调督安神针刺治疗心脾两虚型失眠的临床疗效评价

Evaluation of Clinical Efficacy of Heart and Spleen Deficiency Type Insomnia Treated by Acupuncture for Regulating Governor Vessel and Tranquilizing Spirit

【目的】观察调督安神针刺法结合药物艾司唑仑治疗心脾两虚型失眠的临床疗效。【方法】将70例心脾两虚型原发性失眠患者随机分为治疗组和对照组各35例。对照组给予睡前口服艾司唑仑片治疗,连续治疗6周;治疗组在对照组口服药物的基础上给予调督安神针刺治疗,取穴百会、印堂、神庭、安眠、神门、三阴交等,每周3次,连续治疗6周。分别在治疗前、治疗3周、治疗6周,以及治疗结束后1个月随访,采用匹兹堡睡眠质量指数(PSQI)、Epworth思睡量表、阿森斯失眠量表(AIS)对患者的睡眠情况进行评估。【结果】(1)脱落情况:治疗组有5例、对照组有3例患者不能按照规定如期进行治疗而脱落,最终治疗组30例、对照组32例患者完成试验。(2)疗效情况:治疗组总有效率为90.0%,优于对照组的71.9%,差异有统计学意义(P<0.01)。(3)治疗3周、治疗6周及治疗结束后1个月随访时,治疗组在降低PSQI、Epworth和AIS量表评分方面均优于对照组,差异均有统计学意义(P<0.05或P<0.01)。【结论】调督安神针刺法结合药物艾司唑仑治疗心脾两虚型原发性失眠的疗效确切,其疗效明显优于单纯药物治疗。

Objective To evaluate the clinical effect of acupuncture combined with estazolam for the treatment of primary insomnia with heart and spleen deficiency type. Methods Seventy qualified patients were randomized into treatment group and control group,35 in each group. Both groups received oral use of estazolam before bed time for 6 continuous weeks,and acupuncture group was additionally given acupuncture for regulating governor vessel and tranquilizing spirit on acupoints of Baihui（GV20）, Yintang（GV29）, Shenting（GV25）, Anmian（EX-HN22）,Shenmen（H7）,Sanyinjiao（SP6）,3 times a week and lasting for 6 continuous weeks. The sleep state of the patients was estimated according to Pittsburgh Sleep Quality Index（PSQI）,Epworth Sleepiness Scale（ESS）and Athens Insomnia Scale（AIS）before treatment,on the third and the sixth week of treatment,and one month after the completion of treatment. Results（1） Five cases in the treatment group and 3 cases in the control group were dropped out for not completing the treatment timely. In the end, 30 cases in the treatment group and 32 cases in the control group finished the trial.（2）The total effective rate in the treatment group was up to 90.0%,and was 71.9% in control group,the difference being significant（P〈0.01）.（3）Compared to the control group,the scores of PSQI,ESS and AIS were much decreased in treatment group on the third and the sixth week of treatment, and one month after treatment（P〈 0.05 or P 〈0.01）. Conclusion Acupuncture for regulating governor vessel and tranquilizing mind combined with oral use of estazolam exerts certain therapeutic effect for the treatment of heart and spleen deficiency type insomnia, and the effect was superior to that of estazolam alone.