督灸联合磁枣安神汤对心肾不交型失眠症病人睡眠质量的影响

孙晨; 修坤; 周娇丽

督灸联合磁枣安神汤对心肾不交型失眠症病人睡眠质量的影响

Effect of the governor vessel moxibustion combined with Cizao Anshen Decoction on the sleep quality in patients with heart-kidney non-interaction type insomnia disorder

摘要

摘要:
目的： 探讨督灸联合磁枣安神汤对心肾不交型失眠症病人睡眠质量的影响。
方法： 将90例心肾不交型失眠症病人随机分为对照组（45例）和观察组（45例），对2组病人均给予基础治疗和日常干预，对照组给予磁枣安神汤治疗，观察组给予督灸联合磁枣安神汤治疗，持续4个疗程，共28 d。观察2组病人治疗前后睡眠质量、焦虑水平、睡眠结构相关指标（睡眠潜伏期、快速动眼睡眠时间、入睡后清醒时间、总睡眠时间）、血清学水平皮质醇（CORT）、促肾上腺皮质激素（ACTH）、肿瘤坏死因子–α（TNF–α）、白细胞介素–1β（IL–1β）、中医证候积分等变化情况，并评估其临床疗效及安全性。
结果： 干预4个疗程后，观察组PSQI评分、GAD–7评分均低于对照组（P ＜ 0.01），睡眠潜伏期、快速动眼睡眠时间、入睡后清醒时间均低于对照组，总睡眠时间高于对照组（P ＜ 0.01），CORT水平、ACTH水平均低于对照组，TNF–α水平、IL–1β水平均低于对照组（P ＜ 0.05 ~ P ＜ 0.01），中医证候积分低于对照组（P ＜ 0.01），治疗总有效率高于对照组（P ＜ 0.05）。
结论： 督灸联合磁枣安神汤治疗心肾不交型失眠症疗效显著，可提高睡眠质量，改善睡眠结构，其机制可能与降低炎症因子含量、抑制亢奋的HPA轴，缩短觉醒时间有关，且安全有效。

Abstract:
Objective To investigate the effects of Governor vessel moxibustion combined with Cizao Anshen Decoction on the sleep quality in patients with insomnia disorder of heart-kidney disharmony pattern.
Methods Using a random number table, 90 patients with heart-kidney disharmony insomnia were divided into the control group (n = 45) and obvservation group (n = 45). Two groups were given basic treatment and daily intervention. The control group was treated with Cizao Anshen Decoction, while the observation group was treated with Governor vessel moxibustion combined with Cizao Anshen Decoction. The treatment lasted for 4 courses, totaling 28 days. The sleep quality, anxiety level, sleep structure-related indicators (sleep latency, rapid eye movement sleep time, waking time after falling asleep and total sleep time), erological levelscortisol (CORT), adrenocorticotropic hormone (ACTH), tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) and changes in TCM syndrome scores in two groups were observed before and after treatment. The clinical efficacy and safety were assessed.
Results After 4 courses of intervention, the PSQI and GAD-7 scores in the observation group were lower than those in control group (P ＜ 0.01), the sleep latency, rapid eye movement sleep time, and waking time after falling asleep were lower than those in control group, the total sleep time was higher than that in control group (P ＜ 0.01), and the CORT and ACTH levels were lower than those in control group. The levels of TNF-α and IL-1β in the observation group were lower than those in control group (P ＜ 0.05 to P ＜ 0.01), the TCM syndrome score was lower than that in control group (P ＜ 0.01), and the total effective rate of treatment was higher than that in control group (P ＜ 0.05).
Conclusions Du Moxibustion combined with Cizao Anshen Decoction has a significant therapeutic effects on insomnia of the heart-kidney disharmony type. It can improve sleep quality and sleep structure. The mechanism may be related to reducing the content of inflammatory factors, inhibiting the overactive HPA axis, and shortening the awakening time, and it is safe and effective.

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