摘要
目的探讨董氏奇穴针刺法配合养心安神祛痰汤对痰湿内蕴型失眠患者睡眠质量及γ-氨基丁酸(GABA)、谷氨酸(Glu)、多巴胺(DA)、5-羟色胺(5-HT)血清表达的影响。方法选取2017年11月—2019年1月医院痰湿内蕴型失眠患者123例进行前瞻性研究,根据随机数字表法分为对照A组、对照B组、联合组,各41例。对照A组采取常规针刺及镇静药物,对照B组采取养心安神祛痰汤,联合组采取养心安神祛痰汤及董氏奇穴针刺法联合治疗,均治疗1个月。治疗1个月后统计3组临床疗效、治疗前后睡眠质量评分、痰湿体质评分、血清GABA、Glu水平、DA、5-HT水平,并随访3~9个月统计疾病复发率。结果联合组总有效率(92.68%,38/41)高于对照A组(73.17%,30/41)、对照B组(73.17%,30/41)(P<0.05);治疗后3组药物应用、日间功能、睡眠效率、睡眠障碍、入睡时间、主观睡眠质量、睡眠时间、总分较治疗前降低,且联合组低于对照A、B组(P<0.05);治疗后3组痰湿体质评分较治疗前降低,且联合组低于对照A、B组(P<0.05);治疗后3组血清GABA水平较治疗前增高,Glu水平较治疗前降低,且联合组血清GABA水平高于对照A组、对照B组,Glu水平低于对照A组、对照B组(P<0.05);治疗后3组血清DA水平较治疗前降低,5-HT水平较治疗前增高,且联合组DA水平低于对照A组、对照B组,5-HT水平高于对照A组、对照B组(P<0.05);治疗后3个月、6个月、9个月联合组疾病复发率[(0.00%(0/41)、0.00%(0/41)、2.44%(1/41)]与对照A组[2.44%(1/41)、4.88%(2/41)、7.32%(3/41)]、对照B组[2.44%(1/41)、4.88%(2/41)、4.88%(2/41)]间差异无统计学意义(P>0.05)。结论联合采取养心安神祛痰汤及董氏奇穴针刺法治疗痰湿内蕴型失眠,可有效调节患者痰湿体质,改善其睡眠质量,提高疾病整体治疗效果,并可调节血清GABA、Glu等水平。
Objective To explore the effect of Dong's extra acupoints acupuncture combined with Yangxin Anshen Qutan Decoction(养心安神祛痰汤)on sleep quality of insomnia patients with phlegm-dampness internal accumulation type and the effect on expressions ofγ-aminobutyric acid(GABA),glutamic acid(Glu),dopamine(DA)and serotonin(5-HT)in serum.Methods A prospective study of 123 patients with insomnia with phlegm-dampness internal accumulation type in the hospital from November 2017 to January 2019 was conducted.According to the random number table method,the patients were divided into control group A,control group B and combination group,with 41 cases in each group.The control group A received conventional acupuncture and sedative drugs,while the control group B received Yangxin Anshen Qutan Decoction and the combination group was treated with Yangxin Anshen Qutan Decoction and Dong's extra acupoints acupuncture.All groups were treated for one month.After one month of treatment,the clinical efficacy,sleep quality score,the phlegm-dampness constitution score,levels of GABA and Glu in serum,levels of DA and 5-HT before and after treatment of the three groups were calculated.The disease recurrence rate was observed for 3~9 months follow-up.Results The total effective rate of the combination group(92.68%,38/41)was higher than that of the control group A(73.17%,30/41)and the control group B(73.17%,30/41)(P<0.05).After treatment,the drug application,daytime function,sleep efficiency,sleep disturbance,time to sleep,subjective sleep quality,sleep time and total score were lower than those before treatment and those of the combination group were lower than those of the control A and B groups(P<0.05).After treatment,the phlegm-dampness constitution score of the three groups was lower than that before treatment,and that of the combination group was lower than that of the control A and B groups(P<0.05).After treatment,the serum GABA levels in the three groups were higher than those before treatment,and the Glu level was lower than that before treatment.The serum GABA level in the combination group was higher than that in the control A and B groups,and the Glu level was lower than that in the control A and B groups(P<0.05).After treatment,the serum DA levels in the three groups were lower than those before treatment,and the 5-HT levels were higher than those before treatment and the DA level of the combination group was lower than that of the control A and B groups,and the level of 5-HT was higher than that of the control A and B groups(P<0.05).There was no significant difference in the disease recurrence rate of the combination group[0.00%(0/41),0.00%(0/41),2.44%(1/41)]compared with that of the control group A[2.44%(1/41),4.88%(2/41),7.32%(3/41)]and the control group B[2.44%(1/41),4.88%(2/41),4.88%(2/41)]at the third,sixth and ninth month after treatment(P>0.05).Conclusion The combination of Yangxin Anshen Qutan Decoction and Dong's extra acupoints acupuncture is used to treat insomnia patients with phlegm-dampness internal accumulation type.It can effectively regulate patients'phlegm-dampness constitution,improve their sleep quality and the overall treatment effect of the disease and adjust the levels of GABA and Glu in serum.
作者
徐开全
周娃妮
仝乐
房铭
冷梅
XU Kaiquan;ZHOU Wani;TONG Le;FANG Ming;LENG Mei(Qingdao Hospital of Traditional Chinese Medicine of Qingdao,Qingdao 266033,Shandong,China;Huangdao Hospital of Traditional Chinese Medicine of Qingdao,Qingdao 266033,Shandong,China)
出处
《中华中医药学刊》
CAS
北大核心
2022年第5期99-103,共5页
Chinese Archives of Traditional Chinese Medicine
基金
国家中医药管理局中医药行业科研项目(201908733)
关键词
董氏奇穴针刺法
养心安神祛痰汤
痰湿内蕴
失眠
睡眠质量
谷氨酸
γ-氨基丁酸
Dong's extra acupoints acupuncture
Yangxin Anshen Qutan Decoction(养心安神祛痰汤)
phlegm-dampness internal accumulation
insomnia
sleep quality
glutamic acid
γ-aminobutyric acid
