针灸联合认知行为治疗对失眠症患者的疗效研究

Original Article Effect of acupuncture combined with cognitive behavior therapy on insomnia

目的探讨针灸联合认知行为治疗对失眠症患者的疗效。方法选取2018年6月至2020年6月在衢州市中医医院针灸科门诊就诊的失眠症患者90例,采用随机数字表法分为联合组(n=46例)及对照组(n=44例)。联合组采用针灸治疗及认知行为治疗,对照组采用认知行为治疗;比较两组汉密尔顿抑郁量表(HAMD)评分、汉密尔顿焦虑量表(HAMA)评分及失眠严重程度指数(ISI)评分、入睡潜伏期、总睡眠时间、入睡后觉醒次数、在床时间及睡眠效率的差异。结果治疗结束时,联合组治愈率(28.26%)、显效率(54.35%)、总有效率(95.65%)均高于对照组的11.36%(χ^(2)=4.013,P=0.045)、31.82%(χ^(2)=4.649,P=0.031)、79.55%(χ^(2)=5.438,P=0.020);联合组HAMA评分[(13.05±2.19)分]、ISI评分[(13.01±3.03)分]、入睡潜伏期[(28.03±7.50)min]及入睡后觉醒次数[(1.36±0.91)次]低于对照组[(14.92±3.04)分,t=1.803,P=0.040]、[(15.02±3.22)分,t=3.201,P=0.031]、[(36.15±7.87)min,t=3.186,P=0.033]及[(1.94±1.05)次,t=3.254,P=0.027];联合组睡眠效率[(83.28±5. 41)%]高于对照组[(79.56±5.20)%,t=2.278,P=0.043]。结论针灸治疗联合认知行为治疗对失眠症患者疗效优于单纯认知行为治疗,值得临床推广应用。

Objective To investigate the effect of acupuncture combined with cognitive behavior therapy on insomnia.Methods A total of 90 patients with insomnia who received treatment in Department of Acupuncture and Moxibustion,Quzhou Municipal Hospital of Traditional Chinese Medicine,China from June 2018 to June 2020 were included in this study.They were randomly assigned to receive acupuncture combined with cognitive behavior therapy(combined treatment group,n=46)or cognitive behavior therapy(control group,n=44).The Hamilton Rating Scale for Depression(HAMD)score,the Hamilton Anxiety Scale(HAMA)score,the insomnia severity index(ISI),sleep onset latency,total sleep time,wake-up times after sleep onset,bedtime,sleep quality were compared between the two groups.Results At the end of treatment,the cure rate,effective rate and total effective rate in the combined treatment group were significantly higher than those in the control group(cure rate:28.26%vs.11.36%,χ^(2)=4.013,P=0.045;effective rate:54.35%vs.31.82%,χ^(2)=4.649,P=0.031;total effective rate:95.65%vs.79.55%,χ^(2)=5.438,P=0.020).The HAMA score[(13.05±2.19)points],ISI score[(13.01±3.03)points],sleep onset latency[(28.03±7.50)min]and wake-up times after sleep onset[(1.36±0.91)times]in the combined treatment group were significantly lower or shorter than those in the control group[(14.92±3.04)points,t=1.803,P=0.040;(15.02±3.22)points,t=3.201,P=0.031;(36.15±7.87)min,t=3.186,P=0.033;(1.94±1.05)times,t=3.254,P=0.027].Sleep quality in the combined treatment group was significantly higher than that in the control group[(83.28±5.41)%vs.(79.56±5.20)%,t=2.278,P=0.043].Conclusion Acupuncture combined with cognitive behavior therapy exhibits better efficacy in the treatment of insomnia than cognitive behavior therapy alone and therefore the combined treatment is worthy of clinical application.