肿瘤伴失眠患者的热敏腧穴分布情况及热敏灸临床疗效观察

Distribution of Heat-sensitive Acupoints and Clinical Effect of Heat-sensitive Moxibustion in Tumor Patients with Insomnia

目的观察热敏灸和口服艾司唑仑治疗肿瘤患者失眠的临床疗效,统计肿瘤伴失眠患者高频热敏化腧穴分布。方法将70例肿瘤伴失眠患者随机分为对照组35例和试验组35例。对照组采用口服艾司唑仑治疗方案,该组于药物治疗展开前进行1次热敏化腧穴探查,并对热敏化腧穴予以记录;试验组进行热敏化腧穴探查并记录其热敏化腧穴后,依据探查结果选取灸感较好的两个穴位进行为期2周、每日1次的热敏灸治疗。比较两组患者治疗前后匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)、焦虑自评量表(self-rating anxiety scale,SAS)、抑郁自评量表(self-rating depression scale,SDS)评分,治疗后以及随访时基于两组患者PSQI评分进行疗效比较。结果两组患者治疗后PSQI评分均较治疗前显著减少(P<0.05);两组患者随访时PSQI评分以及治疗前与随访时PSQI评分的差值比较,差异均有统计学意义(P<0.05)。两组患者治疗后SAS评分、SDS评分均较治疗前显著减少(P<0.05);两组患者治疗后SAS评分、SDS评分差值比较,差异均无统计学意义(P>0.05)。治疗后两组患者基于PSQI评分的疗效比较,差异无统计学意义(P>0.05);随访时两组患者基于PSQI评分的疗效比较,差异有统计学意义(P<0.05)。两组热敏化腧穴共计347个,其中高发热敏穴区敏感的腧穴有261个。其中位于前五的高频热敏腧穴分布区域包括内关穴(旁)、阴陵泉穴(旁)、手三里穴(旁)、曲池穴(旁)、阳陵泉穴(旁)。结论热敏灸能有效改善患者睡眠情况,同时也可缓解患者的焦虑症状以及抑郁症状;在停止治疗后,热敏灸能维持较长期的疗效;肿瘤伴失眠患者的热敏腧穴为内关穴(旁)、阴陵泉穴(旁)、手三里穴(旁)、曲池穴(旁)、阳陵泉穴(旁)。

Objective To investigate the clinical efficacy of heat-sensitive moxibustion versusoral estazolamin the treatment of insomnia in tumor patients and the distribution of high-frequency heat-sensitized acupoints by exploring the heat-sensitized acupoints in tumor patients with insomnia.Methods A total of 70 tumor patients with insomnia were randomly divided into control group(oral estazolam)and experimental group(heat-sensitive moxibustion),with 35 patients in each group.The patients in the control group were givenoral estazolam and received the exploration of heat-sensitized acupoints once before pharmacotherapy to record the heat-sensitized acupoints;after heat-sensitized acupoints were explored and recorded,the patients in the experimental group were given heat-sensitive moxibustion,once a day for 2 weeks,at the two acupoints with the best sense of moxibustion based on the results of exploration.The two groups were compared in terms of Pittsburgh sleep quality index(PSQI),self-rating anxiety scale(SAS),and self-rating depression scale(SDS)scores,and treatment outcome was compared between the two groups based on PSQI score after treatment and at follow-up.Results Both groups had a significant reduction in PSQI score after treatment(P<0.05),and there were significant differences between the two groups in PSQI score at follow-up and the change in PSQI score from before treatment to at follow-up(P<0.05).Both groups had significant reductions in SAS and SDS scores after treatment(P<0.05),and there were no significant differences in the changes in SAS and SDS scores after treatment between the two groups(P>0.05).There was no significant difference between the two groups in treatment outcome based on PSQI score after treatment(P>0.05),while there was a significant difference between the two groups in treatment outcome based on PSQI score at follow-up(P<0.05).There were 347 heat-sensitized acupoints in the two groups,among which 261 were the most sensitive acupoints in the heat-sensitive areas,and the top 5 high-frequency distribution areas of heat-sensitized acupoints included Neiguan(side),Yinlingquan(side),Shousanli(side),Quchi(side),and Yanglingquan(side).Conclusion Heat-sensitive moxibustion can effectively improve sleep and relieve anxiety and depression symptoms,and after heat-sensitive moxibustion is stopped,it can maintain the effect for a longer period of time than estazolam.Heat-sensitized acupoints include Neiguan(side),Yinlingquan(side),Shousanli(side),Quchi(side),and Yanglingquan(side)in tumor patients with insomnia.