脐四边穴针刺疗法联合益心健脾安神方治疗老年心脾两虚型失眠的临床观察

Effect of Qisibian Points Combined with Yixin Jianpi Anshen Prescription on Elderly Insomnia Patients with Deficiency of Both Heart and Spleen

目的:探讨以脐四边穴为主穴的针刺疗法联合益心健脾安神方对老年心脾两虚型失眠病人快速动眼睡眠、睡眠质量及认知功能的影响。方法:选取2020年7月—2021年12月郑州市中医院收治的老年心脾两虚型失眠病人78例为研究对象,采用随机数字表法分为参照组与研究组,每组39例。参照组实施益心健脾安神方治疗方案,研究组实施以脐四边穴为主穴的针刺疗法联合益心健脾安神方治疗方案。评定两组治疗4周后临床治疗总有效率、中医证候评分、匹兹堡睡眠质量指数(PSQI)、快速动眼睡眠期时间、蒙特利尔认知评估量表(MoCA)评分。结果:治疗4周后,研究组临床治疗总有效率、MoCA评分均高于参照组(P<0.05);中医证候评分、PSQI量表评分均低于参照组(P<0.05);治疗4周后,研究组快速动眼睡眠期时间长于参照组(P<0.05)。结论:以脐四边穴为主穴的针刺疗法联合益心健脾安神方用于老年心脾两虚型失眠病人,临床效果更佳,可控制症状,延长总睡眠时间和快速动眼睡眠潜伏期时间,提高睡眠质量,并改善认知功能。

Objective:To explore the effect of Qisibian points combined with Yixin Jianpi Anshen Prescription on elderly patients insomnia with deficiency of both heart and spleen.Methods:A total of 78 elderly insomnia patients with heart and spleen deficiency were were divided into control group and research group by random number table method,with 39 cases in each group.The control group implemented the Yixin Jianpi Anshen prescription treatment plan,and the study group implemented the acupuncture therapy combined with Yixin Jianpi Anshen prescription treatment and acupuncture of Qisibian points.The total effective rate of clinical treatment,TCM syndrome score,Pittsburgh Sleep Quality Index(PSQI),rapid eye movement sleep period time,and Montreal Cognitive Assessment Scale(MoCA)score were evaluated after 4 weeks of treatment in both groups.Results:After 4 weeks of treatment,the total clinical treatment effective rate and MoCA score of the study group were higher than those of the control group(P<0.05);TCM syndrome score and PSQI scale score were lower than those of the control group(P<0.05).After 4 weeks of treatment,the REM sleep period in the study group was longer than that in the control group(P<0.05).Conclusion:Qisibian points as the main point combined with Yixin Jianpi Anshen prescription for elderly insomnia patients with both heart and spleen deficiency shows better clinical effect,which can control symptoms,extend total sleep time and rapid eye movement sleep latency time,improve sleep quality and cognitive function.