调督疏肝安神针法联合超低频经颅磁刺激仪治疗原发性失眠临床疗效及安全性探究

Clinical Efficacy and Safety of Tiaodu Shugan Anshen Acupuncture Combined with Ultra-Low Frequency Transcranial Magnetic Stimulation in Treating Primary Insomnia

目的:探究调督疏肝安神针法联合超低频经颅磁刺激仪治疗原发性失眠临床疗效及安全性。方法:共纳入200例原发性失眠患者,均由延安大学附属医院中医科和疼痛科2018年12月—2019年8月收治,采取随机数字表法将患者分为两组,对照组患者(100例)口服艾司唑仑片治疗,观察组患者(100例)采用调督疏肝安神针法联合超低频经颅磁刺激仪治疗,比较两组患者治疗前后匹兹堡睡眠指数(PSQI)评分变化、临床疗效、治疗前后患者每日觉醒次数、Epworth思睡量表评分、血清5-羟色氨酸(5-HT)和多巴胺(DA)水平变化,并观察治疗副作用。结果:观察组患者总有效率(99/100,99.00%)高于对照组(93/100,93.00%)(P<0.05);治疗前两组患者PSQI评分、Epworth评分相当(P>0.05),治疗后各组患者PSQI评分、Epworth评分均改善且观察组改善优于对照组(P<0.05);治疗前两组患者每日觉醒次数相当(P>0.05),治疗后各组患者每日觉醒次数均较少,且观察组少于对照组(P<0.05);治疗前两组患者5-HT、DA水平相当(P>0.05),治疗后各组患者5-HT、DA水平均改善,且观察组水平改善优于对照组(P<0.05);观察组患者副作用率(1/100,1.00%)低于对照组(8/100,8.00%)(P<0.05)。结论:调督疏肝安神针法联合超低频经颅磁刺激仪治疗原发性失眠临床效果显著,患者睡眠质量改善,副作用率低,安全性高,值得推广及应用。

Objective:To explore the clinical efficacy and safety of Tiaodu Shugan Anshen acupuncture combined with ultra-low frequency transcranial magnetic stimulation in the treatment of primary insomnia.Methods:200 patients with primary insomnia were randomly divided into the control group(n=100)and the observation group(n=100).The control group was treated with Estazolam Tablet,and the observation group was treated with Tiaodu Shugan Anshen acupuncture combined with ultra-low frequency transcranial magnetic stimulation.The score changes in Pittsburgh sleep index(PSQI),clinical efficacy,daily number of awakenings before and after the treatment,score changes in Epworth sleepiness scale,serum levels of 5-HT and DA,and side effects of the treatment were compared between the two groups.Results:The total effective rate of the observation group was 99.00%(99/100),which was significantly higher than 93.00%(93/100)of the control group(P<0.05).There were no statistical differences in the scores of PSQI and Epworth between the two groups before the treatment(P>0.05);the scores of PSQI and Epworth were significantly improved after the treatment(P<0.05),and the improvements in the observation group were more significant(P<0.05).There were no statistical differences in daily awakenings between the two groups before the treatment(P>0.05);the awakenings were significantly decreased after the treatment in the two group(P<0.05);the decreases in the observation group were more significant(P<0.05).There were no statistical differences in the levels of 5-HT and DA between the two groups before the treatment(P>0.05);the levels of 5-HT and DA were significantly improved after the treatment in the two group(P<0.05);the improvements in the observation group were more significant(P<0.05).The rate of side effect in the observation group was 1.00%(1/100),which was significantly lower than 8.00%(8/100)in the control group(P<0.05).Conclusion:The clinical effect of treating primary insomnia with Tiaodu Shugan Anshen acupuncture combined with ultra-low frequency transcranial magnetic stimulation is remarkable,and the patients'sleep quality is improved,the rate of side effect is low,and the safety is high,which is worthy of promotion and application.