五脏调神针法治疗失眠的临床研究
详细信息    本馆镜像全文|  推荐本文 |  |   获取CNKI官网全文
摘要
研究目的
     通过随机对照临床研究,对五脏调神针刺法治疗失眠的有效性进行评价。
     研究方法
     选取2009年2月至2010年4月在台北康禾堂中医诊所就诊的符合纳入标准的60例失眠患者,随机分为治疗组和对照组,每组30例。治疗组针刺选取五脏原穴:神门、太冲、太白、太渊、太溪;对照组选取神门、三阴交、四神聪。两组患者治疗1个疗程评价疗效。通过Epworth困倦量表、自评焦虑量表(SAS)、自评抑郁量表(SDS)、匹兹堡睡眠质量指数量表(PSQI)、中医证候量表进行治疗前后的自身以及组间对比,观察失眠患者的夜间睡眠质量以及白昼机能状态的改善情况。
     结果
     1.疗程结束时,匹兹堡睡眠质量指数较治疗前明显下降(P<0.05),组间差异有统计学意义(P<0.05)。
     2.疗程结束时,Epworth困倦量表积分较治疗前明显下降(P<0.05),组间差异有统计学意义(P<0.05)。
     3.疗程结束时,SAS量表积分较治疗前明显下降(P<0.05),组间差异有统计学意义(P<0.05)。
     4.两组治疗后,患者中医症状计分比较,差异有显著性意义(P<0.05)。
     5.疗程结束时,治疗组痊愈17例,显效7例,有效3例,无效2例,总有效率93.1%,对照组痊愈8例,显效10例,有效6例,无效4例,总有效率85.7%,两组的总体疗效经统计学处理,差异有统计学意义(P<0.05)。
     结论
     “五脏调神”针法具有调节睡眠的作用,它不仅能够改善患者夜间的睡眠质量,同时也能够有效的提高患者白天的机能状态,还可以缓解失眠带来的焦虑及抑郁情绪,其临床疗效明显优于传统针刺治疗。
Objective
     To evaluated the effect of needling by regulating five viscera on insomnia by a randomized controlled trial. Methods
     According to the inclusive criteria,60 cases were chosen from the Taibei Kanghetang Chinese clinic.60 cases were randomly divided into a treatment group (n=30) and a control group(n=30). The treatment group was treated with acupuncture at Yuan point of five viscera. The control group was treated with acupuncture at Shenmen, Sanyinjiao, Sishencong. After receiving a course of treatment, A few tables such as Epworth's weary schedule, Self-anxiety schedule(SAS), Self-depression schedule, PSQI,TCM symptom schedule)are made to compare the effect before and after the treatment or interclass so as to know the situation of sleeping at night and status during the daytime.
     Results
     1. After the treatment by Needling by regulating five viscera, the Pittsburgh sleep quality index was lower than that of the beginning (P< 0.05) There were statistically significant differences between the two groups (P <0.05).
     2. After the treatment by Needling by regulating five viscera, the Epworth's weary schedule was lower than that of the beginning (P< 0.05) There were statistically significant differences between the two groups (P <0.05).
     3. After the treatment by Needling by regulating five viscera, the SAS score was lower than that of the beginning (P< 0.05). There were statistically significant differences between the two groups (P<0.05)
     4. After treatment, there were statistically significant differences between the two groups in TCM symptom integral (P<0.05).
     5. After treatment, in the treatment group,17 cases were cured,7 cases were remarkably effective,3 cases were effective,2 cases were ineffective and the total effective rate was 93.1%. While in the control group,8 cases were cured,10 cases were remarkably effective,6 cases were effective,4 cases were ineffective and the total effective rate was 85.7%. There were statistically significant differences between the two groups in the clinical effect (P<0.05)
     Conclusion
     "Needling by regulating five viscera" not only can improve the sleep quality of the insomnia patient at night, but also improve the status of the function during the daytime. So it improves the living quality of the insomnia patent in the day and night. At the same time it can adjust the disorder function of five organs. The total clinical effect of "Needling by regulating five viscera" were superior to the traditional acupuncture.
引文
[1]Fisher CM. Lacunes:small, deep cerebral infarcts[J]. Neurology,1965, 15:774-784
    [2]Ohayon MM. Epjdemiology of insomnia:what we know and what we still need to learn[J]. Sleep Med Rev,2002; 6:97-111.
    [3]Ohayon MM, Roth T. Place of chronic insomnia in the course of depressive and anxiety disorders[J]. J Psychiatr Res.2003; 37:9-15.
    [4]Moul DE, Nofzinger EA, Pilkonis PA, et al. Symptom reports in severe chronic insomnia[J]. Sleep 2002; 25:553-563.
    [5]Sutton DA, Moldofsky H, Badley EM. Insomnia and health problems in Canadians.2001; 15(24):665-670.
    [6]黄习珍.睡眠呼吸障碍诊治的新进展[J].中国实用内科杂志,1998,18(4):195
    [7]方积乾.生存质量测定方法及应用[M].北京:北京医科大学出版社,2000
    [8]太田龙郎.睡眠觉醒节律障碍[J].精神医学,1989,31(11):6
    [9]竺士秀,张可经,游国雄.鼾症120例多导睡眠图分析[J].中华结核和呼吸杂志,1998;21(8):452.
    [10]心理卫生评定:量表手册[M].北京:中国心理卫生杂志社,2000
    [11]陶松跃,吴美娟,钱蠡.失眠患者动态脑电图睡眠期观察与分析[J].职业与健康,2006,22(1);69-71
    [12]俞孟荪,杨军,周玉彬,等.用微动敏感床垫监测睡眠的研究[J].华航空航天医学杂志,1999;10(11):40
    [13]Roth T. Measuring Treatment Efficiency in Insomnia. J Clinic Psychiatry, 2004; 65(18):8-11
    [14]韩济生.神经科学原理(第二版),北京:北京医科大学出版社,1999,第一版:910-914.
    [15]杨志敏,老膺荣,汤湘江.颜德馨教授从气血失调辨治失眠的经验[J].中医药学刊,2003,21(8):1247-1248.
    [16]高占毅,(6):81权德海.失眠治验举隅[J].新中医,2005,37
    [17]尉平平.亚健康状态的中医辨析[J].浙江临床医学,2005。(1):80—81.
    [18]崔春风.田令群从火论治不寐的经验[J].新中医,1998,30(9):9-10.
    [19]杨方尧.方以正不寐从瘀辨治的思路与方法初探[J].贵阳中医学院学报,1999,21(3):9-10.
    [20]姜向坤,李云,徐向青,等.徐明涟调肝五法治疗顽同性失眠的经验[J].山东中医药大学学报,2000,24(3):199-200.
    [21]许良.王翘楚治不寐学术思想初探[J].巾医文献杂志,2002(4):42-43.
    [22]严石林,李正华.从心辨证治失眠[J].成都中医药大学学报.2002(25)3:59-61.
    [23]康昱.周绍华教授治疗不寐证经验[J].河南中医,1997,17(4):2371.
    [24]吕慰秋.顽固性失眠的证治心法[J].江苏中医,1999,18(3):105-106.
    [25]谢建军.从肝论治八法[J].中国中医基础医学杂志,1997,3(增刊):33-34.
    [26]杨杰.失眠从肝论治五法[J].中国中医基础医学杂志,1997,3(增刊):34-35.
    [27]袁建芬.不寐证从胆论治的体会[J].安徽中医临床杂志,2002,14(6):487-488.
    [28]刘文伟.从脾胃入手治疗不寐[J].甘肃中医学院学报,1996,13(2):37.
    [29]肖玉英.不寐从胃论治五法[J].安徽中医学院学报,1998,17(3):35-36.
    [30]李景.眠证从脾胃论治[J].中国中医基础医学杂志,2002,8(1):28.
    [31]刘克勤.失眠从胃论治[J].山西职工医学院学报,2003,13(3):27-28.
    [32]韩峥.补肾化痰治疗顽固性失眠[J].中国临床医生,2005,33(3):48
    [33]邱丽敏.六味地黄汤加味治疗老年不寐90例[J].中国中医药实用杂志,2003,17(2):102.
    [34]凌玲.养脑胶囊治疗不寐52例[J].陕西中医,2002,23(2):122-123.
    [35]张兰霞,王逸群.失眠的中医辨证治疗[J].中西医结合心脑血管病杂志,2009,7(7):865-866.
    [36]葛秀英.安眠宁胶囊治疗失眠症60例[J].河南中医,2006,26(12):12.
    [37]凌玲.养脑胶囊治疗不寐52例[J].陕西中医,2002,23(2):122.
    [38]张学英,谭毅.柴胡疏肝散加昧治疗不寐43例[J].新中医,2004,36(3):59.
    [39]任丽平.刘雅茹.甜梦口服液结合心理疗法治疗失眠症68例疗效观察[J].时珍国医国药,2007,18(8):20-24.
    [40]陈夏凉,范小芬.乌灵胶囊治疗失眠症60例临床观察[J].浙江中西医结合杂志,2007,17(7):442-443.
    [41]王蕾,陈琼,范超平.参松养心胶囊治疗脑卒巾后失眠症的疗效观察[J].中国实用神经疾病杂志,2007,10(5):108.
    [42]赵丹.琥珀宁神丸治顽同性失眠120例[J].中国民间疗法,2007,15(7):24-25.
    [43]王义方,李华芳.落花生叶制剂治疗失眠症的临床全盲验证观察[J].上海中医药杂志,2001,5:11.
    [44]王斌,施亦青.《伤寒论》方辨治失眠六法考释[J].实用中医内科杂志,2008,22(2):14-15.
    [45]韦少宣.失眠症的论治与《灵枢》卫气运行理论关系探讨[J].广西中医学院学 报,2009,12(3):1-2.
    [46]刘博.针灸治疗顽固性失眠40例临床观察[J].中国民间疗法,2001,9(7):11.
    [47]李铁成,李岩,刘茂祥.针刺疗法治疗失眠56例[J].针灸临床杂志,2003,19(5):9.
    [48]侯春英,刘强.针刺治疗失眠150例疗效观察[J].新中医,2005,37(3):61.
    [49]李军民.针刺治疗失眠症70例临床观察[J].针灸临床杂志,2001,17(7):25.
    [50]候率.针刺治疗失眠症48例疗效观察[J].中国工业医学杂志,2001,14(4):241.
    [51]李滋平.针刺百会、神庭穴为主治疗失眠症110例临床观察[J].针灸临床杂志,2006,22(9):9.
    [52]高希言,赵欣纪,马巧琳,等.调卫健脑针法治疗失眠症40例临床观察[J].时珍国医国药,2006,17(9):1633-1634.
    [53]王海波.针刺会穴治疗不寐证78例[J].针灸临床杂志,2004,20(11):40
    [54]张沁春,梁雪芳,黄青林.失眠的针灸辨治[J].针灸临床杂志,2003,19(2):17.
    [55]陈丽娜,谭玲玲.针灸治疗失眠108例疗效观察[J].浙江中西医结合杂志,2003,13(10):654.
    [56]韩燕.针灸治疗失眠症验案4则[J].上海针灸杂志,2003,22(8):32.
    [57]王艳波,张秋菊.针灸治疗顽固性失眠[J].黑龙江中医药,2001,5:51.
    [58]张洪,邓鸿,熊可.针刺调阴跷阳跷治疗失眠症87例临床观察[J].中国针灸,2003,23(7):394.
    [59]饶忠东,温明,胡跃华.丝竹空透率谷为主治疗顽固性失眠50例疗效观察[J].中国针灸,2001,21(7):407.
    [60]陈宏伟,曹东方,唐永春.泻阳补阴法治疗失眠症38例临床观察[J].上海针灸杂志,2004,23(7):14.
    [61]雷发声,张步郎.按摩治疗失眠症[J].光明中医,2008,23(1):28-30.
    [62]冉先武.推拿治疗失眠症[J].湖北中医杂志,2008,30(1):52.
    [63]薛长青.推拿加特定穴治疗失眠症的研究[J].中国现代药物应用,2007,1(12):57.
    [64]高晓冬.推拿点穴辨证治疗不寐116例[J].实用中医内科杂志,2008,22(5):102-103.
    [65]马燕香.推拿点穴治疗失眠300例.按摩与导引,2008,24(12):17.
    [66]李春杰.推拿辨证治疗失眠101例体会.按摩与导引,2008,24(12):15.
    [67]何育风,黄锦军,赖耀铭,等.推拿手法治疗失眠49例临床观察[J].江苏中医 药,2009,41(6):49.
    [68]袁广宇.艾灸治疗失眠症80例疗效观察[J].针灸临床杂志2007,23(10):37-38
    [69]严兴强.灸百会穴治疗顽固性失眠49例疗效观察[J].针灸临床杂志,1999,15(5):37
    [70]王华兰,尤艳利.艾灸配合捏脊治疗失眠症62例[J].陕西中医2005,26(5):453-454
    [71]王华美.手法、温针灸治疗失眠症546例[J].四川中医,2003,21(8):85.
    [72]陈茹.针灸治疗失眠52例临床观察[J]甘肃中医,2001,14(3):6.
    [73]孙宁,谢福利,潘怀义,等.天灸疗法治疗心胆气虚型失眠36例[J].辽宁中医药大学学报,2008,10(3):108.
    [74]阮经文,廖新学,严英硕,等.电针头穴和体穴对慢性失眠患者睡眠结构的影响[J].中国康复,2009,24(3):159-161.
    [67]梁树艺.电针头部腧穴治疗失眠症疗效观察[J].针灸临床杂志,2009,25(3):24-25.
    [76]彭冬青,董玉喜,王秋红.电针风池穴治疗失眠症临床观察[J].中国中医药远程现代教育,2008,6(12):1492-1493.
    [69]肖晓玲,刘志顺.不同时间电针治疗失眠疗效评价[J].针刺研究,2008,33(3):201-204.
    [70]陈力.电针治疗失眠症不同穴位组方的对照研究[J].中国针灸,2005,25(10):687-688.
    [79]陈丽仪,郭元琦.不寐证针灸治疗新思路[J].针灸临床杂志,2004,20(10):21.
    [80]高亚莉.耳穴治疗失眠症60例[J].实用医技杂志,2007,14(29):4108-4109.
    [81]王松涛.磁珠耳压治疗失眠疗效观察[J].安徽中医临床杂志,2002,(4):165.
    [82]黄桂兴.针刺治疗失眠66例[J].针刺研究,2000,25(3):220-221.
    [83]王鹏,王威,贾成文.耳穴贴压治疗失眠症32例[J].上海针灸杂志,2006,25(9):27-27.
    [84]刘卫红,危北海,李建,等.耳穴贴压疗法干预睡眠障碍为主的亚健康状态临床随机对照研究[J].中华中医药学刊,2008,26(2):298-299.
    [85]唐春芹,高志强.耳穴压豆治疗失眠80例[J].中国民间疗法,2003,11(2):22-23.
    [86]刘丽萍.针刺耳根敏感点治疗失眠54例[J].中医药研究,2000,16(1):32.
    [87]杨久华.针刺配合耳穴贴压治疗顽固性失眠症疗效观察[J].中国疗养医学,2005,14(2):99-100.
    [88]盖亚男,许海燕.耳穴脉冲治疗失眠200例的体会[J].中医外治杂 志,2004,13(6):31.
    [89]李晓清,李乃荣.梅花针治疗妇女更年期失眠50例[J].上海针灸杂志,2000,19(4):27.
    [90]庄丹红.梅花针叩刺背俞穴治疗顽固性失眠42例[J].上海针灸杂志,2004.23(5):33.
    [91]岳延荣.梅花针结合捏脊法治疗失眠症42例[J].针灸临床杂志,2005,21(10):30.
    [92]王宪平,吴晶萍.腕踝针治疗失眠32例临床观察[J].针灸临床杂志,2000,16(2):10-11.
    [93]戚传远,李治双.刮痧治疗失眠60例[J].山西中医,1999,15(3):30.
    [94]贾英丽,李红.刮痧治疗顽固性失眠24例[J].针灸临床杂志,2000,16(3):391.
    [95]李丽,陈海明,白杰,等.足穴治疗对亚健康人群105例睡眠干预的研究[J].世界中医药,2008,3(2):99.
    [96]马延平.维生素B1穴位注射治疗不寐20例[J].新疆中医药,2001,19(1):37.
    [97]万静,张会峰.穴位封闭治疗顽固性失眠35例[J].现代康复,2001,5(8):120.
    [98]张凤华.皮内针治疗不寐29例[J].针灸临床杂志,2001,17(1):31.
    [99]张洪峰.针灸配合认知疗法治疗失眠97例[J].辽宁中医杂志,2006,33(7):866.
    [100]王孝艳,薛素芬,车艳.针刺配合穴位注射治疗不寐38例疗效观察[J].2004,25(3):52.
    [101]王华兰,尤艳利.艾灸配合捏脊治疗失眠症62例[J].陕西中医2005,26(5):453.
    [102]陈丽娜,谭玲玲.针灸治疗失眠108例疗效观察[J].浙江中西医结合杂志,2003,13(10):654.
    [103]刘彦江.针刺结合耳压治疗失眠症110例[J].上海针灸杂志,2003,8:31.
    [104]许红,胡振霞,王翘楚.针药结合治疗失眠症的临床研究[J].辽宁中医杂志,2003,30(7):570.
    [105]罗素珍,陈玉玲,温明:针刺加穴位注射治疗失眠125例[J].上海针灸杂志,2000,19(2):14.
    [106]陈贵珍.针刺四神聪为主治疗失眠的临床观察[J].上海针灸杂志,1999,18(3):17.
    [107]付文霞,刘海涛,苏兰英.针刺结合走罐治疗顽固性失眠56例[J].针灸临床杂志,2001,17(1):24.
    [108]王英震,王燕霞,周芳.针刺配合拔罐治疗失眠症59例[J].医学理论与实践,2004,17(5):533-534.
    [109]夏东斌,黄泳,李小敏.针刺配合走罐治疗青少年失眠症128例临床观察[J].四川中医,2004,22(2):90.
    [110]杨军雄.针刺配合脚部推拿治失眠58例[J].针灸临床杂志,2004,20(1):9.
    [111]段进成,陆彦春.针刺配合推拿治疗失眠症32例疗效观察[J].针灸临床杂志,2002,18(1):32.
    [112]张宜,杜少辉.针刺配合温胆汤治疗老年失眠的临床研究[J].江西中医学院学报,2000,12(4):161.
    [113]王凯.电针配合中药治疗失眠症的临床观察[J].针灸临床杂志,2006,22(5):34-35.
    [114]许纲.针刺治疗失眠症45例疗效分析[J].海针灸杂志,1997,16(6):101.
    [115]皮敏.针刺治疗失眠及其对r-氨基丁酸影响的研究[J],江西中医学院学报,2000,12(4):1601.
    [116]张悦.针刺治疗药物依赖性失眠[J].中国针灸,2002,22(3):185.
    [117]赵仓焕,任莉,宋媛.不同穴位处方电针对失眠大IL-1β、TNF-α及IL-6鼠下丘脑影响[J].暨南大学学报(医学版),2008,29(2):177-180.
    [118]张斌,荣润国.失眠的认知行为治疗[J].中国心理卫生杂志,2004,18(12):882-884.
    [119]李雁鹏,赵忠新.认知-行为疗法治疗慢性失眠的研究进展[J].重庆医学,2009,38(10):1148-1150.
    [120]王文骁,杨玲.失眠症及其治疗新进展[J].中华现代临床医学杂志,2008,6(11):981-983.
    [121]Lai HI. Music improves sleep quality in older adults [J]. Journal of Advanced Nursing.2005;49(3):234-244.
    [122]Levin Y. " Brain music " in the treatment of patients with insomnia[J]. Neuroscience and Behavioral Physiology.1998;28(3):330-335
    [123]吴任刚,乌立新,张春改,等.脑波同步化治疗非器质性失眠症临床疗效分析[J].中国心理卫生杂志.2001:15(2):119-120.
    [124]Montgomery P, Dennis J. A systematic review of non-pharmacological therapy for sleep problems in later life[J]. Sleep Med Ret.2004;8(1):47-62.
    [125]Guilleminault C, Clerk A, Black J, et al. Nondrug Treatment trials in psycho-physiologic insomnia [J]. Archives of Internal Medicine.1995.155(8): 838-844.
    [126]许长春,王黎荔,刘军方等.低能量He-Ne激光脑定向治疗失眠症[J].前卫医药杂志,2001,18(5):337-338.
    [127]Su Y, Hu Pc. Development and current status in flotation BEST [J]. Chin J Clin Psychol.1999; 7(4):248-251.
    [128]失眠专家组.失眠定义、诊断及药物治疗专家共识[J].中华神经科杂志,2006,39(2):141-143.
    [129]刘贤臣,唐茂芹,胡蕾等.匹兹堡睡眠质量指数的信度和效度研究[J].中华精神科杂志,1996:29(2):103-107.
    [130]潘集阳.睡眠障碍临床诊疗[M].广州:华南工大出版社,2001年10月,第1版:30.
    [131]潘集阳.睡眠障碍临床诊疗[M].广州:华南工大出版社,2001年10月,第1版:36.

© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号

地址:北京市海淀区学院路29号 邮编:100083

电话:办公室:(+86 10)66554848;文献借阅、咨询服务、科技查新:66554700