调心安神针刺法联合认知行为疗法对慢性失眠症患者的影响

Effect of heart regulating and mind calming acupuncture combined with cognitive behavioraltherapy on patients with chronic insomnia

目的探讨调心安神针刺法联合认知行为疗法对慢性失眠症(CID)患者的影响。方法前瞻性选取陕西中医药大学附属医院2021年9月至2023年8月收治的CID患者102例,按照随机抽签法分为对照组、观察组,各51例。对照组男29例、女22例,年龄(40.26±8.54)岁;观察组男27例、女24例,年龄(42.73±8.15)岁。对照组给予认知行为疗法,观察组给予调心安神针刺法联合认知行为疗法,两组均每周干预1次,持续4周。统计对比两组治疗效果,治疗前与治疗4周失眠严重指数量表(ISI)、匹兹堡睡眠质量指数(PSQI)、焦虑自评量表(SAS)、抑郁自评量表(SDS)评分及血清神经递质水平。组间比较采用独立样本t检验、χ^(2)检验。结果观察组治疗总有效率为96.08%(49/51),高于对照组的84.31%(43/51),差异有统计学意义(χ^(2)=3.991,P=0.046)。治疗4周,观察组ISI、PSQI评分分别为(9.53±2.74)分、(6.17±2.45)分,均低于对照组[(11.23±2.58)分、(10.32±2.62)分],差异均有统计学意义(均P<0.05);观察组γ-氨基丁酸、谷氨酸水平分别为(10.42±1.32)ng/L、(17.42±0.92)μmol/L,均高于对照组[(8.61±0.95)ng/L、(15.62±1.24)μmol/L],差异均有统计学意义(均P<0.05);观察组SAS、SDS评分分别为(31.42±5.52)分、(36.15±6.43)分,均低于对照组(39.63±5.47)分、(41.62±5.79)分,差异均有统计学意义(均P<0.05)。结论调心安神针刺法联合认知行为疗法治疗CID患者效果确切,能减轻失眠程度,改善睡眠质量,提高血清神经递质水平,缓解不良情绪。

Objective To analyze the effect of heart regulating and mind calming acupuncture combined with cognitive behavioral therapy on patients with chronic insomnia(CID).Methods One hundred and two patients with CID treated at Hospital Affiliated to Shaanxi University of Chinese Medicine from September 2021 to August 2023 were selected,and divided into a control group and an observation group by lottery,with 51 cases in each group.There were 29 males and 22 females in the control group;they were (40.26±8.54) years old. There were27 males and 24 females in the observation group;they were (42.73±8.15) years old. The controlgroup received cognitive-behavioral therapy, while the observation group received heart regulatingand mind calming acupuncture and cognitive-behavioral therapy. Both groups were intervened oncea week for 4 weeks. The treatment effects and scores of Insomnia Severity Index (ISI), PittsburghSleep Quality Index (PSQI), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS)and serum neurotransmitter levels before the treatment and after 4 weeks' treatment werecompared between the two groups. Independent-sample t test and χ^(2) test were applied. Results The total effective rate of the observation group was higher than that of the control group [96.08%(49/51) vs. 84.31% (43/51)], with a statistical difference (χ^(2)=3.991, P=0.046). After 4 weeks'treatment, the scores of ISI and PSQI in the observation group were lower than those in the controlgroup [(9.53±2.74) vs. (11.23±2.58) and (6.17±2.45) vs. (10.32±2.62)], with statistical differences(both P<0.05). After 4 weeks' treatment, the levels of γ -aminobutyric acid and glutamic acid in theobservation group were higher those in the control group [(10.42±1.32) ng/L vs. (8.61±0.95) ng/Land (17.42±0.92) μmol/L vs. (15.62±5.52) μmol/L], with statistical differences (both P<0.05).After 4 weeks' treatment, the scores of SAS and SDS in the observation group were lower than thosein the control group [(31.42±5.52) vs. (39.63±5.47) and (36.15±6.43) vs. (41.62±5.79)], withstatistical differences (both P<0.05). Conclusion Heart regulating and mind calming acupuncturecombined with cognitive behavioral therapy for patients with CID can improve the treatment effect,alleviate their insomnia, improve their sleep quality and serum neurotransmitter levels, and alleviatetheir adverse emotions.