针刺治疗失眠临床疗效及对5-HT含量的影响

Clinical Efficacy of Acupuncture for Insomnia and Its Effect on 5-HT

目的通过观察针刺对肝郁化火型失眠患者的5-HT含量以及治疗效果的影响,探讨针刺法治疗肝郁化火型失眠的应用价值以及理论基础。方法选取肝郁化火型失眠患者共187例为研究对象,随机分为两组,对照组93例给予曲唑酮口服,每次100 mg,每日2次,10 d为1个疗程,共治疗2个疗程;观察组94例针刺神门、百会、印堂、合谷、太冲,每日1次,治疗10 d为1个疗程,共治疗2个疗程。两组患者治疗前后均抽取外周血液,检测5-HT含量变化,同时进行匹兹堡睡眠质量指数评定量表(PSQI)、汉密尔顿抑郁量表24项版(HAMD)、Asberg副作用量表(SERS)以及临床疗效评价。结果两组患者治疗前5-HT含量无显著性差异(P>0.05);两组治疗后5-HT含量虽然均见显著升高(P<0.05),观察组患者5-HT含量显著高于对照组(P<0.05);两组患者治疗后PSQI以及HAMD评分均见降低(P<0.05),观察组患者PSQI、HAMD以及SERS评分显著低于对照组(P<0.05);观察组总有效率(92.6%)显著高于对照组(81.7%)(P<0.05)。结论针刺能够显著降低失眠患者5-HT含量,总有效率优于药物治疗。

Objective To explore the value of acupuncture in treating insomnia due to stagnated liver qi transforming into fire and its theoretical foundation, by observing the treatment effect of acupuncture in treating insomnia due to stagnated liver qi transforming into fire and its influence on 5-hydroxy tryptamine（5-HT） content. Method Totally 187 patients with insomnia due to stagnated liver qi transforming into fire were selected and randomized into two groups. The 93 cases in the control group were intervened by orally taking Trazodone, 100 mg for each dose, twice a day, 10 d as a course, totally for 2 courses; the 94 cases in the observation group were intervened by acupuncture at Shenmen（HT7）, Baihui（GV20）, Yintang（GV29）, Hegu（LI 4）, and Taichong（LR 3）, once a day, 10 d as a treatment course, totally for 2 courses. Peripheral blood was collected from the two groups before and after intervention to detect the change of 5-HT content. Meanwhile, the Pittsburgh Sleep Quality Index（PSQI）, Hamilton Depression Scale（HAMD, 24-item version）, Asberg Rating Scale for Side Effects（SERS）, and clinical efficacies were assessed. Result The difference in 5-HT content between the two groups was statistically insignificant before intervention（P0.05）; 5-HT contents were significantly increased in both groups after intervention（P0.05）, while the content in the observation group was markedly higher than that in the control group（P0.05）; after treatment, the PSQI and HAMD scores were decreased in both groups（P0.05）, while the PSQI, HAMD, and SERS scores in the observation group were markedly lower than those in the control group（P0.05）; the total effective rate was 92.6% in the observation group, significantly higher than 81,7% in the control group（P0.05）. Conclusion Acupuncture can significantly down-regulate 5-HT content in insomnia patients, and its total effective rate is higher than that of medication.