针刺联合酸枣仁汤治疗不寐症的作用机制分析

Mechanism Analysis of Combining Acupuncture with Suanzaoren Decoction in the Treatment of Insomnia

目的:观察针刺联合酸枣仁汤治疗不寐症的疗效并讨论其作用机制。方法:选择2012年5月~2016年1月我院门诊收治的不寐患者80例作为研究对象,根据就诊先后顺序依次编号分为观察组与对照组,各40例。对照组应用西药地西泮片治疗,观察组采取针刺联合酸枣仁汤进行治疗。比较两组治疗前后的睡眠质量(应用PSQI评价)、总睡眠时间和阿森斯失眠量表(AIS)血浆神经肽Y(NPY)及5-羟色胺(5-HT)水平改变,记录治疗效果及不良反应发生情况。结果:治疗后观察组患者治疗总有效率和血浆中NPY明显高于对照组,而观察组血浆中5-HT明显低于对照组,差异均具有统计学意义(P<0.05)。治疗后两组患者的PSQI、总睡眠时间和AIS评分均出现显著改善,且治疗后观察组患者PSQI和AIS评分均显著低于对照组,而总睡眠时间明显高于对照组,差异均具有统计学意义(P<0.05)。观察组患者不良反应发生率明显低于对照组,差异具有统计学意义(P<0.05)。结论:针刺联合酸枣仁汤治疗不寐症可有效改善患者睡眠质量,安全性高,值得临床推广应用。

Objective ： To observe the efficacy of using acupuncture combined with Suanzaoren Decoction in the treatment of insomnia and to discuss its mechanism of action. Methods ： S0 insomnia outpatients treated in our hospital from May 2012 to Jan- uary 2016 were selected as the research objects, numbered the patients by their clinic sequences, they were divided into observa- tion group and controlled group （each 40 cases）. The controlled group received Diazepam Tablets, the observation group was given acupuncture combined with Suanzaoren Decoction. Sleep quality （evaluated by PSQI） before and after the treatment, total sleeping time, Athens Insomnia Scale （AIS） plasma, the levels of neuropeptide Y （NPY） and serotonin （5-HT） , the total ef- fective rate and adverse reaction rate during the treatment in the two groups were compared. Results： After treatment, total effec- tive rate of the patients in the observation group and plasma NPY was significantly higher than the controlled group, 5-HT was significantly lower than the controlled group （P 〈 0. 05）. After treatment, PSQI scores, total sleeping time and AIS scores of the two groups were significantly reduced （ P 〈 0. 05 ）. The AIS patients PSQI scores in the observation group were significantly lower than the controlled group after treatment, while total sleep time was significantly higher than the controlled group after treat- ment （P 〈 0. 05）. The total effective rate of the observation group was 92. 5%, which was significantly higher than the con- trolled group （72. 5% ） （P 〈 0. 05）. Conclusion： Acupuncture combined with Suanzaoren Decoction in treating insomnia can improve patients＇ sleep quality effectively with high safety, which is worth spreading.