【作者】 杜鹃；

【导师】 张宏；

【作者基本信息】 广州中医药大学 ， 针灸推拿学， 2012， 博士

【摘要】 目的对照观察针刺调神方、常规针刺处方对失眠症的治疗效果,比较两者的疗效特点和差异,并探讨调神针刺方治疗失眠症的作用机理。方法将62例符合纳入标准的患者随机分为两组,以针刺调神方为治疗组,以常规针刺处方为对照组,治疗组31例,对照组31例。治疗组取穴：四神聪、神庭、印堂、内关双、三阴交双、天枢双、中脘、关元。对照组取穴：印堂、四神聪、安眠双、神门双、照海双、申脉双,随证配穴：肝火扰心加行间、侠溪；痰热内扰加丰隆、内庭；心脾两虚加心俞、脾俞；心肾不交加心俞、肾俞；心胆气虚加心俞、胆俞。治疗前后均采用SPIEGEL量表、Athens失眠量表(AIS)、匹兹堡睡眠质量指数量表(PSQI)、抑郁自评量表(SDS)、焦虑自评量表(SAS)进行评分疗效比较。成果两组治疗后各量表评分均有降低,其差异具有统计学意义(P<0.05),两组PSQI各项目评分治疗前后比较有显著差异(P<0.01),治疗后各项目中,在总睡眠质量、日间功能和睡眠障碍的功能评定上,治疗组优于对照组(P<0.05)。两组治疗后总有效率无显著差异,但治疗组的愈显率要高于对照组(P<0.05)。结论针刺调神方与常规针刺处方对失眠症均具有治疗作用,二者总体临床疗效无明显差异,但在愈显率方面针刺调神方组高于常规针刺处方组；两组临床睡眠质量总体评价无明显差异,针刺调神方组在改善睡眠质量、日间功能、睡眠障碍上要优于常规针刺处方组。更多还原

【Abstract】 ObjectiveThe study will observe the effect of acupuncture with the method of reg ulating the spirit,compared to the common method with acupuncture,further more,contract the characteristics and the differences between the two met hods,and explore the mechanism of the better one.MethodsIn this trial,the62patients who meet the standards,are randomly assig ned to the two groups,one is the treatment group,including31patients,us ing the method of regulating the spirit,the other one is the control grou p, also including31patients, using the method of the common method.the p oints in treatment group are:sishencong(EX-HN1),shenting(GV24),yintang(EX-HN3),neiguan(P6),san yinjiao(SP6),tianshu(S25),zhognwan(CV12),guanyuan(C V4).the points in the control group are:yintang(EX-HN3),sishencong(EX-HN1),anmian(EX1),shenmen(H7),zhaohai(K6),shenmai(BL-62),the minor points ar e:xingjian(L2) and xiaxi(GB43),corresponding to liver fire harassing th e heart type,fenglong(S40) and neiting(ST44),corresponding to internal d isturbance of pyrophlegm and fire type,xinshu(BL15) and pishu(BL20),corre sponding to the weakness of heart and spleen,xinshu(BL15) and shenshu(BL23),corresponding to the incoherence of heart and kidney type,xinshu(BL15) and danshu(BL19),corresponding to deficiency of heart-qi and gallbladder-qi type.score will be counted by using the five scales,including SPIEG EL, Athens,PSQI,SDA,SAS scale before and after the treatment to judge the clinical efficacy.ResultsThe score of the5scales in two groups are all lowered after the treatment,and the comparisons of total score have significant differences(P<0.05). the comparisons of each item of PSQI of the two groups have significant differences(P<0.01). The treatment group is better than those of control group at the aspects of sleep quality,daytime function and sleep disorder(P<0.05).There is no significant difference in the total effective rate between the two groups,while there is significant difference in the recovery and the effectual rate(P<0.05).ConclusionThe two methods all have clinical treatment effect,and have no difference in total treatment effect,but the rate of recovery and effectual rate are better than the control group.the overall evaluations of the two groups have no apparent difference,while the treantment group is better than the control group on sleep quality,daytime function and sleep disorder.更多还原