浅针刺激镇静、山根穴治疗原发性失眠29例

29 Cases of Primary Insomnia Treated by Superficial Needling at Zhenjing and Shangen Extra-Acupoints

目的观察浅针刺激镇静、山根穴治疗原发性失眠的疗效,并探讨其对血清下丘脑-垂体-肾上腺轴(HPA轴)激素促肾上腺皮质激素(ACTH)、皮质醇(COR)、促肾上腺皮质激素释放激素(CRH)的影响。方法选取2022年8月—2023年9月在福建中医药大学附属康复医院门诊就诊的原发性失眠患者60例,按照随机数字表法分为对照组和观察组各30例,最终对照组完成30例,观察组完成29例。对照组给予艾司唑仑片,临睡前30 min服用,每日1片,7 d为1疗程,共2个疗程。观察组取镇静、山根穴进行浅针手法治疗,每周治疗5次,5次为1个疗程,共2个疗程,中间间隔2 d。观察2组治疗前后匹兹堡睡眠质量指数量表(PSQI)总分及各项评分,外周血清中ACTH、COR、CRH含量的变化,并比较2组临床疗效。结果与治疗前比较,治疗后2组的血清ACTH、COR、CRH含量,PSQI总分及各项评分均降低(P<0.05)。与对照组比较,观察组日间功能障碍评分下降(P<0.05)。观察组总有效率为75.86%,对照组总有效率为73.77%,差异无统计学意义(P>0.05)。结论浅针疗法治疗原发性失眠有效,尤其是在提高日间功能障碍评分方面优于常规治疗,其作用机理可能与降低血清中HPA轴激素ACTH、COR、CRH含量有关。

Objective:To observe the curative effect of superficial needling at Zhenjing and Shangen extra-acupoints in the treatment of the primary insomnia,and to discuss its effect on adrenocorticotropic hormone(ACTH),cortisol(COR)and corticotropin releasing hormone(CRH)in the peripheral serum.Methods:60 outpatients with primary insomnia who were admitted to the Affiliated Rehabilitation Hospital of Fujian University of Traditional Chinese Medicine from August 2022 to September 2023 were divided into control group and observation group by random number table method,with 30 cases in each group.Finally,30 cases in control group and 29 cases in observation group were completed in the study.Patients in the control group took one estazolam tablet orally 30 minutes before bedtime a day,7 days as a course of treatment,for a total of 2 courses.Patients in the observation group were treated by superficial needling at Zhenjing and Shangen extra-acupoints,5 times a week as a course of treatment,for a total of 2 courses with an interval of 2 days.The total scale and each scale of the pittsburgh sleep quality index(PSQI),the changes of ACTH,COR and CRH content in the peripheral serum were observed before and after treatment,and the curative effect between the two groups was compared.Results:Compared with those before treatment,the ACTH,COR and CRH content in the peripheral serum,the total scale and each scale of the PSQI decreased in the two groups(P<0.05).Compared with the control group,the daytime dysfunction score decreased in the observation group(P<0.05).The total clinical efficiency was 75.86%in the observation group and 73.77%in the control group,there was no significant difference between the two groups(P>0.05).Conclusion:The superficial needling is effective in treating primary insomnia,especially in the improvement of daytime dysfunction,and its mechanism may be related to the reduction of ACTH,COR,CRH content in the peripheral serum.