归脾汤的临床应用联合耳穴贴压疗治疗血液透析患者心脾两虚型失眠的临床效果分析

Analysis of clinical effect of Guipi decoction combined auricular point sticking therapy on insomnia with deficiency of heart and spleen in hemodialysis patients

目的:研究归脾汤的临床应用联合耳穴贴压疗法治疗血液透析患者心脾两虚型失眠症状的改善情况,探讨对比中医联合治疗血液透析患者此型失眠与西医治疗的不同点与临床优越性。方法:选择在南通市海门区中医院行血液透析的82例心脾两虚型失眠患者,将其随机分为观察组和治疗组,每组41例。观察组采用归脾汤的临床应用同时配合耳穴贴压疗法,对照组采用常规的艾司唑仑及谷维素药物治疗,最后对比两组治疗后的睡眠质量[匹兹堡睡眠质量指数量表(Pittsburgh Sleep Quality Index,PSQI)评分]、中医证候积分、不良反应情况、汉密尔顿焦虑量表(Hamilton Anxiety Scale,HAMA)和汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD)评分情况,停药后治愈情况。结果:经过治疗30 d后,观察组的PSQI睡眠质量评分比对照组显著低(P<0.05);观察组的中医证候积分比对照组显著低(P<0.05);观察组的不良反应发生率比对照组显著低(P<0.05),观察组的HAMA和HAMD评分明显比对照组低(P<0.05),治疗60 d后观察组的治愈率明显比对照组高。结论:归脾汤的临床应用联合耳穴贴压疗法治疗血液透析患者心脾两虚型失眠较西医常规治疗更有优势,临床疗效满意,且不易引起不良反应,治愈率高,值得临床推广。

Objective:To study the clinical application of Guipi decoction(归脾汤)combined auricular point sticking therapy on insomnia with deficiency of heart and spleen in hemodialysis patients,and to explore the differences and clinical advantages of traditional Chinese medicine combined with western medicine in the treatment of this type of insomnia in hemodialysis patients.Methods:82 cases of insomnia with deficiency of both heart and spleen in Haimen District Hospital of Traditional Chinese Medicine were randomly divided into the observation group and the treatment group,with 41 cases in each group.The observation group was treated with Guipi decoction combined with auricular point sticking therapy,while the control group was treated with conventional western medicine estazolam and oryzanol.Finally,the PSQI score,TCM syndrome score,adverse reactions,HAMA and HAMD scores,and cure rate after drug withdrawal of the two groups were compared.Results:After 30 days of treatment,the PSQI sleep quality score of the observation group was significantly lower than that of the control group(P<0.05);the TCM syndrome score of the observation group was significantly lower than that of the control group(P<0.05);the incidence of adverse reactions of the observation group was significantly lower than the control group(P<0.05),the HAMA and HAMD scores in the observation group were significantly lower than the control group(P<0.05),and the cure rate of the observation group was significantly higher than the control group after 60 days of treatment.Conclusion:The clinical application of Guipi decoction combined with auricular point sticking therapy has more advantages than the conventional treatment of Western medicine in the treatment of hemodialysis patients with insomnia of deficiency of both heart and spleen,it has satisfactory clinical effect,less adverse reactions,and high cure rate,which is worthy of clinical promotion.