养心和胃益眠汤结合针刺安眠穴治疗老年失眠的临床研究
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摘要
目的:探究养心和胃益眠汤结合针刺安眠穴治疗老年失眠的临床疗效。方法:随机选取医院收治的99例老年失眠症患者,随机分为对照组49例、观察组50例,对照组给予西药酒石酸唑吡坦治疗、观察组给予养心和胃益眠汤结合针刺安眠穴治疗,分析两组患者的临床疗效、实验室指标、睡眠质量与时间、药物不良反应及复发率情况。结果:观察组患者治疗后总有效率(96.00%)与对照组患者的(83.67%)相比明显较高,差异有统计学意义(P<0.05)。观察组患者治疗后的BUN(5.01±0.70)mmol/L、Scr(98.78±11.05)mmol/L、ALT(24.22±2.04)μ/L、AST(23.79±2.12)μ/L水平明显优于对照组患者BUN(6.69±1.01)mmol/L、Scr(117.44±12.88)mmol/L、ALT(28.69±2.15)μ/L、AST(28.99±2.28)μ/L,差异有统计学意义(P<0.05)。观察组患者治疗后的睡眠质量评分(7.10±0.44)、入睡时间(24.19±2.01)min及睡眠时间(8.06±0.69)h明显优于对照组患者的睡眠质量评分(9.89±0.52)、入睡时间(28.15±2.84)min及睡眠时间(7.11±0.65)h,差异有统计学意义(P<0.05)。观察组患者治疗后2周、4周的不良反应发生率及复发率(2.00%)、(6.00%)、(4.00%)与对照组患者的(12.24%)、(20.41%)、(16.33%)相比明显较低(P<0.05)。结论:老年失眠患者采用养心和胃益眠汤结合针刺安眠穴治疗后效果显著,改善睡眠质量,延长睡眠时间,降低复发率,不良反应少,肾脏及肝脏指标未见异常变化,安全可靠,临床作用重大。
Objective:To explore the clinical efficacy of Yangxin Hewei Yimian Decoction in the treatment of senile insomnia. Methods:We randomly selected 99 cases of senile insomnia patients in our hospital. The patients were randomly divided into the control group(49 cases) and the observation group(50 cases). The patients in the control group were given zolpidem tartrate treatment, and those in the observation group were given Yangxin Hewei Yimian Decoction combined with acupuncture at hypnotic acupoint, and clinical efficacy, laboratory indicators, sleep quality, time, adverse reaction and recurrence rate of two groups were compared.Results:The total effective rate of the observation group after treatment(96%) was significantly higher than that of the control group(83.67%), and the difference was statistically significant(P<0.05). After treatment,the observation group's BUN(5.01±0.70)mmol/L, Scr(98.78±11.05)mmol/L, ALT(24.22±2.04)μ/L, AST(23.79±2.12)μ/L were significantly higher than the control group's BUN(6.69±1.01)mmol/L, Scr(117.44±12.88)mmol/L, ALT(28.69±2.15)μ/L, AST(28.99±2.28)μ/L, and the difference was statistically significant(P<0.05). After treatment,the sleep quality(7.10±0.44), sleep time(24.19±2.01)min and sleep time(8.06±0.69)h of the observation group were significantly better than the control group's sleep quality score(9.89±0.52), sleep time(28.15 ±2.84)min and sleep time(7.11±0.65)h, and the difference was statistically significant(P<0.05). After 2 and 4 weeks treatment, the observation group's incidence rate of adverse reactions was 2% and 6%, and the recurrence rate was 4%, which were significantly lower than those in the control group[(12.24%),(20.41%) and(16.33%) ](P<0.05). Conclusion:Yangxin Hewei Yimian Decoction combined with acupuncture at Hypnotic acupoint has significant effect, and can improve sleep quality, prolong the sleep time, reduce the recurrence rate, with fewer adverse reactions. The kidney and liver indexes had no abnormal changes.
Objective:To explore the clinical efficacy of Yangxin Hewei Yimian Decoction in the treatment of senile insomnia. Methods:We randomly selected 99 cases of senile insomnia patients in our hospital. The patients were randomly divided into the control group(49 cases) and the observation group(50 cases). The patients in the control group were given zolpidem tartrate treatment, and those in the observation group were given Yangxin Hewei Yimian Decoction combined with acupuncture at hypnotic acupoint, and clinical efficacy, laboratory indicators, sleep quality, time, adverse reaction and recurrence rate of two groups were compared.Results:The total effective rate of the observation group after treatment(96%) was significantly higher than that of the control group(83.67%), and the difference was statistically significant(P<0.05). After treatment,the observation group's BUN(5.01±0.70)mmol/L, Scr(98.78±11.05)mmol/L, ALT(24.22±2.04)μ/L, AST(23.79±2.12)μ/L were significantly higher than the control group's BUN(6.69±1.01)mmol/L, Scr(117.44±12.88)mmol/L, ALT(28.69±2.15)μ/L, AST(28.99±2.28)μ/L, and the difference was statistically significant(P<0.05). After treatment,the sleep quality(7.10±0.44), sleep time(24.19±2.01)min and sleep time(8.06±0.69)h of the observation group were significantly better than the control group's sleep quality score(9.89±0.52), sleep time(28.15 ±2.84)min and sleep time(7.11±0.65)h, and the difference was statistically significant(P<0.05). After 2 and 4 weeks treatment, the observation group's incidence rate of adverse reactions was 2% and 6%, and the recurrence rate was 4%, which were significantly lower than those in the control group[(12.24%),(20.41%) and(16.33%) ](P<0.05). Conclusion:Yangxin Hewei Yimian Decoction combined with acupuncture at Hypnotic acupoint has significant effect, and can improve sleep quality, prolong the sleep time, reduce the recurrence rate, with fewer adverse reactions. The kidney and liver indexes had no abnormal changes.
引文
[1] 赵非一,许红,燕海霞.针药结合治疗失眠临床研究进展[J].中华中医药学刊,2016,34(2):346-349.
[2] 李泓,袁斓,周仕轶,等.不同针刺方法治疗围绝经期肝郁化火失眠症的疗效观察[J].成都中医药大学学报,2016,39(3):34-37.
[3] Nasreddine ZS,Phinips NA,Bedirrian V,et al.The Montreal cognitive impairment assessmet(MoCA):a brief screening tool for mild cognitive impairment[J].J Am Geriatr Soc,2015,53(4):695-699.
[4] 贾莹梅.针刺四神聪、百会穴对失眠患者血清氨基酸类神经递质影响研[J].中国医药导刊,2016,18(6):567-568,571.
[5] 洪秋阳.针刺“前四关”为主配合耳尖放血治疗原发性失眠32例[J].中国针灸,2016,36(11):1144-1145.
[6] 刘军兴.针刺对脑卒中后失眠患者觉醒状态调节作用临床研究[J].中医学报,2017,32(12):2544-2548.
[7] Cordi MJ,Hirsiger S,Merillat S,et al.Improving sleep and cognition by hypnotic suggestion in the elderly[J].Neuropsychologia,2015,69(2):176-182.
[8] 傅云其,谢鸿康,姚小萍,等.滞针震颤针刺法刺激安眠穴治疗失眠症的临床研究[J].中华全科医学,2017,15(4):681-684.
[9] 王晓霞,石子璇,陆洪虎,等.针刺联合百乐眠胶囊治疗失眠症疗效观察[J].陕西中医,2017,38(12):1778-1779.
[10] 茅利玉,徐新亚.乌梅丸联合针刺疗法对失眠症患者血清5-HT、BDNF及SAS积分影响研究[J].中华中医药学刊,2017,35(12):3187-3189.
[11] Lazarov O,Hollands C.Hippocampal neurogensis:Learningto remember[J].Prog Neurobiol,2016,3(4):138-140.
[12] 张晓哲.针灸联合中医药治疗肝郁化火型失眠的临床对照研究[J].辽宁中医杂志,2017,44(1):143-145.
[13] 龚阳陵,万裕萍,龚墩.清宁片联合针刺十三鬼穴治疗中风后失眠疗效观察[J].陕西中医,2017,38(12):1630-1632.
[14] 杨翠花,何林熹,乔玲,等.针刺治疗老年性失眠Meta分析[J].中医学报,2018,33(1):161-165.
[15] Asnis GM,Thomas M,Henderson MA.Pharmacotherapy Treatment options for Insomnia:A Primer for Clinicians[J].Int J Mol Sci,2015,17(1):50.
[16] 洪秋阳,杨惠民,赵吉平,等.灵龟八法结合火针治疗心脾两虚型失眠疗效观察[J].中华全科医学,2018,16(2):296-298,312.
[17] 张宜滨,陈宥伊.芪枣安神汤合针刺治疗心脾两虚型失眠疗效观察[J].四川中医,2018,36(2):130-133.
[18] Rodriguez JC,Dzierzewski JM,Alessi CA.Sleep problems in the elderly[J].Med Clin North Am,2015,99(2):431-439.
[19] 辛海,张健,张广中.真武汤配合针刺治疗失眠的疗效观察[J].中华中医药杂志,2018,33(1):380-382.
[20] 李姗姗,刘清泉,于翔,等.柴胡桂枝干姜汤加味联合针灸疗法治疗肝脾不调型原发性失眠的临床效果[J].中国医药导报,2017,14(33):154-156,168.
[2] 李泓,袁斓,周仕轶,等.不同针刺方法治疗围绝经期肝郁化火失眠症的疗效观察[J].成都中医药大学学报,2016,39(3):34-37.
[3] Nasreddine ZS,Phinips NA,Bedirrian V,et al.The Montreal cognitive impairment assessmet(MoCA):a brief screening tool for mild cognitive impairment[J].J Am Geriatr Soc,2015,53(4):695-699.
[4] 贾莹梅.针刺四神聪、百会穴对失眠患者血清氨基酸类神经递质影响研[J].中国医药导刊,2016,18(6):567-568,571.
[5] 洪秋阳.针刺“前四关”为主配合耳尖放血治疗原发性失眠32例[J].中国针灸,2016,36(11):1144-1145.
[6] 刘军兴.针刺对脑卒中后失眠患者觉醒状态调节作用临床研究[J].中医学报,2017,32(12):2544-2548.
[7] Cordi MJ,Hirsiger S,Merillat S,et al.Improving sleep and cognition by hypnotic suggestion in the elderly[J].Neuropsychologia,2015,69(2):176-182.
[8] 傅云其,谢鸿康,姚小萍,等.滞针震颤针刺法刺激安眠穴治疗失眠症的临床研究[J].中华全科医学,2017,15(4):681-684.
[9] 王晓霞,石子璇,陆洪虎,等.针刺联合百乐眠胶囊治疗失眠症疗效观察[J].陕西中医,2017,38(12):1778-1779.
[10] 茅利玉,徐新亚.乌梅丸联合针刺疗法对失眠症患者血清5-HT、BDNF及SAS积分影响研究[J].中华中医药学刊,2017,35(12):3187-3189.
[11] Lazarov O,Hollands C.Hippocampal neurogensis:Learningto remember[J].Prog Neurobiol,2016,3(4):138-140.
[12] 张晓哲.针灸联合中医药治疗肝郁化火型失眠的临床对照研究[J].辽宁中医杂志,2017,44(1):143-145.
[13] 龚阳陵,万裕萍,龚墩.清宁片联合针刺十三鬼穴治疗中风后失眠疗效观察[J].陕西中医,2017,38(12):1630-1632.
[14] 杨翠花,何林熹,乔玲,等.针刺治疗老年性失眠Meta分析[J].中医学报,2018,33(1):161-165.
[15] Asnis GM,Thomas M,Henderson MA.Pharmacotherapy Treatment options for Insomnia:A Primer for Clinicians[J].Int J Mol Sci,2015,17(1):50.
[16] 洪秋阳,杨惠民,赵吉平,等.灵龟八法结合火针治疗心脾两虚型失眠疗效观察[J].中华全科医学,2018,16(2):296-298,312.
[17] 张宜滨,陈宥伊.芪枣安神汤合针刺治疗心脾两虚型失眠疗效观察[J].四川中医,2018,36(2):130-133.
[18] Rodriguez JC,Dzierzewski JM,Alessi CA.Sleep problems in the elderly[J].Med Clin North Am,2015,99(2):431-439.
[19] 辛海,张健,张广中.真武汤配合针刺治疗失眠的疗效观察[J].中华中医药杂志,2018,33(1):380-382.
[20] 李姗姗,刘清泉,于翔,等.柴胡桂枝干姜汤加味联合针灸疗法治疗肝脾不调型原发性失眠的临床效果[J].中国医药导报,2017,14(33):154-156,168.