基于调和阴阳理论针灸组方治疗老年肝郁化火型失眠

Clinical study on acupuncture and moxibustion in treating senile insomnia with the pattern of liver depression transforming into fifire based on the theory of regulating yin and yang

目的探讨基于调和阴阳理论针灸组方治疗老年肝郁化火型失眠的临床疗效。方法将老年肝郁化火型失眠患者80例按照随机数表法分为对照组与观察组,各40例。对照组采用西药治疗,观察组在对照组基础上联合调和阴阳法针灸治疗。观察2组治疗前后中医证候积分、多导睡眠图、匹兹堡睡眠质量指数量表(PSQI)、失眠严重程度指数量表(ISI)、爱普沃斯嗜睡量表(ESS)、血清单胺递质指标5-羟色胺(5-HT)、谷氨酸(GA)、神经肽Y(NPY)、γ-氨基丁酸(GABA)变化,并评价2组治疗总有效率和治疗安全性。结果观察组治疗后各项中医证候积分、睡眠潜伏期、觉醒时间、PSQI评分、ISI评分、ESS评分均低于对照组(P<0.05),睡眠总时间、快速眼动睡眠期、5-HT、GA、NPY、GABA指标均高于对照组(P<0.05);观察组治疗总有效率(92.5%,37/40)高于对照组(77.5%,31/40)(P<0.05);2组不良反应发生情况比较,差异无统计学意义(P>0.05)。结论基于调和阴阳理论的针灸组方联合西药治疗老年肝郁化火型失眠疗效明显,能够缓解患者不适症状,减轻日间嗜睡程度,调节神经递质表达,改善睡眠质量,且不良反应少。

Objective To explore the clinical efficacy of acupuncture and moxibustion in the treatment of senile insomnia with the syndrome of liver depression transforming into fire based on the theory of regulating yin and yang.Methods A total of 80 elderly insomnia patients with the liver depression transforming into fire syndrome were randomly divided into a control group and an observation group using a random number table method.The control group was treated with western medicine,while the observation group was additionally treated with acupuncture and moxibustion for regulating yin and yang.The changes in the traditional Chinese medicine syndrome scores,polysomnography,Pittsburgh Sleep Quality Index(PSQI)scores,Insomnia Severity Index(ISI)scores,Epworth Sleepiness Scale(ESS)scores,serum monoamine neurotransmitter indicators[5-hydroxytryptamine(5-HT),glutamate(GA),neuropeptide Y(NPY),γ-aminobutyric acid(GABA)]were observed before and after treatment in the two groups,and the total effective rate of treatment,safety were evaluated in the two groups.Results After treatment,the scores of various traditional Chinese medicine syndromes,sleep latency,awakening time,PSQI scores,ISI scores,and ESS scores were all lower in the observation group than those in the control group(P<0.05),while the total sleep time,rapid eye movement sleep period,5-HT,GA,NPY,GABA indicators,and total effective rate of treatment were all higher in the observation group than those in the control group(P<0.05).Both groups had fewer adverse reactions,and there was no statistically significant difference between the two groups(P>0.05).Conclusion Based on the theory of regulating yin and yang,the combination of acupuncture and moxibustion and western medicine has an obvious curative effect in treating senile insomnia with the syndrome of liver depression transforming into fire,which can alleviate the patients’uncomfortable symptoms,reduce the degree of daytime sleepiness,regulate the expression of neurotransmitters,improve the quality of sleep,and have fewer adverse reactions.