交泰方针灸联合清心安神汤治疗失眠心肾不交证

Jiaotai Prescription Acupuncture Combined with Qingxin Anshen Decoction in the Treatment of Insomnia with Syndrome of Disharmony Between Heart and Kidney

目的:探讨交泰方针灸联合清心安神汤对老年心肾不交型失眠患者睡眠质量及血清5-羟色胺(5-hydroxytryptamine,5-HT)水平的影响。方法:将204例老年心肾不交型失眠患者依据随机数字表法分为试验组、对照A组、对照B组,各68例。对照A组采用清心安神汤治疗,对照B组采用交泰方针灸治疗,试验组采用交泰方针灸联合清心安神汤治疗,3组均持续治疗1个月。比较3组治疗前、治疗1个月后中医证候积分、临床效果、睡眠质量评分(pittsburgh sleep quality index,PSQI)、血清5-HT、去甲肾上腺素(norepinephrine,NE)水平及多导睡眠图指标(睡眠潜伏期时间、睡眠效率、总睡眠时间、觉醒次数)水平。结果:治疗1个月后,3组中医证候积分均低于治疗前,且试验组低于对照A组、对照B组(P<0.05);试验组有效率(97.06%)高于对照A组(76.47%)及对照B组(82.35%)(P<0.05);3组PSQI评分均低于治疗前,且试验组低于对照A组及对照B组(P<0.05);3组血清5-HT高于治疗前,且试验组高于对照A组及对照B组;血清NE水平低于治疗前,且试验组低于对照A组及对照B组(P<0.05);3组睡眠潜伏期时间、觉醒次数均低于治疗前,且试验组低于对照A组及对照B组,睡眠效率、总睡眠时间均高于治疗前,且试验组高于对照A组及对照B组(P<0.05)。结论:交泰方针灸联合清心安神汤治疗老年心肾不交型失眠,能进一步提高血清5-HT水平,降低血清NE水平,可显著改善患者临床症状,提高睡眠质量,具有较高应用价值。

Objective:To study the effect of Jiaotai Prescription acupuncture combined with Qingxin Anshen Decoction on sleep quality and serum 5-hydroxytryptamine(5-HT)levels of insomnia in elderly patients with syndrome of disharmony between heart and kidney.Methods:According to the random number table method,204 elderly patients with syndrome of disharmony between heart and kidney were divided into experimental group,control group A,and control group B,with 68 cases in each group.The control group A was treated with Qingxin Anshen Decoction,the control group B was treated with Jiaotai Prescription acupuncture,and the experimental group was treated with Jiaotai Prescription acupuncture combined with Qingxin Anshen Decoction.The three groups were treated for 1 month.Three groups of TCM syndrome scores,clinical effects,pittsburgh sleep quality index(PSQI),serum 5-HT,norepinephrine(NE)levels and polysomnography indicators(sleep latency,sleep efficiency,total sleep time,number of awakenings)before treatment and 1 month after treatment were compared.Results:After 1 month of treatment:TCM syndrome scores in the three groups were lower than before treatment,and the test group was lower than the control group A and control group B(P<0.05);the effective rate of the test group(97.06%)was higher than that of the control group A(76.47%)and the control group B(82.35%)(P<0.05);the PSQI scores of the 3 groups were lower than before treatment,and the test group was low-er than the control group A and control group B(P<0.05);the serum 5-HT of the 3 groups was higher than that before treatment,and the test group was higher than the control group A and control group B;serum NE level is lower than before treatment,and the test group is lower than the control group A and the control group B(P<0.05);the sleep latency and the number of awakenings in the three groups were lower than before treatment,and the test group was lower than the control group A and control group B,and the sleep efficiency and total sleep time were higher than before treatment,and the test group was higher than the control group A and control group B(P<0.05).Conclusion:Jiaotai Prescription acupuncture combined with Qingxin Anshen Decoction can further increase serum 5-HT and reduce serum NE levels in elderly patients with syndrome of disharmony between heart and kidney.It can significantly improve patients'clinical symptoms and improve sleep quality.It has high application value.