1. 浙江医院针灸科,浙江,杭州,310013
2. 浙江省中医院针灸科,浙江,杭州,310006
3. 浙江大学国际医院,浙江,杭州,310058
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ZHANG Shao-ying, XU Fu, ZHOU Hai-jiang, et al. Clinical observation of catgut implantation at acupoint in the treatment of insomnia with syndrome of qi and blood deficiency. [J]. Shanghai Journal of Traditional Chinese Medicine 51(4):63-66(2017)
目的:观察穴位埋线治疗气血两虚型失眠症的临床疗效。 方法:将123例气血两虚型失眠症患者随机分成埋线组、针刺组、药物组,每组41例。埋线组予穴位埋线疗法,针刺组予相同穴位针刺,药物组予艾司唑仑口服。各组疗效均为30天,观察临床疗效,比较匹兹堡睡眠质量指数(PSQI)评分及睡眠时间的变化情况。 结果:①最终完成试验者埋线组40例、针刺组39例、药物组38例。②疗程结束时埋线组、针刺组、药物组临床总有效率分别为95.00%、87.18%、65.79%;组间临床疗效比较,埋线组明显优于药物组(P<0.05),而与针刺组相当(P>0.05)。随访时埋线组、针刺组、药物组临床总有效率分别为80.00%、61.54%、39.47%。与疗程结束时比较,各组病情均出现一定程度的反复。组间临床疗效比较,埋线组明显优于针刺组、药物组(P<0.05),而针刺组又优于药物组(P<0.05)。③组间治疗后比较,PSQI总评分埋线组与针刺组相当(P>0.05),且两者均明显低于药物组(P<0.05);从各项睡眠因子比较分析,埋线组与针刺组无显著差别(P>0.05),埋线组在睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、日间功能方面显著优于药物组(P<0.05);针刺组在睡眠质量、入睡时间、睡眠障碍、日间功能方面显著优于药物组(P<0.05)。④治疗后与随访时组内比较,各组总评分及各项睡眠因子差异均有统计学意义,表明各组均有一定程度的复发(P<0.05)。组间随访时比较,总评分埋线组分别明显低于针刺组、药物组(P<0.05),而针刺组与药物组相当(P>0.05);从各项睡眠因子分析,埋线组在睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍方面依然明显优于药物组(P<0.05),而在睡眠质量、睡眠时间、睡眠障碍方面也明显优于针刺组(P<0.05)。⑤治疗后与随访时组内比较,各组睡眠时间差异均有统计学意义(P<0.05),表明各组病情均出现反复。组间治疗后比较,睡眠时间埋线组明显长于针刺组、药物组(P<0.05),而针刺组和药物组时间相当(P>0.05);组间随访时比较,睡眠时间埋线组明显长于针刺组、药物组(P<0.05),而针刺组又明显长于药物组(P<0.05)。 结论:穴位埋线治疗气血两虚型失眠症的近期及持续疗效满意,同时与传统针刺疗法或助眠药物相比,其治疗频率低、时间短,更易被患者接受。
Objective:To observe the clinical efficacy of catgut implantation at acupoint in the treatment of insomnia with syndrome of qi and blood deficiency. Methods123 cases of insomnia with syndrome of qi and blood deficiency were randomly divided into the catgut implantation group,acupuncture group and drug group,41 cases in each group. The catgut implantation group was treated with the therapy of catgut implantation at acupoint,the acupuncture group was treated with acupuncture at the same acupoint,the drug group was orally treated with estazolam,with a course of 30 days. The clinical efficacy was observed,and the pittsburgh sleep quality index (PSQI)scores and sleep time were compared. Results:①Finally 40 cases in the catgut implantation group,39 cases in the acupuncture group and 38 cases in the drug group completed the trial.②At the end of the treatment,the total effective rate of the catgut implantation group,acupuncture group and drug group was 95.00%,87.18% and 65.79% respectively.For the comparison of clinical efficacy between groups,the effect of the catgut implantation group was significantly better than that of the drug group(P<0.05),and equivalent to that of the acupuncture group(P>0.05).When followed-up,the total effective rate of the catgut implantation group,acupuncture group and drug group was 80.00%,61.54% and 39.74% respectively.Compared with the efficacy at the end of treatment,there was a certain degree of recurrence in each group. For the comparison of clinical efficacy between groups,the effect of the catgut implantation group was significantly better than that of the acupuncture group and drug group(P<0.05),but the effect of the acupuncture group was better than that of the drug group(P<0.05).③For the comparison between groups after treatment,the total score of PSQI in the catgut implantation group was equivalent to that of the acupuncture group(P>0.05),and the total score in these two groups was significantly lower than that in the drug group(P<0.05). For the comparison of each sleep-related factor,there were no significant differences between the catgut implantation group and acupuncture group(P>0.05),the scores on sleep quality,fall sleep time, sleep time,sleep efficiency,sleep disorders and daytime function in the catgut implantation group were significantly better than those of the drug group(P<0.05),the scores on sleep quality,fall sleep time,sleep disorders and daytime function in the acupuncture group were significantly better than those of the drug group(P<0.05).④For the comparison of PSQI after treatment and follow-up,the differences on the total score and each sleep-related factor in all groups were statistically significant,which suggested that there was a certain degree of recurrence in each group(P<0.05). For the comparison between groups during follow-up,the total score in the catgut implantation group was significantly lower than that in the acupuncture group and drug group(P<0.05),while the total score in the acupuncture group was equivalent to that of the drug group(P>0.05).For the comparison of each sleep-related factor during follow-up,the scores on sleep quality,fall sleep time,sleep time,sleep efficiency and sleep disorders in the catgut implantation group were still significantly better than those of the drug group(P<0.05),while the scores on sleep quality,sleep time,sleep disorders in the catgut implantation group were significantly better than those of the acupuncture group(P<0.05).⑤For the comparison after treatment and follow-up,the differences on the sleep time in all groups were statistically significant(P<0.05),which suggested that there were recurrence in each group. For the comparison between groups after treatment,the sleep time in the catgut implantation group was significantly longer than that in the acupuncture group and drug group(P<0.05),and the sleep time in the acupuncture group was equivalent to that of the drug group(P>0.05). For the comparison between groups during follow-up,the sleep time in the catgut implantation group was significantly longer than that in the acupuncture group and drug group(P<0.05),and the sleep time in the acupuncture group was significantly longer than that in the drug group(P<0.05). Conclusion:Catgut implantation at acupoint shows good recent and sustained efficacy in the treatment of insomnia with syndrome of qi and blood deficiency,compared with traditional acupuncture or hypnotic drugs,this therapy is more easily accepted by patients due to the advantages of lower frequency and less time.
失眠症不寐气血两虚穴位埋线长效针感
insomniaagrypniadeficiency of qi and bloodcatgut implantation at acupointlong-term needling sensation
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