柴胡桂枝干姜湯加味聯(lián)合針灸療法治療肝脾不調(diào)型原發(fā)性失眠的臨床效果

李?yuàn)檴?+劉清泉++于翔+石廣霞

[摘要] 目的 探究柴胡桂枝干姜湯加味合針灸療法治療原發(fā)性失眠的臨床效果。 方法 選取北京市昌平區(qū)中西醫(yī)結(jié)合醫(yī)院2014年5月～2016年5月收治的90例原發(fā)性失眠患者，采取隨機(jī)數(shù)字表法分為對(duì)照組與觀察組，每組各45例。對(duì)照組給予針灸療法，觀察組在對(duì)照組治療方法基礎(chǔ)上給予柴胡桂枝干姜湯治療，以14 d為1個(gè)療程，兩組均連續(xù)治療3個(gè)療程。比較兩組臨床療效、匹茲堡睡眠質(zhì)量指數(shù)（PSQI）及睡眠參數(shù)。 結(jié)果 觀察組臨床總有效率高于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P < 0.05）。與治療前相比，兩組治療后PQSI評(píng)分均明顯降低，且觀察組治療后PSQI評(píng)分低于同期對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P < 0.05）。與治療前相比，兩組治療后睡眠參數(shù)有所改善，且觀察組改善效果優(yōu)于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P < 0.05）。 結(jié)論 柴胡桂枝干姜湯加味合針灸療法治療原發(fā)性失眠的效果顯著，能夠有效改善睡眠質(zhì)量。

[關(guān)鍵詞] 柴胡桂枝干姜湯；針灸；原發(fā)性失眠

[中圖分類號(hào)] R277 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 1673-7210（2017）11（c）-0154-04

The clinical effect of Chaihu Guizhi Ganjiang Decoction combined with acupuncture in treating primary insomnia with syndrome of disharmony between liver and spleen

LI Shanshan1 LIU Qingquan2 YU Xiang1 SHI Guangxia2

1.Department of Acupuncture， Beijing Changping Hospital of Integrated Chinese and Western Medicine， Beijing 102208， China； 2. Beijing Hospital of Traditional Chinese Medicine， CMU， Beijing 100010， China

[Abstract] Objective To explore the clinical effect of Chaihu Guizhi Ganjiang Decoction combined with acupuncture in treating primary insomnia. Methods From May 2014 to May 2016， 90 cases with primary insomnia treated in Beijing Changping Hospital of Integrated Chinese and Western Medicine were selected and divided into control group and observation group by random number table， with 45 cases in each group. The control group was treated by acupuncture therapy， and the observation group was treated by Chaihu Guizhi Ganjiang Decoction based on the control group. With 14 d as one course of treatment， the two groups were treated for 3 consecutive courses. The clinical effect， PSQI score and sleeping parameter in the two groups were compared. Results The total effective rate of the observation group was better than that of control group （P < 0.05）. After treatment， the PQSI scores in the two groups were lower than those before treatment， and the PQSI score in the observation group was lower than that in the control group， with statistically significant difference （P < 0.05）. After treatment， the sleeping parameter in the two groups was better than that before treatment， and the sleeping parameter in the observation group was better than that in the control group， with statistically significant difference （P < 0.05）. Conclusion The clinical effect of Chaihu Guizhi Ganjiang Decoction combined with acupuncture in treating primary insomnia is remarkable， which can effectively improve sleep quality.

[Key words] Chaihu Guizhi Ganjiang Decoction； Acupuncture； Primary insomnia

失眠作為臨床上一類發(fā)病率較高的常見病，對(duì)患者的生命健康及生活質(zhì)量造成了較大的影響。原發(fā)性失眠主要指每周至少發(fā)生3次以上且維持1個(gè)月以上的情況，但并非由其他軀體類疾病、精神類疾病或其他藥物的使用所導(dǎo)致[1-2]。據(jù)調(diào)查資料顯示，迫于社會(huì)發(fā)展太快的腳步，人們生活節(jié)奏加速，壓力逐漸增大，引起越來越多的人失眠，目前有10%～15%的患者受到原發(fā)性失眠的困擾，其中絕大部分為肝脾不調(diào)型[3]。采用安眠藥物治療可作為改善失眠患者的有效手段，但依賴性較強(qiáng)，容易為患者帶來諸多負(fù)面影響。中醫(yī)認(rèn)為，失眠屬于不寐的范疇，有諸多治療方法均可取得顯著效果。北京市昌平區(qū)中西醫(yī)結(jié)合醫(yī)院（以下簡(jiǎn)稱“我院”）將柴胡桂枝干姜湯加味應(yīng)用于肝脾不調(diào)型原發(fā)性失眠的治療過程中，結(jié)果報(bào)道如下：