揿针治疗老年性失眠临床观察

Clinical study of lifting needle in the treatment of senile insomnia

目的随着我国老龄化问题日益严重,老年性失眠发病率逐年增加。本研究观察普通针刺与揿针治疗老年性失眠的疗效差异。方法选择2016-01-01-2018-02-28上海市闵行区莘庄社区卫生服务中心中医针灸科门诊收治的60例老年性失眠患者为研究对象,按照组间基本特征均衡可比的原则分为揿针疗法组和普通针刺组,每组30例。取穴均为安眠穴、内关穴、心俞穴、肾俞穴和太溪穴,均每周治疗2次,治疗4周。4周后及随访1个月后以匹兹堡睡眠质量指数(pittsburgh sleep quality index,PSQI)和临床疗效进行组间疗效比较。结果治疗后,揿针疗法组入睡时间得分为(1.07±0.29)分,低于普通针刺组的(1.18±0.38)分,t=9.832,P=0.025;揿针疗法组睡眠时间得分为(0.89±0.62)分,低于普通针刺组的(1.28±0.48)分,t=11.321,P=0.031;揿针疗法组睡眠质量得分为(1.65±0.78)分,低于普通针刺组的(1.73±0.61)分,t=18.341,P=0.027;揿针疗法组睡眠障碍得分为(1.11±0.49)分,低于普通针刺组的(1.48±0.48)分,t=10.441,P=0.025;揿针疗法组睡眠效率得分为(1.39±0.46)分,低于普通针刺组的(1.48±0.49)分,t=12.339,P=0.036;揿针疗法组日间功能得分为(1.05±0.58)分,低于普通针刺组的(1.63±0.59)分,t=8.341,P=0.038;揿针疗法组PSQI总评分为(6.81±1.59)分,低于普通针刺组的(8.86±1.92)分,t=9.319,P=0.032。揿针疗法组治疗后临床疗效总有效率为93.33%,优于普通针刺组的73.33%,Z=-2.425,P=0.015;随访1个月后,揿针疗法组总有效率为86.67%,优于普通针刺组的63.33%,Z=-2.295,P=0.022。结论揿针疗法相比较普通针刺更能改善老年性失眠患者相关临床症状,临床疗效可维持至随访1个月。

OBJECTIVE With the increasingly serious problem of aging in China,the incidence of senile insomnia is increasing year by year.In this study,we observes the difference between curative effect of common acupuncture and sacral acupuncture on senile insomnia.METHODS From January 01,2016 to February 28,2016,a total of 60 elderly patients with insomnia treated by the Department of Chinese Medicine Acupuncture in Xinzhuang Community Health Service Center of Minhang District in Shanghai were selected as the research objects.There were 30 cases in the acupunyure group and the ordinary acupuncture group.The acupoints were all taken from Anmian,Neiguan,Xinshu,Shenshu and Taixi.They were treated twice a week for 4 weeks.After 4 weeks and 1 month of follow-up,the pittsburgh sleep quality index(PSQI)and clinical efficacy were used to compare the efficacy between groups.RESULTS After treatment,the sleep time score of the acupuncture group was(1.07±0.29)points,which was lower than that of the ordinary acupuncture group(1.18±0.38)points,t=9.832,P=0.025;The sleep time score of the acupuncture group was(0.89±0.62)points,which was lower than that of the ordinary acupuncture group(1.28±0.48)points,t=11.321,P=0.031;The sleep quality score of the acupuncture group was(1.65±0.78)points,which was lower than that of the ordinary acupuncture group(1.73±0.61)points,t=18.341,P=0.027;The sleep disturbance score of the acupuncture group was(1.11±0.49)points,which was lower than that of the ordinary acupuncture group(1.48±0.48)points,t=10.441,P=0.025;The sleep efficiency score of the acupuncture group was(1.39±0.46)points,which was lower than that of the ordinary acupuncture group(1.48±0.49)points,t=12.339,P=0.036;the day function score of the acupuncture group was(1.05±0.58)points,which was lower than that of the ordinary acupuncture group(1.63±0.59)points,t=8.341,P=0.038;the total PSQI score of the acupuncture group was(6.81±1.59)points,which was lower than that of the ordinary acupuncture group(8.86±1.92)points,t=9.319,P=0.032.The total effective rate of the clinical effect after treatment in the acupuncture group was 93.33%,which was better than that of the ordinary acupuncture group(73.33%,Z=-2.425,P=0.015);After 1 month of follow-up,the total effective rate of the acupuncture group was 86.67%,which was better than that of the ordinary acupuncture group(63.33%,Z=-2.295,P=0.022).CONCLUSION The acupuncture therapy can improve the clinical symptoms of senile insomnia patients compared with ordinary acupuncture,and the clinical effect can be maintained to 1 month follow-up.