热敏灸治疗失眠临床研究概况
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摘要
临床上对失眠患者疗效观察及评价标准并不统一,缺乏客观性。而作为国际公认评价睡眠障碍"金标准"—多导睡眠图,已广泛用于与睡眠相关疾病临床评价。但通过搜索文献发现,临床报道中几乎没有应用多导睡眠图进行疗效评价,大多还是以量表评价为主。热敏灸治疗失眠效果显著,操作简单,但仍存在一些不足:临床研究中多是热敏灸结合其他疗法,缺少对热敏灸治疗失眠的单一研究;临床研究样本量普遍较少,且多停留在对患者近期疗效观察,缺少远期疗效的观察及后期的随访;临床上失眠也可由其他疾病诱发,因此需要进一步对热敏灸治疗失眠合并其他疾病进行实验及临床研究。热敏灸作为一种新艾灸疗法,找到准确的热敏化腧穴并施以消敏饱和灸是临床疗效的关键,操作者应经过专业的培训再进行施灸,以提高临床疗效。
Clinical observation and evaluation criteria for insomnia patients are not uniform and lack of objectivity.Polysomnography,as an internationally recognized "golden standard" for evaluating sleep disorders,has been widely used in clinical evaluation of sleep-related diseases.However,through searching the related literatures,it has been found that there are few clinical reports using polysomnography to evaluate the efficacy,and most of them were based on scale evaluation.Moxibustion of heat sensibilizing state of accupoints is effective and simple in treating insomnia,but there are still some problems:Most of the clinical studies are combined with other therapies,lack of a single study on the treatment of insomnia by moxibustion of heat sensibilizing state of accupoints.The number of clinical research samples is generally small,and mostly stay in the observation of short-term efficacy of patients,lack of long-term efficacy observation and late follow-up.Insomnia can also be induced by other diseases in clinical practice.Therefore,further experimental and clinical studies on moxibustion of heat sensibilizing state of accupoints for insomnia with other diseases are needed.As a new moxibustion therapy,the key to the clinical effect is to find the accurate heat sensibilizing acupoints and apply the saturated moxibustion to alleviate the sensitization.The operator should receive professional training and then apply the moxibustion to improve the clinical effect.
Clinical observation and evaluation criteria for insomnia patients are not uniform and lack of objectivity.Polysomnography,as an internationally recognized "golden standard" for evaluating sleep disorders,has been widely used in clinical evaluation of sleep-related diseases.However,through searching the related literatures,it has been found that there are few clinical reports using polysomnography to evaluate the efficacy,and most of them were based on scale evaluation.Moxibustion of heat sensibilizing state of accupoints is effective and simple in treating insomnia,but there are still some problems:Most of the clinical studies are combined with other therapies,lack of a single study on the treatment of insomnia by moxibustion of heat sensibilizing state of accupoints.The number of clinical research samples is generally small,and mostly stay in the observation of short-term efficacy of patients,lack of long-term efficacy observation and late follow-up.Insomnia can also be induced by other diseases in clinical practice.Therefore,further experimental and clinical studies on moxibustion of heat sensibilizing state of accupoints for insomnia with other diseases are needed.As a new moxibustion therapy,the key to the clinical effect is to find the accurate heat sensibilizing acupoints and apply the saturated moxibustion to alleviate the sensitization.The operator should receive professional training and then apply the moxibustion to improve the clinical effect.
引文
[1] 韩艳丽,张志军,王宝亮.针刺四神聪、百会治疗失眠68例[J].河南中医,2017,37(12):2194-2196.
[2] 王彦霞,杨桦.穴位埋线治疗心脾两虚型失眠临床研究[J].河南中医,2017,37(12):2203-2204.
[3] 高贤琼.中西药合用在治疗失眠症方面的临床应用进展[J].中国医药指南,2014,12(6):40.
[4] 王卓,蔡刚,张会琴,等.参松养心胶囊治疗冠心病合并失眠症的临床观察[J].中医学报,2011,26(11):1363-1364.
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[6] 支晓丽.梁静玉教授从脏腑论治不寐经验[J].光明中医,2017,32(22):3227-3228.
[7] 汪长春,杨文明.杨文明治疗不寐经验[J].中医药临床杂志,2017,29(8):1234-1236.
[8] 冯红礼,何丽娜.从“胃不和则卧不安”探讨失眠的证治[J].陕西中医药大学学报,2017,40(6):16-17.
[9] 马恰怡,李艳,曹莲瑛,等.试述失眠从督脉论治[J].江苏中医药,2014,46(5):9-10.
[10] 陈星宇,诸毅晖,邹婷婷,等.针灸辨治“肝病不寐”[J].辽宁中医杂志,2017,44(11):2401-2403.
[11] 许晓伍,黄妙纯,刘凤岚,等.失眠的病因学研究进展[J].世界睡眠医学杂志,2017,4(5):307-312.
[12] 独家能,刘聪,郝旭亮,等.生理性失眠发病机制的研究进展[J].中国医药导报,2017,14(29):37-40.
[13] 高奎亮,解建国.从肾论治不寐[J].中国中医药现代远程教育,2017,15(16):69-70.
[14] 关之凡.中医辨证分型治疗失眠研究进展[J].亚太传统医药,2017,13(20):73-75.
[15] 李安洪,赵琴.1063 例失眠患者证型分布及诊治规律探讨[J].陕西中医,2014,35(2):158-159.
[16] 黄小芹,王长松.110例失眠患者证型与舌象特征关系的研究[J].东南大学学报(医学版),2015,34(1):100-103.
[17] 于长禾.辨证论治失眠疗效评价的医生队列研究[D].北京:中国中医科学院,2016.
[18] 方昉.加味调肝方治疗肝郁气滞型失眠的临床研究[D].杭州:浙江中医药大学,2015.
[19] 窦锡彬,张红参,李克明,等.壮医药线点灸联合针刺对失眠患者血浆Orexin及HPA轴的影响[J].右江民族医学院学报,2013,55(1):9-11.
[20] 李玉洁.腹针疗法治疗慢性原发性失眠心肾不交证的临床疗效评价及对血浆5-HT影响的研究[D].贵阳:贵阳中医学院,2015.
[21] 潘丽英.艾灸治疗失眠临床研究进展[J].广西中医药,2014,38(2):4-6.
[22] 肖爱娇,付勇,王河宝,等.热敏灸对PCPA致失眠大鼠SOD、MDA的影响[J].江西中医药大学学报,2014,26(2):44-47.
[23] 肖爱娇,王河宝,刘海云.热敏灸对失眠大鼠模型血清内分泌激素水平的影响[J].江西中医学院学报,2013,25(4):32-35.
[24] 李丽春,梁燕,胡永红,等.热敏灸对肝郁气滞型失眠患者焦虑抑郁的影响(英文)[J].世界针灸杂志:英文版,2018,22(1):15-18,75.
[25] 徐海燕.热敏灸配合头针丛刺治疗失眠 58 例[[J].南京中医药大学学报,2014,30(2):189-191.
[26] 周运.薄氏腹针结合热敏灸治疗失眠临床研究[J].新中医,2014,46(10):183-186.
[27] 吕彬,刘黎明.热敏灸配合埋针治疗失眠的临床观察[J].湖北中医药大报,2016,18(6):84-86.
[28] 刘建新,马金顺,陈鹏典.任督脉热敏灸联合耳穴压豆治疗失眠症临床观察[J].山西中医,2015,31(11):31-32.
[29] 李清萍,薛松,吴国庆.热敏灸配合耳穴压豆治疗慢性肾衰患者失眠的临床观察及护理[J].光明中医,2015,30(5):1022-1024.
[30] 吴凡伟,李耀龙.热敏灸配合中药治疗失眠30例[J].针灸临床杂志,2010,26(10):22-23.
[31] 何竞,张华,张俊,等.热敏灸结合天王补心汤治疗阴虚火旺型亚健康失眠30例[J].中国中医药现代远程教育,2014,12(4):44-45.
[32] 张月腾.热敏灸治疗心脾两虚型肿瘤相关性失眠的临床研究[D].广州:广州中医药大学,2017.
[33] 宋春花,张庆生,罗玉龙,等.热敏点灸法结合心理疗法治疗失眠的临床研究[J].科技信息,2010,27(17):411.
[34] 周红勤,高希言,朱敬云,等.艾灸治疗失眠的临床研究[J].中医学报,2011,26(4):505-506.
[35] JU Y L,CHI X,LIU J X.Forty cases of insomnia treated by suspendedmoxibustion at Baihui(GV 20)[J].J Tradit Chin Med,2009,29(2):95-96.
[36] 陈日新,康明非.腧穴热敏化艾灸新疗法[M].北京:人民卫生出版社,2006:4.
[37] 陈日新,陈明人,康明非.热敏灸实用读本[M].北京:人民卫生出版社,2009:21-99.
[38] 肖爱娇,康明非,胡丽,等.热敏灸对失眠大鼠行为学以及甩尾反应潜伏期的影响[J].时珍国医国药,2013,24(10):2548-2550.
[39] 迟振海,陈日新.失眠患者背部热敏腧穴高发部位的临床观察[J].江西中医药,2011,42(1):46-47.
[2] 王彦霞,杨桦.穴位埋线治疗心脾两虚型失眠临床研究[J].河南中医,2017,37(12):2203-2204.
[3] 高贤琼.中西药合用在治疗失眠症方面的临床应用进展[J].中国医药指南,2014,12(6):40.
[4] 王卓,蔡刚,张会琴,等.参松养心胶囊治疗冠心病合并失眠症的临床观察[J].中医学报,2011,26(11):1363-1364.
[5] 杨志敏.国医大师颜德馨辨治失眠验案[N].中国中医药报,2017-05-01(002).
[6] 支晓丽.梁静玉教授从脏腑论治不寐经验[J].光明中医,2017,32(22):3227-3228.
[7] 汪长春,杨文明.杨文明治疗不寐经验[J].中医药临床杂志,2017,29(8):1234-1236.
[8] 冯红礼,何丽娜.从“胃不和则卧不安”探讨失眠的证治[J].陕西中医药大学学报,2017,40(6):16-17.
[9] 马恰怡,李艳,曹莲瑛,等.试述失眠从督脉论治[J].江苏中医药,2014,46(5):9-10.
[10] 陈星宇,诸毅晖,邹婷婷,等.针灸辨治“肝病不寐”[J].辽宁中医杂志,2017,44(11):2401-2403.
[11] 许晓伍,黄妙纯,刘凤岚,等.失眠的病因学研究进展[J].世界睡眠医学杂志,2017,4(5):307-312.
[12] 独家能,刘聪,郝旭亮,等.生理性失眠发病机制的研究进展[J].中国医药导报,2017,14(29):37-40.
[13] 高奎亮,解建国.从肾论治不寐[J].中国中医药现代远程教育,2017,15(16):69-70.
[14] 关之凡.中医辨证分型治疗失眠研究进展[J].亚太传统医药,2017,13(20):73-75.
[15] 李安洪,赵琴.1063 例失眠患者证型分布及诊治规律探讨[J].陕西中医,2014,35(2):158-159.
[16] 黄小芹,王长松.110例失眠患者证型与舌象特征关系的研究[J].东南大学学报(医学版),2015,34(1):100-103.
[17] 于长禾.辨证论治失眠疗效评价的医生队列研究[D].北京:中国中医科学院,2016.
[18] 方昉.加味调肝方治疗肝郁气滞型失眠的临床研究[D].杭州:浙江中医药大学,2015.
[19] 窦锡彬,张红参,李克明,等.壮医药线点灸联合针刺对失眠患者血浆Orexin及HPA轴的影响[J].右江民族医学院学报,2013,55(1):9-11.
[20] 李玉洁.腹针疗法治疗慢性原发性失眠心肾不交证的临床疗效评价及对血浆5-HT影响的研究[D].贵阳:贵阳中医学院,2015.
[21] 潘丽英.艾灸治疗失眠临床研究进展[J].广西中医药,2014,38(2):4-6.
[22] 肖爱娇,付勇,王河宝,等.热敏灸对PCPA致失眠大鼠SOD、MDA的影响[J].江西中医药大学学报,2014,26(2):44-47.
[23] 肖爱娇,王河宝,刘海云.热敏灸对失眠大鼠模型血清内分泌激素水平的影响[J].江西中医学院学报,2013,25(4):32-35.
[24] 李丽春,梁燕,胡永红,等.热敏灸对肝郁气滞型失眠患者焦虑抑郁的影响(英文)[J].世界针灸杂志:英文版,2018,22(1):15-18,75.
[25] 徐海燕.热敏灸配合头针丛刺治疗失眠 58 例[[J].南京中医药大学学报,2014,30(2):189-191.
[26] 周运.薄氏腹针结合热敏灸治疗失眠临床研究[J].新中医,2014,46(10):183-186.
[27] 吕彬,刘黎明.热敏灸配合埋针治疗失眠的临床观察[J].湖北中医药大报,2016,18(6):84-86.
[28] 刘建新,马金顺,陈鹏典.任督脉热敏灸联合耳穴压豆治疗失眠症临床观察[J].山西中医,2015,31(11):31-32.
[29] 李清萍,薛松,吴国庆.热敏灸配合耳穴压豆治疗慢性肾衰患者失眠的临床观察及护理[J].光明中医,2015,30(5):1022-1024.
[30] 吴凡伟,李耀龙.热敏灸配合中药治疗失眠30例[J].针灸临床杂志,2010,26(10):22-23.
[31] 何竞,张华,张俊,等.热敏灸结合天王补心汤治疗阴虚火旺型亚健康失眠30例[J].中国中医药现代远程教育,2014,12(4):44-45.
[32] 张月腾.热敏灸治疗心脾两虚型肿瘤相关性失眠的临床研究[D].广州:广州中医药大学,2017.
[33] 宋春花,张庆生,罗玉龙,等.热敏点灸法结合心理疗法治疗失眠的临床研究[J].科技信息,2010,27(17):411.
[34] 周红勤,高希言,朱敬云,等.艾灸治疗失眠的临床研究[J].中医学报,2011,26(4):505-506.
[35] JU Y L,CHI X,LIU J X.Forty cases of insomnia treated by suspendedmoxibustion at Baihui(GV 20)[J].J Tradit Chin Med,2009,29(2):95-96.
[36] 陈日新,康明非.腧穴热敏化艾灸新疗法[M].北京:人民卫生出版社,2006:4.
[37] 陈日新,陈明人,康明非.热敏灸实用读本[M].北京:人民卫生出版社,2009:21-99.
[38] 肖爱娇,康明非,胡丽,等.热敏灸对失眠大鼠行为学以及甩尾反应潜伏期的影响[J].时珍国医国药,2013,24(10):2548-2550.
[39] 迟振海,陈日新.失眠患者背部热敏腧穴高发部位的临床观察[J].江西中医药,2011,42(1):46-47.