芳香按摩联合脐针对焦虑性失眠心肾不交证临床疗效观察

Clinical Efficacy Observation of Aromatherapy Massage Combined with Umbilical Acupuncture for AnxietyInduced Insomnia with Heart-kidney Imbalance Syndrome

目的:探讨芳香按摩联合脐针对焦虑性失眠(心肾不交证)患者的临床疗效和心理状态影响。方法:研究对象为2022年8月至2023年10月江西中医药大学附属医院88例焦虑性失眠(心肾不交型)患者,随机分为两组,有3例患者脱落,最终完成对照组43例、观察组42例。对照组患者予口服艾司唑仑,观察组患者采用芳香按摩联合脐针治疗,测定患者治疗前后的血清多巴胺(DA)和5-羟色胺(5-HT)水平,采用匹兹堡睡眠质量指数(PSQI)、汉密尔顿焦虑评分(HAMA)和中医证候积分作为结局指标,比较两组患者有效率和不良事件率。结果:治疗后观察组患者血清DA与5-HT水平高于对照组;治疗后观察组患者PSQI、HAMA评分低于对照组;治疗后观察组患者中医证候积分的主症、次症和总积分低于对照组;观察组患者总有效率为85.71%,高于对照组的74.42%,上述差异均具有统计学意义(P<0.05)。两组患者的不良反应率比较,差异无统计学意义(P>0.05)。结论:芳香按摩联合脐针治疗焦虑性失眠(心肾不交证)患者在临床应用上有效可靠,安全性和传统药物相当,能够改善睡眠状况和心理状态,其作用机制与调控血清情绪相关神经递质有关。

Objective To explore the clinical efficacy and psychological impact of aromatherapy massage combined with umbilical acupuncture on patients with anxiety-induced insomnia(Heart-kidney imbalance syndrome).Methods The subjects were 88 cases of anxiety-induced insomnia(Heart-kidney imbalance type)from August 2022 to October 2023 in the Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine.They were randomly divided into two groups,with 3 patients dropping out,resulting in 43 cases in the control group and 42 cases in the observation group.The control group received oral estazolam,while the observation group was treated with aromatherapy massage combined with umbilical acupuncture.Serum dopamine(DA)and 5-hydroxytryptamine(5-HT)levels were measured before and after treatment.The Pittsburgh sleep quality index(PSQI),Hamilton anxicty scale(HAMA),and Traditional Chinese Medicine(TCM)syndrome scores were used as outcome measures to compare the efficacy and adverse event rates between the two groups.Results After treatment,the serum levels of DA and 5-HT in the observation group were higher than those in the control group;the scores of PSQI and HAMA in the observation group were lower than those in the control group;the TCM syndrome scores for primary,secondary,and total symptoms in the observation group were lower than those in the control group;the total effective rate in the observation group was 85.71%,higher than the 74.42%in the control group.All these differences were statistically significant(P<0.05).There was no statistically significant difference in the adverse reaction rate between the two groups(P>0.05).Conclusion Aromatherapy massage combined with umbilical acupuncture is effective and reliable in the clinical treatment of anxiety-induced insomnia patients with Heart-kidney imbalance syndrome.It has similar safety to traditional medications and can improve sleep and psychological status.Its mechanism of action is related to the regulation of serum neurotransmitters associated with mood.