于对照组的不良反应率10%,差异有统计学意义(P<0.05)。结论:针灸联合中药汤剂内服辨治肝郁化火型失眠患者,能有效改善患者的睡眠质量,改善患者的睡眠时间、睡眠效率和睡眠深度,调畅患者的情志,是中医内外治法的有效结合,副作用少,突显出中医药治疗的优势与特色,值得临床上进行深入研究应用。

Objective ： To observe the clinical effect of acupuncture combined with traditional Chinese medicine treatment of liver fire retarding type insomnia. Methods： From February 2011 to March 2013 in our hospital, 123 cases of liver fire retarding type insomnia were randomly divided into the control group （ 60 cases ） and observation group （ 63 cases ）. Patients in the control group took Estazolam Tablets for half an hour before going to bed 1 mg. The observation group was treated by acupuncture combined with traditional Chinese medicine decoction, 4 weeks as a course. Improvement of the two groups were observed in patients with sleep quality, sleep time, sleep time, sleep efficiency, sleep disorder after treatment and the treatment emergent symptoms scale （ TESS ） was used to evaluate the adverse reactions in the course of treatment, comparing the integral changes of sleep and two groups＇ treatment efficiency. Results ： The rate was 78.3% in the control group and that of observation group was 90.4%. The control group＇s rate was significantly lower than the efficiency of the observation group and the difference was statistically significant （ P〈0.05 ）. After treatment, sleep quality, sleep time, sleep efficiency, sleep disorder improved and symptom scores decreased and the difference was statistically significant （ P〈0.05 ）. In the course of treatment, observation group＇s adverse reaction rate was 4.76% and the control group＇s adverse reaction rate was I0% and the difference was statistically significant （ P〈0.05 ）. Conclusion ： Acupuncture combined with traditional Chinese medicine decoction in treating patients with liver depression transforming into fire type insomnia, can effectively improve the quality of sleep in patients with sleep, improve sleep efficiency and sleep depth. It has few side effects, highlights the advantages and characteristics of Chinese medicine treatment, and is worthy of clinical application of in-depth study.