温胆汤化裁联合脐针治疗痰热内扰型失眠的临床研究

Clinical study of modified Wendan decoction combined with umbilical acupuncture for the treatment of insomnia with phlegm⁃heat internal disturbance

目的:研究温胆汤化裁联合脐针治疗痰热内扰型失眠的临床疗效。方法:选取我院2021年3月至2023年2月门诊的80例痰热内扰型失眠患者为研究对象,随机分为2组,每组40例。治疗组采用温胆汤化裁联合脐针治疗,对照组采用艾司唑仑治疗,疗程4周。观察比较两组患者治疗前后匹兹堡睡眠质量指数(PSQI)评分及中医症状积分,同时评价两组治疗后临床有效率。结果:两组治疗后PSQI各因子评分均较治疗前明显下降(P<0.05),治疗组除入睡时间因子治疗后与对照组无显著差异外,其余睡眠质量、睡眠时间、睡眠效率、睡眠障碍、日间功能均较对照组治疗后明显改善(P<0.05)。两组治疗后中医症状评分总分均较治疗前明显下降(P<0.05);与对照组治疗后相比较,治疗组所有主症及次症积分治疗后更低(P<0.05)。治疗组总有效率为92.5%,对照组为80%,两组无显著差异(P>0.05)。结论:温胆汤化裁联合脐针治疗痰热内扰型失眠疗效与艾司唑仑相当,但能有效缓解心烦懊憹、胸闷脘痞、口苦、痰多、头晕目眩等伴随症状。

Objective:To study the clinical efficacy of modified Wendan decoction combined with umbilical acupuncture for the treatment of insomnia with phlegm-heat internal disturbance.Methods:80 patients with phlegm-heat internal disturbance type insomnia in our outpatient department from March 2021 to February 2023 were selected as the research subjects and randomly divided into two groups,with 40 cases in each group.The treatment group was treated with modified Wendan decoction combined with umbilical acupuncture,and the control group was treated with estazolam.Both groups were treated for 4 weeks.Observe and compare the Pittsburgh Sleep Quality Index(PSQI)scores and Traditional Chinese Medicine(TCM)symptom scores of two groups of patients before and after treatment,and evaluate the clinical effective rate of the two groups after treatment.Results:After treatment,the scores of PSQI factors in both groups were significantly decreased compared with those before treatment(P<0.05).Except for the factor of sleep onset time,the other five factors of sleep quality,sleep time,sleep efficiency,sleep disturbance and daytime function in the treatment group were significantly improved than those in the control group after treatment(P<0.05).The total scores of TCM symptoms in the two groups after treatment were significantly lower than those before treatment(P<0.05).Compared with the control group after treatment,the scores of all primary and secondary symptoms in the treatment group were lower after treatment(P<0.05).The total effective rate of the treatment group was 92.5%,while the control group was 80%.There was no significant difference between the two groups(P>0.05).Conclusions:The combination of modified Wendan decoction and umbilical acupuncture in the treatment of insomnia with phlegm-heat internal disturbance has a similar therapeutic effect comparable to that of eszolam,but it can effectively alleviate accompanying symptoms such as upset,chest tightness and abdominal distension,bitter mouth,excessive phlegm and dizziness.