针灸治疗慢性失眠的时效性与量效性临床研究(1)
摘要：目的 为提高慢性失眠患者的治疗效果，临床对针灸治疗的时效性与量效性进行研究。方法 选取我院2014年3月～2015年7月收治的96例慢性失眠患者，根据入院时间分批在分组，第一批45例患者分为晨治组(早上进行针灸治疗)与午治组(下午进行针灸)，观察两组治疗效果；依据第一批结果将第二批45例患者分为每日组(每日进行治疗)与隔日组(每2d进行一次针灸)，观察两组治疗效果。结果 治疗后两组在睡眠质量、睡眠效率、催眠药物、睡眠时间、日间功能方面差别无意义，P>0.05，晨治组较午治组入睡时间长，P<0.05；治疗后两组在睡眠质量、睡眠效率、催眠药物、睡眠时间、日间功能、入睡时间方面差别无意义，P>0.05。结论 对于慢性失眠患者临床采用针灸治疗无明显时效性与量效性，但对入睡困难者可选择下午针灸。
关键词：时效性；针灸；慢性；失眠；量效性；疗效
Abstract：Objective To improve the treatment effect in patients with chronic insomnia and study the timeliness and dose effect of acupuncture therapy.Methods 96 patients with chronic insomnia treated from March 2014 to July 2015 in our hospital were selected.The patients were divided into groups according to the admission time of hospital.For the first group，they were divided into morning group(take the acupuncture therapy in the morning)and afternoon group(take the acupuncture therapy in the afternoon)；the curative effect for two groups was observed.For the second group，they were divided into daily group(take the therapy each day)and alternate group(take the therapy every two days)；the curative effect for two groups was observed.Results After treatment，the sleep quality，sleep efficiency，hypnotic，sleeping time and daytime function for two groups was not signficantly different(P>0.05)；the time of falling asleep for morning group was longer than that of afternoon group(P<0.05)；after treatment，the sleep quality，sleep efficiency，hypnotic，sleeping time，daytime function and time of falling asleep for two groups was not signficantly different(P>0.05).Conclusion For patients with chronic insomnia，the acupuncture therapy has no obvious timeliness and dose effect.The acupunture therapy in the afternoon is good for the patients with the difficulty of falling asleep.
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Key words：Timeliness；Acupuncture；Chronic；Insomnia；Dose effect；Curative effect
慢性失眠多指患者每周至少3d且持续3个月以上的睡眠紊乱，其致病因素至今未明，但研究表明长期精神压力、兴奋、睡眠规律改变、手术、咳嗽、心绞痛、夜尿多、呼吸困难等均是引发疾病的常见因素。慢性患者多数在经历刺激、焦虑、压力、兴奋时，因为工作等原因造成睡眠规律改变时，至高海拔的地方，患者受到持续性压力，因疾病出现疼痛、心绞痛咳嗽等症状以及躯体疲劳均有可能导致短暂性失眠障碍，若不及时治疗失眠情况严重，有引发慢性失眠的可能性[1]。针灸是治疗慢性失眠的常用方法，有学者认为针灸有时效性与量效性，不同时间施针会影响患者治疗效果[2]。本次我院对针灸时效性与量效性进行临床研究，现报道如下。
1 资料与方法
1.1一般资料 选取我院2014年3月～2015年7月收治的96例慢性失眠患者，根据入院时间分批在分组，第一批45例患者分为晨治组与午治组；依据第一批结果将第二批45例患者分为每日组与隔日组，所有患者经检查符合慢性失眠临床诊断标准[3]，且患者时间均在3个月以上，患者可积极配合治疗，非疾病引发疼痛、咳嗽或手术等外在因素造成的失眠。所有患者年龄、职业等一般资料差别无意义，P>0.05。
1.2方法 所有患者均进行针灸治疗，主穴为：神门、四神聪、申脉、内关、太溪、三阴交、照海辅穴为：大陵、太冲、气海、神庭、心俞、丰隆、隐白、曲池、风隆、大陵、印堂等每次留针30～40min，10d为1个疗程，共治疗2～4个疗程，每个程后休息3d，继续下一个疗程；治疗期间，有服用催眠药的患者，要逐渐减药至最少量或停服。, 百拇医药(李一凡)
关键词：时效性；针灸；慢性；失眠；量效性；疗效
Abstract：Objective To improve the treatment effect in patients with chronic insomnia and study the timeliness and dose effect of acupuncture therapy.Methods 96 patients with chronic insomnia treated from March 2014 to July 2015 in our hospital were selected.The patients were divided into groups according to the admission time of hospital.For the first group，they were divided into morning group(take the acupuncture therapy in the morning)and afternoon group(take the acupuncture therapy in the afternoon)；the curative effect for two groups was observed.For the second group，they were divided into daily group(take the therapy each day)and alternate group(take the therapy every two days)；the curative effect for two groups was observed.Results After treatment，the sleep quality，sleep efficiency，hypnotic，sleeping time and daytime function for two groups was not signficantly different(P>0.05)；the time of falling asleep for morning group was longer than that of afternoon group(P<0.05)；after treatment，the sleep quality，sleep efficiency，hypnotic，sleeping time，daytime function and time of falling asleep for two groups was not signficantly different(P>0.05).Conclusion For patients with chronic insomnia，the acupuncture therapy has no obvious timeliness and dose effect.The acupunture therapy in the afternoon is good for the patients with the difficulty of falling asleep.
, http://www.100md.com
Key words：Timeliness；Acupuncture；Chronic；Insomnia；Dose effect；Curative effect
慢性失眠多指患者每周至少3d且持续3个月以上的睡眠紊乱，其致病因素至今未明，但研究表明长期精神压力、兴奋、睡眠规律改变、手术、咳嗽、心绞痛、夜尿多、呼吸困难等均是引发疾病的常见因素。慢性患者多数在经历刺激、焦虑、压力、兴奋时，因为工作等原因造成睡眠规律改变时，至高海拔的地方，患者受到持续性压力，因疾病出现疼痛、心绞痛咳嗽等症状以及躯体疲劳均有可能导致短暂性失眠障碍，若不及时治疗失眠情况严重，有引发慢性失眠的可能性[1]。针灸是治疗慢性失眠的常用方法，有学者认为针灸有时效性与量效性，不同时间施针会影响患者治疗效果[2]。本次我院对针灸时效性与量效性进行临床研究，现报道如下。
1 资料与方法
1.1一般资料 选取我院2014年3月～2015年7月收治的96例慢性失眠患者，根据入院时间分批在分组，第一批45例患者分为晨治组与午治组；依据第一批结果将第二批45例患者分为每日组与隔日组，所有患者经检查符合慢性失眠临床诊断标准[3]，且患者时间均在3个月以上，患者可积极配合治疗，非疾病引发疼痛、咳嗽或手术等外在因素造成的失眠。所有患者年龄、职业等一般资料差别无意义，P>0.05。
1.2方法 所有患者均进行针灸治疗，主穴为：神门、四神聪、申脉、内关、太溪、三阴交、照海辅穴为：大陵、太冲、气海、神庭、心俞、丰隆、隐白、曲池、风隆、大陵、印堂等每次留针30～40min，10d为1个疗程，共治疗2～4个疗程，每个程后休息3d，继续下一个疗程；治疗期间，有服用催眠药的患者，要逐渐减药至最少量或停服。, 百拇医药(李一凡)