上海针灸杂志2025，Vol.44Issue(10)：1188-1195,8.DOI:10.13460/j.issn.1005-0957.2025.10.1188
针药并用治疗心脾两虚型老年慢性失眠的疗效观察
Efficacy observation of acupuncture combined with medication for chronic insomnia in elderly patients with deficiency of the heart and spleen pattern
摘要
Abstract
Objective To observe the clinical efficacy of acupuncture at umbilicus four-sided points combined with Gan Mai Qi Xian Ci Shi decoction in treating elderly patients with chronic insomnia of deficiency of the heart and spleen pattern.Method A total of 120 elderly patients with chronic insomnia of deficiency of the heart and spleen pattern were randomly divided into three groups(a study group,an acupuncture group and a medication group)using a random number table,with 40 cases in each group.All three groups received conventional Western medicine treatment.The acupuncture group additionally received acupuncture at umbilicus four-sided points,the medication group additionally received oral Gan Mai Qi Xian Ci Shi decoction,and the study group additionally received both acupuncture at umbilicus four-sided points and Gan Mai Qi Xian Ci Shi decoction.The clinical efficacy,recurrence rate,and incidence of adverse reactions were compared among the three groups.Changes in TCM syndrome scores,sleep quality[Pittsburgh sleep quality index(PSQI)],sleep structure parameters[sleep efficiency(SE),total sleep time(TST),sleep onset latency(SOL),wake after sleep onset(WASO),non-rapid eye movement stages 1,2,and 3(N1,N2,N3),rapid eye movement sleep(REM)],neurotransmitter levels[serum dopamine(DA),melatonin(MT),5-hydroxytryptamine(5-HT)],and quality of life[Generic Quality of Life Inventory(GQOLI-74)]were observed before and after treatment.Result The total effective rate in the study group was 95.0%,which was higher than that in the acupuncture group(80.0%)and the medication group(75.0%)(P＜0.05).After treatment,TCM syndrome scores and PSQI scores in the study group were lower than those in the acupuncture group and the medication group,while the acupuncture group had lower TCM syndrome scores and PSQI scores than the medication group(P＜0.05).The study group showed better improvements in SE,TST,N3,and REM compared to the acupuncture group and the medication group(P＜0.05),and the acupuncture group showed better improvements in these parameters than the medication group(P＜0.05).The study group had lower SOL,WASO,N1,and N2 than the acupuncture group and the medication group(P＜0.05),and the acupuncture group had lower SOL,WASO,N1,and N2 than the medication group(P＜0.05).The study group had lower serum DA levels than the acupuncture group and the medication group(P＜0.05),while the medication group had lower DA levels than the acupuncture group(P＜0.05).The study group had higher serum MT and 5-HT levels than the acupuncture group and the medication group,and the medication group had higher MT and 5-HT levels than the acupuncture group(P＜0.05).The study group had higher GQOLI-74 scores than the acupuncture group and the medication group(P＜0.05).No significant difference was observed in the incidence of adverse reactions among the three groups(P＜0.05).The recurrence rate in the study group was 2.6%,which was lower than that in the acupuncture group(17.9%)and the medication group(21.1%)(P＜0.05).Conclusion On the basis of conventional Western medicine treatment,acupuncture at umbilicus four-sided points combined with Gan Mai Qi Xian Ci Shi decoction is more effective than either treatment alone for elderly patients with chronic insomnia of deficiency of the heart and spleen pattern.It can improve sleep quality,correct neurotransmitter imbalances,enhance quality of life,and reduce recurrence rates.关键词
针刺疗法/针药并用/失眠/入睡和睡眠障碍/心脾两虚/老年Key words
Acupuncture therapy/Acupuncture medication combined/Insomnia/Sleep initiation and maintenance disorders/Deficiency of the heart and spleen pattern/Elderly分类
医药卫生引用本文复制引用
王佳,于洁,刘亚南,刘方方..针药并用治疗心脾两虚型老年慢性失眠的疗效观察[J].上海针灸杂志,2025,44(10):1188-1195,8.基金项目
承德市科学技术研究与发展计划项目(202102A006) （202102A006）
