解郁调神针法治疗肝郁气滞型失眠的临床疗效观察

Clinical effect observation on Jieyu Tiaoshen Acupuncture treating insomnia of liver depression and qi stagnation syndrome

目的:观察解郁调神针法治疗肝郁气滞型失眠的疗效及对神经递质水平的影响。方法:将102例肝郁气滞型失眠患者随机分为对照组和治疗组,每组51例。对照组采用常规穴位针刺治疗;治疗组采用解郁调神针刺法治疗,共治疗4周。观察两组匹兹堡睡眠质量指数表(PSQI)、失眠严重程度指数表(ISI)、汉密尔顿焦虑量表(HAMA)、汉密尔顿焦虑量表(HAMD)评分,5-羟色胺(5-HT)、去甲肾上腺素(NE)、多巴胺(DA)、γ-氨基丁酸(GABA)水平以及临床疗效。结果:PSQI、ISI评分组别与时间的交互作用有统计学意义(P<0.05,P<0.01);治疗2、4周后,两组患者的PSQI、ISI、HAMA、HAMD评分较治疗前显著降低(P<0.05);治疗2、4周后,治疗组的PSQI、ISI评分均低于对照组(P<0.05)。5-HT、GABA水平组别与时间的交互作用有统计学意义(P<0.01);治疗2、4周后,两组患者的5-HT、GABA水平较治疗前显著升高,NE、DA水平显著降低(P<0.05);治疗2、4周后,治疗组的GABA水平高于对照组,NE、DA水平低于对照组(P<0.05),且治疗4周后,治疗组的5-HT水平高于对照组(P<0.05)。治疗组总有效率[96.00%(48/50)]显著高于对照组[81.63%(40/49)](P<0.05)。结论:解郁调神针法治疗心肝郁气滞型失眠的疗效确切,可明显改善患者失眠伴焦虑、抑郁等精神症状,安全有效,值得大力推广运用。

Objective: To observe the curative effect of Jieyu Tiaoshen Acupuncture on insomnia of liver depression and qi stagnation and its influence on neurotransmitter levels. Methods: A total of 102 patients with liver depression and qi stagnation insomnia were randomly divided into control group and treatment group, with 51 cases in each group. The control group was treated with conventional acupuncture at acupoints;the treatment group was treated with acupuncture for Jieyu Tiaoshen Acupuncture for a total of 4 weeks. Observe two groups of Pittsburgh Sleep Quality Index(PSQI) scores, Insomnia Severity Index(ISI) scores, Hamilton Anxiety Scale(HAMA) scores, Hamilton Anxiety Scale(HAMD) scores, 5-hydroxytryptamine(5-HT), norepinephrine(NE), dopamine(DA), γ-aminobutyric acid(GABA) levels and clinical efficacy. Results: The interaction between the PSQI and ISI score groups and time was statistically significant(P<0.05, P<0.01), Compared before the treatment, the PSQI, ISI, HAMA, and HAMD scores of the two groups of patients decreased(P<0.05). After 2 weeks of treatment and 4 weeks of treatment, the PSQI, ISI scores of the treatment group were lower than those of the control group(P<0.05). The interaction between 5-HT and GABA level groups and time was statistically significant(P<0.01);Compared before the treatment, the 5-HT and GABA levels of the two groups of patients increased after 2 and 4 weeks of the treatment, and the NE and DA levels gradually decreased(P<0.05);after 2, 4 weeks of treatment, the GABA levels of the treatment group were higher than those of the control group, and the NE and DA levels were lower than the control group(P<0.05). After 4 weeks of treatment, the 5-HT level of the treatment group were higher than that of the control group(P<0.05). The total effective rate in the treatment group [96.00%(48/50)]was significantly higher than the rate of the control group [81.63%(40/49)](P<0.05). Conclusion: Jieyu Tiaoshen Acupuncture has a definite effect on the treatment of insomnia of liver depression and qi stagnation. It can significantly improve the patients with insomnia accompanied by anxiety, depression and other mental symptoms. It is safe and effective, and it is worthy of vigorous promotion and application.