方氏头皮针对失眠症患者压力知觉及睡眠结构的影响:随机对照试验

Effect of Fang′s scalp acupuncture on perceived stress and sleep structure in insomnia patients:a randomized controlled trial

目的:比较方氏头皮针结合体针与单纯体针治疗失眠症的疗效。方法:将66例失眠症患者随机分为观察组(33例,脱落1例)和对照组(33例,脱落2例)。对照组采用常规针刺,穴取神门、百会、照海、三阴交等;观察组在对照组治疗基础上加用方氏头皮针,头穴取伏象头、伏脏上焦、伏脏中焦、思维等,飞针直刺后行震颤手法。两组均每日1次,共治疗2周。于治疗前后观察两组匹兹堡睡眠质量指数(PSQI)评分、中文版压力知觉量表(CPSS)评分及多导睡眠监测相关参数[总睡眠时间(TST)、睡眠潜伏期(SOL)、觉醒时间(WASO)、睡眠效率(SE),快速眼动睡眠相(REM)与非快速眼动睡眠相1、2、3和4期时间占TST的百分比,即REM%、N1%、N2%、N3%],并比较两组疗效。结果:治疗后,两组PSQI各项评分及总分、CPSS评分均较治疗前降低(P<0.01,P<0.05);除睡眠质量外,观察组PSQI各项评分及总分、CPSS评分均低于对照组(P<0.01,P<0.05)。治疗后,两组TST、SE%、REM%、N3%均较治疗前升高(P<0.01,P<0.05),两组SOL、WASO、N1%及观察组N2%均较治疗前降低(P<0.01,P<0.05);观察组SE%、REM%及N3%高于对照组(P<0.05),N1%、N2%低于对照组(P<0.05)。观察组总有效率为93.8%(30/32),高于对照组的87.1%(27/31,P<0.05)。结论:在常规体针基础上,配合方氏头皮针能明显改善失眠症患者的睡眠质量、压力知觉,并调节睡眠结构。

Objective To compare the efficacy on insomnia between Fang′s scalp acupuncture combined with conventional acupuncture and the simple conventional acupuncture.Methods A total of 66 patients with insomnia were randomly divided into an observation group(33 cases,1 case dropped off)and a control group(33 cases,2 cases dropped off).In the control group,the routine acupuncture therapy was applied to Shenmen(HT 7),Baihui(GV 20),Zhaohai(KI 6)and Sanyinjiao(SP 6),etc.Based on the treatment as the control group,Fang’s scalp acupuncture therapy was supplemented at fuxiang tou,fuzang shangjiao,fuzang zhongjiao,siwei,etc.At these scalp points,the needles were inserted perpendicularly with flying needling technique and manipulated with trembling one.In either group,the treatment was given once daily,continuously for 2 weeks.Before and after treatment,separately,the score of Pittsburgh sleep quality index(PSQI)and the score of Chinese perceived stress scale(CPSS)were observed,as well as the parameters monitored by polysomnography,i.g.total sleep time(TST),sleep onset latency(SOL),wakefulness after the sleep onset(WASO),sleep efficiency(SE),the percentages of the time of rapid eye movement sleep phase(REM)and non-rapid eye movement sleep phase 1,2,3 and 4 in TST(REM%,N1%,N2%,N3%).The efficacy was compared between two groups.Results After treatment,the scores of each factor and the total scores of PSQI,as well as CPSS scores were all lower than those before treatment in the two groups(P<0.01,P<0.05);except the score for sleep quality,the score of each factor and the total score of PSQI,as well as CPSS score in the observation group were lower than those in the control group(P<0.01,P<0.05).After treatment,TST,SE%,REM%and N3%were increased and SOL,WASO,N1%were decreased as compared with before treatment in the two groups(P<0.01,P<0.05),and N2%in the observation group was decreased(P<0.01);SE%,REM%and N3%in the observation group were higher than the control group(P<0.05)and N1%and N2%were lower than the control group(P<0.05).The total effective rate was 93.8%(30/32)in the observation group,higher than 87.1%(27/31)in the control group(P<0.05).Conclusion Fang′s scalp acupuncture,on the base of routine acupuncture,obviously improves the sleep quality and perceived stress and adjusts the sleep structure in the patients with insomnia.