针刺五脏俞加膈俞为主穴辨证治疗慢性失眠患者70例临床观察

Clinical Observation on Acupuncture with Shu-points of Five-organs and Point Geshu(BL17) as Main Points in Treating 70 Cases of Chronic Insomnia According to Different Syndromes

目的观察针刺五脏俞加膈俞为主穴辨证治疗慢性失眠的临床疗效。方法收集慢性失眠患者140例,随机分为治疗组和对照组各70例,治疗组主穴选取五脏俞加膈俞予针刺治疗,对照组选取双侧神门、内关、安眠,百会。同时两组根据中医辨证分型进行配穴,两组针刺治疗均每日1次,连续5天为1个疗程,每个疗程结束后休息2天,共治疗4个疗程。比较两组患者临床疗效,并采用匹兹堡睡眠质量指数(PSQI)对两组治疗前后睡眠质量进行评价,包括睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、催眠药物、日间功能障碍7个相关因子。结果治疗组临床疗效总有效率为80%,对照组为70%,治疗组明显优于对照组(P<0.05)。治疗组治疗后睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、睡眠药物、日间功能障碍评分及PSQI总分均较治疗前下降(P<0.05);对照组治疗后仅睡眠障碍评分和总分较治疗前降低(P<0.05)。治疗后两组间比较,除睡眠障碍、睡眠药物评分差异无统计学意义,其余各项目治疗组评分均低于对照组(P<0.05)。结论针刺五脏俞加膈俞为主穴辨证治疗慢性失眠疗效确切,并优于常规穴位,对于改善睡眠质量、入睡时间、睡眠时间、睡眠效率、日间功能障碍效果更好。

Objective To observe the clinical effect of acupuncture with Shu-points of five-organs and point Geshu （BL17） as main points in treating chronic insomnia according to different syndromes. Methods Totally 140 patients with chronic insomnia were collected and randomly divided into treatment group and control group with 70 in each. Treatment group was needled at Shu-points of five-organs and point Geshu （BL17） as main points. Control group was needled at bilateral points Shenmen （HT7）, Neiguan （PC6）, Anmian （Extra point ） and Baihui （DU20）. Adjunct points were chosen according to different syndromes for both groups. Both groups were treated once every day, and one therapy course includes five consecutive days, followed by a break of two days. The treatment lasts for four courses in total. The clinical effect was compared between the two groups. The sleep quality was evaluated in both groups before and after treatment adopting Pittsburgh Sleep Quality Index （PSQI）, with indexes of sleep quality, time for falling asleep, sleep time, sleep efficiency, sleep disorders, hypnotic and daytime dysfunction. Results Total effective rate was 80% in treatment group and 70% in control group. Treatment group was superior to control group （ P 〈 0.05 ）. Scores of sleep quality, time for falling asleep, sleep time, sleep efficiency, sleep disorders, hyp- notic and daytime dysfunction and total score of PSQI decreased in treatment group after treatment （P 〈 0.05 ） ; and scores of sleep disorders and total score of PSQI decreased in control group after treatment （P 〈 0. 05 ）. There was no significant difference in scores of sleep disorders and hypnotic between two groups; but scores of other items in treat- ment group were obviously lower than those in control group （ P 〈 0. 05 ）. Conclusion Acupuncture with Shu- points of five-organs and point Geshu （BL17） as main points is effective and superior to with routine points in treating chronic insomnia according to different syndromes. The effect is better in improving sleep quality, time for falling a- sleep, sleep time, sleep efficiency and daytime dysfunction.