上海针灸杂志2025，Vol.44Issue(7)：816-821,6.DOI:10.13460/j.issn.1005-0957.2025.07.0816
针刺联合耳穴贴压治疗慢性失眠伴焦虑抑郁状态的疗效观察
Clinical observation on the efficacy of acupuncture combined with auricular acupressure in the treatment of chronic insomnia with comorbid anxiety and depression
摘要
Abstract
Objective To observe the clinical efficacy of acupuncture combined with auricular acupressure in the treatment of chronic insomnia accompanied by anxiety and depression.Methods A total of 108 patients with chronic insomnia and comorbid anxiety and depression were randomly divided into two groups:the auricular acupressure group(58 cases)and the control group(50 cases).Both groups received escitalopram,the control group was treated with acupuncture,while the auricular acupressure group received acupuncture combined with auricular acupressure.The change in the Pittsburgh sleep quality index(PSQI),the 24-item Hamilton depression rating scale(HAMD-24),the Hamilton anxiety rating scale(HAMA),the general perceived self-efficacy scale(GSES),and the MOS 36-item short-form health survey(SF-36)were observed before and after treatment in the two groups.The serum levels of norepinephrine(NE),dopamine(DA),γ-aminobutyric acid(GABA),and 5-hydroxytryptamine(5-HT)were compared between the two groups.Clinical efficacy between the two groups was also compared.Results The total effective rate was 94.8%in the auricular acupressure group,significantly higher than 82.0%in the control group(P＜0.05).After treatment,both groups showed significant reductions in HAMD,HAMA,and PSQI scores(P＜0.05)compared to those before treatment,and the scores were lower in the auricular acupressure group than in the control group(P＜0.05).GSES score increased significantly in both groups post-treatment compared to those before treatment,and was higher in the auricular acupressure group than in the control group(P＜0.05).After treatment,the scores of each item in SF-36 also improved significantly in both groups compared to those before treatment(P＜0.05),with the auricular acupressure group scoring higher than the control group(P＜0.05).Serum NE and DA levels decreased after treatment in both groups compared to those before treatment(P＜0.05),and the levels were lower in the auricular acupressure group than in the control group(P＜0.05).GABA and 5-HT levels increased significantly post-treatment in both groups compared to those before treatment(P＜0.05),and the levels were higher in the auricular acupressure group than in the control group(P＜0.05).Conclusion Acupuncture combined with auricular acupressure and Western medication can alleviate negative emotional states,improve sleep quality,enhance self-efficacy,and improve quality of life in patients with chronic insomnia and comorbid anxiety and depression.These effects may be associated with the modulation of neurotransmitter levels.关键词
耳穴贴压/针刺疗法/针药并用/焦虑抑郁状态/失眠/神经递质Key words
Auricular acupressure/Acupuncture therapy/Acupuncture medication combined/Anxiety and depression/Insomnia/Neurotransmitters分类
医药卫生引用本文复制引用
林锋,刘继洪..针刺联合耳穴贴压治疗慢性失眠伴焦虑抑郁状态的疗效观察[J].上海针灸杂志,2025,44(7):816-821,6.基金项目
广东省中医药局中医药科研项目(20211368) （20211368）
