基于子午流注理论运用揿针疗法治疗失眠心脾两虚证患者的临床观察

The effect of press needle embedding on insomnia due to heart-spleen deficiency based on midnight-noon and ebb-flow acupoint selection

目的观察基于子午流注理论运用揿针疗法治疗失眠心脾两虚证患者的临床疗效。方法将180例失眠心脾两虚证患者随机分为治疗组90例、对照组90例,剔除脱落病例后治疗组80例、对照组76例。治疗组基于子午流注理论运用揿针疗法,对照组予常规揿针疗法。观察临床疗效、匹兹堡睡眠质量指数(PSQI)评分、中医症状评分,并进行安全性评估。结果治疗组80例中,痊愈6例,显效13例,有效46例,无效15例,总有效65例,总有效率为81.25%;对照组76例中,痊愈3例,显效9例,有效35例,无效29例,总有效47例,总有效率为61.84%。经秩和检验,Z=-2.541,P=0.039,P<0.05,说明治疗组临床疗效优于对照组。治疗后治疗组PSQI总分、睡眠质量、入睡时间、睡眠时间、睡眠困难、日间功能障碍评分较本组治疗前均降低(P<0.05)。对照组PSQI总分、睡眠质量、入睡时间、睡眠时间、日间功能障碍评分较本组治疗前均降低(P<0.05)。治疗组PSQI总分、睡眠时间、睡眠困难、日间功能障碍评分较对照组降低明显,治疗前后评分差值比较,差异均有统计学意义(P<0.05)。治疗后治疗组入睡困难、多梦易醒、心悸健忘、神疲乏力、腹胀食少、头晕目眩、便溏、面色无华评分较本组治疗前均降低(P<0.05)。对照组入睡困难、多梦易醒、心悸健忘、神疲乏力、腹胀食少、头晕目眩、便溏评分较本组治疗前均降低(P<0.05)。治疗组入睡困难、多梦易醒、神疲乏力、腹胀食少评分较对照组降低明显,治疗前后评分差值比较,差异均有统计学意义(P<0.05)。治疗期间未发生严重不良反应。结论基于子午流注理论运用揿针疗法治疗失眠心脾两虚证患者具有较好的临床疗效。

Objective To investigate the clinical efficacy of press needle embedding on insomnia due to heart-spleen deficiency based on midnight-noon and ebb-flow acupoint selection. Methods 180 insomnia patients with heart-spleen deficiency were randomly divided into treatment group(n=90) and control group(n=90). The treatment group was given press needle embedding therapy based on midnight-noon and ebb-flow doctrine,the control group received routine press needle embedding therapy. There were 80 cases in the treatment group and 76 cases in control group after removing the shedding cases. The course of treatment was 14 days. The total efficacy rate, Pittsburgh sleep quality(PSQI) and TCM symptom score and safety were evaluated. Results Among 80 cases in treatment group,there were 6 cases got recovery,13 cases with obvious effects,15 cases ineffective, 46 showed effective, 15 cases ineffective the total effective cases were 65, and the total effective rate was 81.25%. Among 76 cases in control group,there were 3 cases got recovery,9 cases with obvious effects,35 showed effective,29 cases ineffective, total effective cases were 47,and the total effective rate was 61.84%. Rank sum test analysis showed Z=-2.541,P=0.039,P<0.05,which indicated the total efficacy rate of treatment group was superior to control group.And in treatment group, the total PSQI score, the sleep latency, the sleep efficiency, the sleep disturbance and daytime dysfunction scores were lower after treatment than before(P<0.05). In control group, and the total score, the sleep quality, the sleep duration, the sleep latency and daytime dysfunction scores were lower after treatment(P<0.05).The total PSQI score, the sleep disturbance score, the sleep duration and daytime dysfunction scores was lower in the observation group than control group(P<0.05) after treatment.In treatment group, the scores of insomnia, dreaminess, palpitation and forgetfulness, fatigue, abdominal distension, dizziness, loose stool and complexion were decreased than those before treatment(P< 0.05). In the control group, the scores of insomnia, dreaminess, palpitation and forgetfulness, fatigue, abdominal distension, dizziness and loose stool were decreased than those before treatment(P<0.05). The scores of insomnia, dreaminess, fatigue, abdominal distension and loose stool in the treatment group were decreased than control group. The difference of the scores before and after treatment was statistically significant(P<0.05). There was no adverse reaction. Conclusion Under the guidance of midnight-noon and ebb-flow doctrine, press needle embedding therapy is effective on insomnia due to heart-spleen deficiency.