温针灸脐周四边穴治疗慢性失眠

Observation on the therapeutic effect of warming acupuncture and moxibustion at the four points around the navel in the treatment of chronic insomnia

目的探讨温针灸脐周四边穴治疗慢性失眠的临床疗效及对日间脑功能状态的影响。方法将100例慢性失眠患者按照随机数表法分成观察组与对照组,各50例。对照组口服思诺思治疗,观察组在对照组基础上联合温针灸脐周四边穴治疗。观察2组治疗前和治疗4周后中医心脾两虚证证候积分、匹兹堡睡眠质量指数(PSQI)、失眠严重指数量表(ISI)评分、疲劳量表-14(FS-14)、多导睡眠监测(PSG)指标、日间脑功能状态、血清褪黑素(MT)、多巴胺(DA)、5-羟色胺(5-HT)改善状况,比较2组临床疗效总有效率和治疗安全性。结果治疗后观察组中医心脾两虚证证候积分,PSQI评分,ISI评分,FS-14评分,睡眠潜伏期、入睡后的觉醒时间、日间脑功能状态评分、DA指标均低于对照组(P<0.05),总睡眠时间、睡眠效率、MT、5-HT指标均高于对照组(P<0.05);观察组总有效率(92.00%,46/50)高于对照组(78.00%,39/50);2组均未发生因服用药物或针灸引起的不良反应。结论温针灸脐周四边穴治疗慢性失眠疗效明显,可调节中枢神经系统,减轻机体疲劳感,改善日间脑功能状态,提高整体睡眠质量,治疗安全性较高。

Objective To explore the therapeutic effect of warming acupuncture and moxibustion at four points around the navel in the treatment of chronic insomnia and its influence on daytime brain function.Methods A total of 100 patients with chronic insomnia were randomly divided into an observation group and a control group.The control group was treated with oral administration of sinox,while the observation group was treated with warming acupuncture and moxibustion at the four points around the navel on the basis of sinox.The TCM heart and spleen deficiency syndrome scores,Pittsburgh Sleep Quality Index(PSQI)scores,Insomnia Severity Index(ISI)scores,Fatigue Scale-14(FS-14)scores,polysomnography(PSG)indicators,daytime brain function status,the improvement of serum melatonin(MT),dopamine(DA),5-hydroxytryptamine(5-HT)were observed before and after 4 weeks of treatment in the two groups,and the total effective rate and treatment safety were compared between the two groups.Results After treatment,The TCM heart and spleen deficiency syndrome scores,PSQI scores,ISI scores,FS-14 scores,scores of sleep latency,wake-up time after falling asleep and daytime brain function status,and level of DA indicators were lower in the observation group than those in the control group(P<0.05),while the total sleep time,sleep efficiency,levels of MT and 5-HT were higher than those in the control group(P<0.05).The total effective rate of the observation group was 92.00%(46/50),higher than that of the control group(79.00%,39/50).Both groups had no adverse reactions caused by medication or acupuncture and moxibustion treatment.Conclusion Warming acupuncture and moxibustion at the four points around the navel can achieve an obvious curative effect in the treatment of chronic insomnia,regulating the central nervous system,reducing fatigue,improving the daytime brain function,improving the overall sleep quality,and having high therapeutic safety.