针刺“脐四边穴”对慢性失眠及其并发症的影响

Acupuncture at"umbilical four-acupoints"for chronic insomnia and its comorbid symptoms

目的:观察针刺“脐四边穴”对慢性失眠及其并发症的影响。方法:将120例慢性失眠患者随机分为观察组(60例,脱落8例)和对照组(60例,脱落5例)。观察组在常规取穴(百会及双侧神门、内关、安眠)的基础上配合“脐四边穴”进行针刺治疗,对照组仅取常规穴位针刺治疗,均每日1次,一周6次,共治疗3周。观察两组患者治疗前后及治疗后1个月随访时匹兹堡睡眠质量指数(PSQI)和失眠严重程度指数(ISI)评分,治疗前后Beck焦虑量表(BAI)、Beck抑郁量表(BDI)、疲劳严重度量表(FSS)、Epworth嗜睡量表(ESS)评分,并应用多导睡眠记录仪观察两组患者治疗前后多导睡眠图(PSG)睡眠参数[睡眠潜伏期(SL)、觉醒时间(AT)、睡眠效率(SE)、实际总睡眠时间(TST)]。结果:两组患者治疗后及随访时,PSQI和ISI评分均较治疗前降低(P<0.05),且观察组低于对照组(P<0.05)。治疗后,两组患者BAI、BDI、FSS和ESS评分均较治疗前降低(P<0.05),且观察组低于对照组(P<0.05)。治疗后两组患者SL、AT较治疗前降低(P<0.05),SE、TST较治疗前升高(P<0.05);观察组SL、AT低于对照组(P<0.05),SE、TST高于对照组(P<0.05)。结论:在常规取穴基础上,针刺“脐四边穴”可提高慢性失眠患者睡眠质量,减轻失眠严重程度,改善并发的焦虑、抑郁、疲劳和嗜睡症状。

Objective To observe the effects of acupuncture at"umbilical four-acupoints"on chronic insomnia and its comorbid symptoms.Methods A total of 120 patients with chronic insomnia were randomly divided into an observation group(60 cases,8 cases dropped off)and a control group(60 cases,5 cases dropped off).The patients in the observation group were treated with acupuncture at regular acupoints(Baihui[GV 20]and bilateral Shenmen[HT 7],Neiguan[PC 6],Anmian[Extra]and"umbilical four-acupoints",while the patients in the control group were treated with acupuncture at regular acupoints.Acupuncture was given once a day,6 times a week,for a total of 3 weeks in the two groups.The Pittsburgh sleep quality index(PSQI),insomnia severity index(ISI)scores were observed before treatment,after treatment and in follow-up of one month after treatment completion;the Beck anxiety inventory(BAI),Beck depression inventory(BDI),fatigue severity scale(FSS),and Epworth sleepiness scale(ESS)scores were observed before and after treatment;the sleep parameters of polysomnography(PSG),including sleep latency(SL),awake-up time(AT),sleep efficiency(SE)and total sleep time(TST),were observed before and affer treatment using polysomnography monitor in the two groups.Results Compared with those before treatment,the PSQI and ISI scores in both groups were reduced after treatment and in follow-up(P<0.05),and the PSQI and ISI scores in the observation group were lower than those in the control group after treatment and in follow-up(P<0.05).Compared with those before treatment,the BAI,BDI,FSS and ESS scores in both groups were reduced after treatment(P<0.05),and the BAI,BDI,FSS and ESS scores in the observation group were lower than those in the control group after treatment(P<0.05).Compared with those before treatment,the SL and AT in both groups were reduced after treatment(P<0.05),while SE and TST were increased after treatment(P<0.05);after treatment,the SL and AT in the observation group were lower than those in the control group(P<0.05),while SE and TST in the observation group were higher than those in the control group(P<0.05).Conclusion On the basis of regular acupoint selection,acupuncture at"umbilical four-acupoints"could improve sleep quality,alleviate the severity of insomnia,and improve the comorbid symptoms i.e.anxiety,depression,fatigue and lethargy in patients with chronic insomnia.