微创穴位埋线治疗痰热内扰型不寐临床观察

Clinical Observation of Catgut Implantation at Acupuncture Point Treating Insomnia with Syndrome of Phlegm-heat Attacking Internally

目的:探讨微创穴位埋线法对痰热内扰型不寐的治疗效果。方法:将75例痰热内扰型不寐患者随机分为埋线组25例,针刺组24例,口服药物组26例,以匹茨堡睡眠质量指数量表(PSQI)及症状分级量化表评价疗效。结果:埋线组、针刺组及口服药物组均可明显改善不寐患者的睡眠。埋线组在总分改善方面及提高睡眠质量方面优于针刺组(P<0.05),在总分改善方面与口服药物组相当,睡眠质量及日间功能方面优于口服药物组(P<0.05),但在改善睡眠时间方面不及口服药物组(P<0.05);埋线组改善中医症状效果与针刺组相当,均优于口服药物组(P<0.05);针刺组的总有效率低于埋线组与口服药物组,后2者接近。治疗结束1个月后随访,PSQI计分改善及中医症状改善均以埋线组最佳,针刺组次之(P<0.05),并且2者的总有效率也优于口服药物组(P<0.01),即2组维持疗效优于药物组。结论:对于痰热内扰型不寐,微创穴位埋线疗效与口服艾司唑仑片近似,优于针刺法,在改善中医症状及疗效维持方面有一定优势,少见不良反应,值得在临床推广。

Objective： To discuss the efficacy of catgut implantation at acupuncture point on insomnia with Syndrome of Phlegmheat attacking internally. Methods： Seventy-five cases of insomnia with Syndrome of Phlegm-heat attacking internally were divided into 3 groups randomly： 25 cases in the catgut implantation at acupuncture point therapy group,24 cases in the acupuncture therapy group and 26 cases in the oral medication group respectively,in which they were therapeutically evaluated according to the Pittsburgh sleep quality index（ PSQI） scores and syndrome-classification quantitative scores. Results： The sleep quality of insomniacs was effectively improved in both of the 2 groups. The aggregate score of improving sleep quality of the patients in the catgut implantation at acupuncture point therapy group was superior to that of the acupuncture therapy group（ P〈0. 05）. The improvement in aggregate score of the catgut implantation at acupuncture point therapy group was close to that of the oral medication group,and sleep quality and daytime function of the former group were better than those of the oral medication group（ P〈0. 05）; however,improvement in sleeping time was not as good as that of the oral medication group（ P〈0. 05）. The syndrome improvement in the catgut implantation at acupuncture point therapy group was similar to that of the acupuncture therapy group and they were all more effective than the oral medication group（ P〈0. 05）. The total effective rate of the catgut implantation at acupuncture point therapy group was close to that of the oral medication group. In the follow-up visit,which was one month after the treatment,PSQI score improvement and syndrome improvement of the catgut implantation at acupuncture point therapy group were better than those of the acupuncture therapy group,while the oral medication group was the worst in the comparison（ P〈0. 05）,and the total effective rate of the catgut implantation at acupuncture point therapy group and the acupuncture therapy group was superior to that of the oral medication group（ P〈0. 01）. Conclusion： The curative effect of the catgut implantation at acupuncture point therapy on insomnia with syndrome of phlegm-heat attacking internally was similar to taking the oral drugs（ Estazolam Tablets）. With rare adverse reactions,its duration of curative effect was better than the oral drugs and worth of being generalized in clinic.