[关键词]
[摘要]
目的:评价调督安神法针灸治疗原发性失眠的临床疗效及安全性。方法:本研究采用患者随机对照试验设计,将72例原发性失眠患者按1∶1比例分为治疗组和对照组。治疗组以调督安神法为治疗原则进行针灸治疗,要求得气,取穴百会、神庭、印堂、神门、安眠、三阴交;对照组为假针灸治疗,假针灸针不刺破皮肤,取穴同治疗组。两组每次均治疗30 min,每周3次,连续治疗4周。分别在治疗前、治疗2周、治疗4周以及治疗结束后2周、4周随访时对患者进行失眠严重程度指数(ISI)、焦虑自评量表(SAS)以及抑郁自评量表(SDS)的评估,观察并记录针灸的不良反应。结果:治疗组完成32例,脱落4例;对照组完成30例,脱落6例。与治疗前相比,两组的ISI评分在治疗后及随访时有显著性差异(P<0.01);与对照组相比,治疗组在治疗4周、治疗结束后2周、4周随访时评分差异有统计学意义(P<0.05),但在治疗2周时差异无统计学意义(P>0.05)。与对照组相比,治疗组的SAS及SDS评分在治疗4周、治疗结束后2周、4周随访时有显著性差异(P<0.01,P<0.05),但在治疗2周时差异无统计学意义(P>0.05)。两组针灸疗法不良事件发生率比较,差异无统计学意义(P>0.05)。结论:调督安神法针灸方案治疗原发性失眠临床疗效显著,安全性高。
[Key word]
[Abstract]
This study was aimed to evaluate the efficacy and safety of acupuncture based on regulating Du meridian and calming mind in the treatment of primary insomnia. A patient-blinded, randomized controlled trial was designed. A total of 72 primary insomnia patients were randomly divided into the treatment group and the control group. Patients in the treatment group received acupuncture with deqi sensation at DU- 20 Baihui, DU- 24 Shenting, EX Yintang, HT- 7 Shenmen, EX Anmian and SP-6 Sanyinjiao. Patients in the control group received sham acupuncture without needle insertion at the same acupoints. All sessions of acupuncture treatment were conducted for 30 minutes each time, 3 times a week, for 4 consecutive weeks. The insomnia severity index (ISI), anxiety self-rating scale (SAS) and depression selfrating scale (SDS) were measured before treatment, 2-week treatment, 4-week treatment, 2 weeks and 4 weeks after treatment. Adverse reactions of acupuncture treatment were also recorded. The results showed that the treatment group completed 32 cases, 4 cases off; the control group completed 30 cases, 6 cases off. Compared with those before treatment, the ISI scores of both groups were significantly different after treatment and at follow-up (P < 0.01). Compared with the control group, there was statistical difference in the treatment group at 4-week treatment, 2 weeks and 4 weeks after treatment (P < 0.05). However, there was no statistical significance at 2-week treatment (P > 0.05). Compared with the control group, there were significant differences on SAS and SDS scores of the treatment group at 4-week treatment, 2 weeks and 4 weeks after treatment (P < 0.01, P < 0.05). However, there was no statistical significance at 2- week treatment (P > 0.05). There was no statistical significance on the comparison of adverse reactions of acupuncture treatment between two groups (P > 0.05). It was concluded that acupuncture treatment based on regulating Du meridian and calming mind was an effective and safe therapy for primary insomnia treatment.
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[基金项目]
国家科学技术部973 计划项目(2009CB522900):灸法的基本作用原理与应用研究规律,负责人:吴焕淦;国家科学技术部973 计划项目(2015CB554500):基于临床的灸法作用机理研究,负责人:吴焕淦;上海市卫计委中医药科研基金项目(2010L036A):原发性失眠针刺优化方案及影响疗效共性技术的临床评价,负责人:徐世芬。