中药穴位贴敷对不同证型多病共存老年失眠症临床研究

Clinical Study on Point Application with Chinese Herbal Medicine for Senile Insomnia with Coexistence of Multiple Diseases of Different Syndrome Types

目的:观察中药穴位贴敷对不同中医证型多病共存老年失眠症的临床疗效。方法:纳入符合肝郁化火、痰热内扰、阴虚火旺、心脾两虚、心虚胆怯型的多病共存的老年失眠症患者各60例,均随机分成对照组与观察组各30例。2组患者基础疾病均给予西医常规治疗、生活习惯及心理状态的指导。对照组给予艾司唑仑片,观察组给予中药穴位贴敷。观察2组近期临床疗效、匹兹堡睡眠质量指数(PSQI)、疲劳量表-14 (FS-14)评分,以及药物不良反应情况。结果:临床疗效总有效率观察组64.00%,对照组30.00%,2组比较,差异有统计学意义(P<0.05)。不同证型睡眠疗效比较,观察组肝郁化火型、痰热内扰型、阴虚火旺型睡眠疗效分别与对照组比较,差异均有统计学意义(P<0.05)。观察组入睡时间、睡眠障碍、日间功能评分均低于对照组(P<0.05);观察组肝郁化火型、阴虚火旺型、痰热内扰型PSQI总分低于对照组(P<0.05);不同证型观察组入睡时间评分均低于对照组(P<0.05);除心脾两虚型外其余证型睡眠障碍评分观察组也低于对照组(P<0.05);观察组肝郁化火型、痰热内扰型睡眠质量评分低于对照组(P<0.05);观察组痰热内扰型、阴虚火旺型日间功能评分低于对照组(P<0.05)。观察组肝郁化火型、痰热内扰型、心虚胆怯型FS-14评分均低于对照组,差异均有统计学意义(P<0.05)。2组治疗期间均未出现相关不良反应。结论:多病共存老年失眠症采用中药穴位贴敷治疗疗效显著,尤其适合存在阳亢及痰热等证候特征的老年失眠人群,可缩短入睡时间,减少睡眠障碍的发生,不良反应少。

Objective:To observe the clinical effect of point application with Chinese herbal medicine for senile insomnia with coexistence of multiple diseases of different syndrome types of Chinese medicine.Methods:Sixty cases of senile insomnia patients with coexistence of multiple diseases of liver constraint transforming into fire type,phlegm-heat harassing the interior type,yin deficiency resulting in vigorous fire type, deficiency of both the heart and spleen type, and heart deficiency with timidity type were respectively included, and each type was randomly divided into the control group and the observation group, with 30 cases in each group of each type respectively. Both groups were given routine western medicine treatment,life habits and psychological guidance for their basic diseases. The control group was treated with Estazolam Tablets,and the observation group was treated with point application with Chinese herbal medicine. The recent clinical effects, scores of Pittsburgh Sleep Quality Index(PSQI) and Fatigue Scale-14(FS-14), and adverse drug reactions were observed in the two groups. Results: The total effective rate of clinical effect was 64.00% in the observation group and 30.00% in the control group,the difference being significant(P<0.05). Compared with those in the control groups of different syndrome types,there were significant differences being found in the comparison of sleep effects in the observation groups of liver constraint transforming into fire type, phlegm-heat harassing the interior type, and yin deficiency resulting in vigorous fire type(P<0.05). The scores of time before falling asleep, sleep disorders, daytime function in the observation groups were lower than those in the control groups(P<0.05);the PSQI scores in the observation groups of liver constraint transforming into fire type, yin deficiency resulting in vigorous fire type, and phlegm-heat harassing the interior type were lower than those in the control groups(P<0.05);the scores of time before falling asleep in the observation groups of different syndrome types were lower than those in the control groups(P<0.05);the scores of sleep disorders in the observation groups of the other syndrome types except deficiency of both the heart and spleen type were lower than those in the control groups(P<0.05);the scores of sleep quality in the observation groups of liver constraint transforming into fire type and phlegm-heat harassing the interior type were lower than those in the control groups(P<0.05);the scores of daytime function in the observation groups of phlegm-heat harassing the interior type and yin deficiency resulting in vigorous fire type were lower than those in the control groups(P<0.05). The FS-14 scores in the observation groups of liver constraint transforming into fire type,phlegm-heat harassing the interior type,and heart deficiency with timidity type were lower than those in the control groups, differences being significant(P<0.05). There was no related adverse reactions being found in the two groups during treatment. Conclusion: Point application with Chinese herbal medicine has a significant curative effect in treating senile insomnia with coexistence of multiple diseases,especially for those with elderly insomnia population with the syndrome characteristics of yang hyperactivity and phlegm-heat,which can shorten the time before falling asleep,and reduce the occurrence of sleep disorders,with few adverse reactions.