耳穴贴压联合加味建中汤治疗失眠心脾两虚证的临床疗效

吕凤娟; 龙琰; 杨秀木; 汪玉玲; 姚玮玮; 徐振卫

doi:10.16766/j.cnki.issn.1674-4152.003648

耳穴贴压联合加味建中汤治疗失眠心脾两虚证的临床疗效

doi: 10.16766/j.cnki.issn.1674-4152.003648

1.
滁州市第一人民医院中西医结合内科，安徽滁州 239000
2.
蚌埠医学院全科医学教研室，安徽蚌埠 233000
3.
滁州城市职业学院药学教研室，安徽滁州 239000
4.
滁州中西医结合医院心内科，安徽滁州 239001

基金项目:

校企合作实践教育基地项目-全科医学实践教学示范基地项目 2021xqhzsjjd051

详细信息

通讯作者:
徐振卫，E-mail: xuzhenwei1981@163.com

中图分类号: R256.23 R224
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出版历程
- 收稿日期: 2023-11-28
- 网络出版日期: 2024-11-19

Clinical efficacy of ear acupoint pressing combined with Modified Jianzhong Decoction in the treatment of insomnia with heart and spleen deficiency syndrome

1.
Department of the Integrated Traditional Chinese and Western Medicine, the First People ' s Hospital of Chuzhou, Chuzhou, Anhui 239000, China

摘要

摘要: 目的观察耳穴贴压联合加味建中汤加减治疗心脾两虚型失眠患者的疗效及较单纯汤药组、单纯耳穴组应用的优越性。方法选取2021年10月—2023年10月于滁州市第一人民医院中西医结合内科就诊并符合入组标准的失眠症患者45例，采用随机数字表法分为3组，其中单纯耳穴治疗组15例，单纯中药汤剂治疗组15例，汤剂+耳穴贴压联合治疗组15例，治疗周期为2周。比较3组受试者治疗前后国际通用SPIEGEL睡眠量表评分、匹兹堡睡眠质量指数量表(PSQI)评分、阿森斯失眠量表(AIS)评分、中医症候积分、SAS焦虑量表评分和SDS抑郁量表评分，并收集患者对治疗满意度的评价。结果加味建中汤联合耳穴贴压治疗组的治疗总有效率为100.00%，较耳穴贴压(73.33%)和加味建中汤(66.67%)的临床总有效率更高(P < 0.05)。治疗2周后，3组患者PSQI和AIS睡眠质量评分较治疗前均下降(P < 0.05)。3组患者治疗后SAS、SDS评分均较治疗前下降(P < 0.05)。与治疗前比较，3组患者的中医症候积分均有不同程度的降低(P < 0.05)，且联合治疗组效果优于单纯治疗组(P < 0.01)。结论耳穴贴压联合加味建中汤加减治疗失眠症患者疗效确切，可有效改善患者失眠症状，提高患者睡眠质量，改善中医症候积分的同时缓解患者心理抑郁、焦虑情绪、提升患者临床满意度，较单纯复方治疗或耳穴贴压技术方案更具有优越性。
- 耳穴贴压 /
- 加味建中汤 /
- 心脾两虚证 /
- 失眠症 /
- 临床疗效
Abstract: Objective To observe the curative effect of ear acupoint pressing combined with Modified Jianzhong Decoction in treating insomnia patients with heart and spleen deficiency and its superiority over single therapy. Methods A total of 45 patients with insomnia who met the enrollment criteria and were treated in our department from October 2021 to October 2023 were selected and divided into a simple auricular point treatment group (15 cases), a simple Chinese medicine decoction treatment group (15 cases), and a decoction+auricular point soy-embedding combined treatment group (15 cases) according to random number table method. The treatment was two weeks. The international SPIEGEL sleep scale score, Pittsburgh sleep quality index (PSQI) score, Assens insomnia scale (AIS) score, and traditional Chinese medicine (TCM) syndrome score, self-rating anxiety scale (SAS) and self-rating depression scale (SDS) score of the three groups were compared before and after the treatment. The evaluation of patients ' satisfaction with the treatment was also collected. Results The total effective rate of Modified Jianzhong Decoction combined with ear point burying bean treatment group was 100.00%, which was higher than that of single ear point sticking (73.33%) or Modified Jianzhong Decoction (66.67%, P < 0.05). After 2 weeks of treatment, PSQI and AIS sleep quality scores in all 3 groups decreased compared with before (P < 0.05). After treatment, SAS and SDS scores of the 3 groups were decreased compared with those before treatment (P < 0.05), and the combined treatment group had the best effect, which improved anxiety and depression more significantly than the other two groups (P < 0.05). Compared with before treatment, the scores of TCM symptoms in the three groups were decreased to different degrees (P < 0.05), and the effect of the combined treatment group was the most significant (P < 0.01). Conclusion The combination of embedding beans in auricular points and Modified Jianzhong Decoction has a definite effect on the treatment of insomnia patients, which can effectively improve the insomnia symptoms of patients, improve the sleep quality of patients, improve the traditional Chinese medicine syndrome score, alleviate the psychological depression and anxiety of patients, and improve the clinical satisfaction of patients, and is more advantageous than the simple combination treatment or embedding beans in auricular points.
- Auricular acupoint burying bean /
- Modified Jianzhong Decoction /
- Heart and spleen deficiency syndrome /
- Insomnia /
- Clinical efficacy

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表 1 3组心脾两虚型失眠患者一般资料比较

Table 1. Comparison of baseline data among the three groups of insomnia patients with heart and spleen deficiency syndrome

组别	例数	性别[例(%)]		年龄(x±s, 岁)	病程(x±s，月)
组别	例数	男性	女性	年龄(x±s, 岁)	病程(x±s，月)
单纯汤剂组	15	6(40.0)	9(60.0)	52.4±10.82	8.37±3.01
单纯耳穴组	15	7(46.7)	8(53.3)	53.27±9.09	8.72±2.54
联合治疗组	15	6(40.0)	9(60.0)	55.87±9.48	8.65±2.68
统计量		0.182^a		0.507^b	0.068^b
P值		0.913		0.606	0.934
注：^a为χ²值，^b为F值。

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表 2 3组心脾两虚型失眠患者治疗前后SPIEGEL睡眠量表评分及临床疗效比较

Table 2. Comparison of SPIEGEL sleep scales ' scores and the clinical efficacy among the three groups of insomnia patients with heart and spleen deficiency syndrome before and after treatment

组别	例数	SPIEGEL(x±s, 分)		临床疗效(例)			总有效率(%)
组别	例数	治疗前	治疗后	显效	有效	无效	总有效率(%)
单纯汤剂组	15	35.20±4.14	22.37±5.94^b	1	9	5	66.67
单纯耳穴组	15	34.07±5.20	21.63±5.95^b	2	9	4	73.33
联合治疗组	15	34.13±5.09	15.80±6.00^b	2	13	0	100.00
统计量		0.260^a	5.462^a		6.227^c		6.436^c
P值		0.773	0.008		0.112		0.011
注：^a为F值，^c为χ²值；与同组治疗前比较，^bP＜0.05。

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表 3 3组心脾两虚型失眠患者治疗前后PSQI和AIS睡眠质量评分比较(x±s, 分)

Table 3. Comparison of sleep quality scores by PSQI and AIS scales among the three groups of insomnia patients with heart and spleen deficiency syndrome before and after treatment (x±s, points)

组别	例数	PSQI		AIS
组别	例数	治疗前	治疗后	治疗前	治疗后
单纯汤剂组	15	15.21±2.11	9.21±1.85^a	17.57±1.95	11.85±1.56^a
单纯耳穴组	15	15.07±2.49	8.71±2.23^a	17.36±1.74	12.50±2.79^a
联合治疗组	15	16.07±2.37	6.21±1.89^a	18.07±2.81	9.93±2.55^a
F值		0.811	9.714	0.407	4.806
P值		0.451	＜0.001	0.669	0.013
注：与同组治疗前比较，^aP＜0.05。

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表 4 3组心脾两虚型失眠患者治疗前后SAS和SDS评分比较(x±s, 分)

Table 4. Comparison of SAS and SDS scores among the three groups of insomnia patients with heart and spleen deficiency syndrome before and after treatment (x±s, points)

组别	例数	PSQI		AIS
组别	例数	治疗前	治疗后	治疗前	治疗后
单纯汤剂组	15	60.64±4.26	45.64±3.97^a	66.36±6.72	48.43±4.13^a
单纯耳穴组	15	59.14±3.78	48.43±3.03^a	65.07±6.23	46.86±7.35^a
联合治疗组	15	61.86±5.51	40.14±3.78^a	63.86±7.35	36.36±4.91^a
F值		1.330	20.410	0.510	20.360
P值		0.275	＜0.001	0.604	＜0.001
注：与同组治疗前比较，^aP＜0.05。

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表 5 3组心脾两虚型失眠患者治疗前后中医症候积分比较(x±s, 分)

Table 5. Comparison of TCM syndrome points among the three groups of insomnia patients with heart and spleen deficiency syndrome before and after treatment (x±s, points)

组别	例数	治疗前	治疗后
单纯汤剂组	15	26.13±4.31	15.20±3.05^a
单纯耳穴组	15	25.73±4.27	14.73±2.94^a
联合治疗组	15	27.47±5.99	11.87±4.69^a
F值		0.514	3.660
P值		0.602	0.034
注：与同组治疗前比较，^aP＜0.05。

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表 6 3组心脾两虚型失眠患者治疗前后满意度比较

Table 6. Comparison of patient satisfaction among the three groups of insomnia patients with heart and spleen deficiency syndrome before and after treatment

组别	例数	满意[例(%)]	一般[例(%)]	不满意[例(%)]	总满意度(%)
单纯汤剂组	15	7(46.67)	2(13.33)	6(40.00)	60.00
单纯耳穴组	15	6(40.00)	4(26.67)	5(33.33)	66.67
联合治疗组	15	13(86.67)	2(13.33)	0	100.00
注：3组总满意度比较，χ²=7.460, P=0.024。

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