蒙医温针治疗偏赫依型失眠症的临床研究

来源 :北京中医药大学 | 被引量 : 1次 | 上传用户:younger666
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Research objective1)To diagnose the disease with "the ten elements" content in mongolian medicine as the starting point,The initial study of "Hei" insomnia more common in clinical.2)To investigate the sleep quality by Pittsburgh Sleep Quality Index(PSQI)each factor and total score,and the sleep process and structure of Polysomnography(PSG),To explore the clinical efficacy of Mongolian medical warm acupuncture.Warming Therapy for "Hei"insomnia.And the detection of serum ACTH,hydrocortisone,melatonin in patients with insomnia,preliminary study on intervention mechanism of Mongolian medical warm acupuncture treatment of insomnia,and provide scientific basis for clinical treatment,improve clinical curative effect.Research methods1.Through statistical analysis 300 cases of retrospective medical cases,the main symptoms of insomnia,predisposing factors,lesion site,incidence season,living environment,patient characteristics,patient age,living habit,patient constitution,disease urgency and other Mongolian medicine diagnosis of disease "ten elements" content,to explore the causes,incentives and common clinical types of insomnia.2.Choose to meet the diagnostic criteria and inclusion criteria of "Hei" type insomnia patientsin 90 cases,Were randomly divided into Mongolian warm acupuncture group,drug group,control acupuncture group,each group of 30 cases.Warming group selected the"dinghui","hei" and "xin" points,every three days in turn conventional Mongolian medical treatment,9 days for a course of treatment,a total of 3 courses of treatment.Acupuncture points acupuncture points for"dinghui","hei" and "xin",and the points on the left 45 degrees angle 1 inch,the rest wes same with the Mongolian Warming group.The drug group was given 1 mg of estazoleam per night.All of them get three courses.(1)To observe the changes and the total curative effect of PSQI in the three groups before and after treatment.(2)The change of PSG index of three groups were observed before and after treatment,analysis of the influence of Mongolian warm acupuncture on insomnia patients taking Heiyi sleep process and sleep structure.(3)The serum adreno corticotropic hormone(ACTH),hydrocortisone(HDY),melatonin(MLT)of three groups were observed before and after treatment,from the perspective of biochemical factors preliminary analysis of possible mechanism of acupuncture treatment of Mongolian medicine taking "Hei" insomnia in order,lay the foundation for further study.Research result1.Through retrospective analysis of 300 patients with insomnia were the main symptoms,inducing factors,the seasonal incidence of the lesion site,living environment,the patient,patient age,living habits,physical fitness,lesions in Mongolian medicine in the diagnosis of diseases such as delayed ten elements content,found the cause "according to give priority to",incentives for excessive heart,body,speech function ",and 300 cases of basis analysis shows that the majority of patients have many "ten elements content induced Hector in accordance with the conditions.2.① Compared with the control acupuncture group,the time of falling asleep after treatment was different in before treatment(P<0.05).② Mongolian warm acupuncture group after treatment of each factor score and total score compared with before treatment,the improvement had different degree(P<0.05),the sleep quality,sleep time,sleep efficiency and daytime function and the total score of PSQI as compared with before treatment there was significant difference(P<0.01).③ There was a significant difference in falling asleep time,sleep time,sleep disorder and PSQI score before and after treatment(P<0.01).④ Among the three groups after treatment,control acupuncture group and drug group,in addition to the differences in sleep efficiency and daytime function of other indicators have different degree(P<0.05);Mongolian warm acupuncture group compared with the drug group,the sleep quality,sleep efficiency and daytime function and the total score of PSQI in sleep time was better than the drug group.The drug group in the time of falling asleep was significantly better than the Mongolian warm acupuncture group.To compare the clinical effect,Mongolian warm acupuncture group compared with the drug group was no significant different(P>0.05),drug group compared with control acupuncture group has significant difference(P<0.05).3.① There was no significant difference between thecontrol acupuncture group and the group before and after treatment in PSG sleep parameters(P>0.05).② The awakenings,total sleep time,sleep time,the REM sleep time,slow wave sleep percentage and percentage of REM sleep in Mongolian warm acupuncture group before and after thetreatment was significantly different(P<0.05).③ Before and after treatment in drug group,the S1 sleep time,sleep latency,number of awakening,awakening time,actualsleeptime and REM sleep percentage were significantly different(P<0.05).④Compared the three groups after treatment,rest in S1 sleep time and sleep latency in Mongolian warm acupuncture group and control acupuncture group,the sleep parameters were different(P<0.05);except REM sleep time and percentage of slow wave sleep compared with control acupuncture group and drug group,the sleep parameters were different(P<0.05);Mongolian warm acupuncture group drug group in addition to the actual sleep time,the sleep parameters were different(P<0.05),in which the number of awakening,awakening time,slow wave sleep percentage and REM time and other aspects of the improvement of Mongolian warm acupuncture group was significantly better than the druggroup,S1 sleep time,sleep latency improvement in drug group is better than the Mongolian warm acupuncture group.4.Changes in serum ACTH levelsAfter treatment,the content of serum ACTH in Mongolian warm acupuncture group and the drug group was significantly improved,which was different from that of the same group before and after treatment(P<0.05),The results showed that the content of ACTH in patients within "Hei"somnia was significantly improved.After treatment,the control acupuncture group on serum ACTH in diagnosis of diseases of Mongolian medicine "the ten elements" content,find the insomnia mainly causes by "Hei",and over 300 cases analysis shows that the majority of patients with many "ten elements" content haveevoked taking "Hei" conditions.Compared with the control acupuncture group,the time of falling asleep after treatment was compared with that before treatment(P<0.05).compared with Mongolian warm acupuncture group before and after treatment of each factor score and total score,the improvement had different degree(P<0.05),the sleep quality,sleep time,sleep efficiency and daytime function and the total score of PSQI as compared with before treatment,there was significant difference(P<0.01).There was a significant difference in sleep time,sleep time,sleep disorder and PSQI score before and after treatment(P<0.01).Between the three groups after treatment,control acupuncturegroup and drug group,in addition to the differences in sleep efficiency and increasing function of other indicators have different degree(P<0.05);Mongolian warm acupuncture group compared with the drug group,the sleep quality,sleep efficiency anddaytime function and the total score of PSQI in sleep time is bettrt than the drug group.The drug group was significantly better than the Mongolian warm acupuncture group infall asleep time.Comparison of the clinical efficacy,the content of Mongolian warm acupuncture H content had no obvious improvement,had no significant differences compared with the same group before and after treatment(P>0.05),indicated that control acupuncture on "Hei" insomnia patients’serum ACTH content with no effect.Mongolian warm acupuncture group and drug group had significant difference(P<0.05),indicated that Mongolian warm acupuncture was better than Estazolam Tablets in improve the content of serum ACTH in patients with "Hei"insomnia.5.Hydrocortisone(HDY)After treatment,the Mongolian warm acupuncture group and medicine group on serum HDY content were decreased,no significant difference(P>0.05);the rate of reduce within two groups,it is Mongolian warm acupuncture group which was better than the drug group(P<0.05),indicating improved aspects of Mongolian warm acupuncture is better than Estazolam Tablets for taking Heiyi HDY content in serum of patients with insomnia.After the treatment in the control on the content of serum HDY of the acupuncture group had no obvious improvement,had no significant differences compared with the same group before and after treatment(P>0.05),indicated that the control acupuncture had no improvement for "Hei" insomnia in HDY content.6.Melatonin(MLT)contentAfter the treatment of Mongolian warm acupuncture group and drug group of serum MLT was significantly improved,compared with the same group before and after treatment were significantly different(P<0.05),description of Mongolian warm acupuncture and estazolam have significant effect on improving the serum MLT content in "Hei" insomnia patients,and the effect is similar.After treatment,the control acupuncture group had no obvious improvement of serum MLT levels,and had no significant differences compared with the same group before and after treatment(P>0.05),indicated that the control acupuncture had no improvement for "Hei" insomnia in MLT contentConclusion1.This study investigated the cognition,etiology,predisposing factors and clinical types of insomnia,to provide the basis for future research.2.Mongolian warm acupuncture can significantly improve the quality of sleep in patients with "Hei" insomnia,increase sleep time,improve sleep efficiency and daytime function.3.Mongolian warm acupuncture can significantly reduce the patients taking "Hei"insomnia awakening during the night time and the number of actual sleep time and REM sleep time,improve the slow wave sleep and REM sleep.4.The Mongolian warm acupuncture can play a role in improving sleep on the subjective and objective aspect.With similar effect as Estazolam Tablets.5.Mongolian warm acupuncture can improve the biochemical indexes like adrenocorticotropic hormone(ACTH),hydrocortisone(HDY),melatonin(MLT)content in"Hei" insomnia significantly.6.Mongolian warm acupuncture had significant effect on the "Hei" insomnia patients,and it is simple,safe.
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