耳穴揿针联合西药治疗脑卒中后失眠临床观察

Efficacy Observation of Post-stroke Insomnia Treated with Auricular Press-needle and Western Medicine

[目的]观察耳穴揿针联合西药治疗脑卒中后失眠的疗效并对其疗效机理进行探讨。[方法]将72例脑卒中后失眠患者随机分为治疗组和对照组各36例,在脑卒中及其他基础病常规诊疗基础上,治疗组予以耳穴揿针联合西药的治疗,对照组予以纯西药的治疗。两组在治疗前、后和治疗结束后1个月进行匹茨堡睡眠质量指数量表(Pittsburgh Sleep Quality Index,PSQI)评分和美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分比较。[结果]在临床疗效方面,治疗组的总体有效率为94.44%,对照组的总有效率为75.00%,差异有统计学意义(P<0.01);在NIHSS的评分方面,对照组减少程度小于治疗组;1个月之后随访,治疗组的PSQI评分前后差异无统计学意义(P>0.05),说明远期效果仍显著,对照组的前后差异有统计学意义(P<0.01),远期效果欠佳。[结论]耳穴揿针联合西药治疗脑卒中后失眠与单纯西药治疗对比,临床疗效更加显著,远期疗效佳,是值得推广的治疗方法。

[Objective] To observe the clinical efficacy of auricular press-needle combined western medicine in treating post-stroke insomnia and explore the mechanism. [Methods] Total 72 patients with post-stroke insomnia were randomized to the treatment group and control group, 36 patients in each group. The two groups were treated with post-stroke insomnia and other basic diseases. The treatment group received auricular press-needle and western medicine, while the control group were only given western medicine. The changes of Pittsburgh Sleep Quality Index（PSQI）scores and National Institute of Health Stroke Scale（NIHSS） scores of the two groups before and after treatment, 1 month after the treatment, were observed to compare the clinical curative effects of the two groups. [Results] The total effective rate of the treatment group was 94.44% better than 75.00% in the control group, the difference was statistically significant（P〈0.01）. The NIHSS scores of treatment group were less than the scores in the control group after treatment. Followup after 1 month, the PSQI scores of treatment group were not statistically significant（ P〉0.05）, the long-term effect remained significant. But the control group was statistically significant（P〈 0.01）, the long-term effect was not significant. [Conclusion] Auricular press-needle combined western medicine treating post-stroke insomnia had better clinical efficacy than only western medicine, promoting the recovery of nerve function. Meanwhile it had excellent long-term effect, thus deserving popularization.