腕踝针、安神散贴敷联合宁心汤治疗心脾两虚、气阴亏虚型癌因性失眠的临床研究

Curative effect of wrist-ankle acupuncture,Anshen Powder sticking combined with Ningxin Decoction for cancer-related insomnia of heart-spleen deficiency and Qi and Yin deficiency type

目的观察腕踝针、安神散贴敷联合宁心汤治疗心脾两虚、气阴亏虚型癌因性失眠的临床有效性。方法将70例心脾两虚、气阴亏虚型癌因性失眠患者按照随机数字表法分为2组。对照组35例予以常规睡眠管理、饮食指导、活动指导、疼痛管理、心理治疗及西医治疗,治疗组35例在对照组治疗基础上联合安神散穴位贴敷、腕踝针、宁心汤治疗。2组均治疗14 d。比较2组治疗前后匹兹堡睡眠质量指数(PSQI)评分、血清人脑源性神经营养因子(BDNF)变化情况,并统计2组疗效和治疗结束后1个月2组服用催眠药物情况。结果治疗组总有效率91.4%(32/35),对照组总有效率74.3%(26/35),治疗组临床疗效优于对照组(P<0.05)。2组治疗后PSQI各项评分及总分均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。2组治疗后血清BDNF水平均较本组治疗前升高(P<0.05),且治疗组治疗后高于对照组(P<0.05)。治疗组随访时继续服用阿普唑仑病例低于对照组(P<0.05)。结论与口服镇静催眠类药物相比,腕踝针、安神散贴敷联合宁心汤治疗能明显提高心脾两虚、气阴亏虚型癌因性失眠患者的睡眠质量,降低疲劳感,减少镇静催眠药物的服用量,改善了患者生活质量,值得临床推广。

Objective To observe the curative effect of wrist-ankle acupuncture(WAA),Anshen Powder sticking combined with Ningxin Decoction for cancer-related insomnia(heart-spleen deficiency and Qi and Yin deficiency type).Methods Totally 70 patients with cancer-related insomnia(heart-spleen deficiency and Qi and Yin deficiency type)were randomly assigned into the treatment group(n=35)and the control group(n=35).All patients were managed by conventional therapy,and those in the treatment group were additionally treated with WAA,Anshen Powder sticking combined with Ningxin Decoction.Treated for 14 days,the aim was to compare Pittsburgh Sleep Quality Index(PSQI)scores,Brain Derived Neurotrophic Factor(BDNF).The curative effect and sedative-hypnotic at 1-month follow-up were assessed.Results The overall effective rate in treatment group was better than that in control group(91.4%[32/35]vs 74.3%[26/35],[P<0.05],respectively).After treatment,PSQI scores in groups were decreased(P<0.05),which were decreased in the treatment group compared with the control group(P<0.05).BDNF levels in groups were increased(P<0.05),which were higher in the treatment group than in the control group(P<0.05).The follow-up dosage of alprazolam in the treatment group were lower than those in the control group(P<0.05).Conclusion Compared to sedative-hypnotic drugs,the three combination therapies can significantly improve sleep quality of these patients,decrease fatigue,reduce the dosage of sedative-hypnotic,improve the quality of life,it is worthy of clinical promotion.