【摘要】 目的观察毕氏神针结合心理疗法治疗痰热扰神型失眠的临床疗效。方法选取2020年1月—2021年1月期间于河南省中医药研究院神志科就诊的80例痰热扰神型失眠症患者,按随机数字表法将所有的患者分为观察组和对照组,每组40例。对照组患者给予常规西药治疗,而观察组患者则在对照组治疗的基础上配合毕氏神针结合心理疗法,两组患者均连续治疗4周,比较两组患者的匹兹堡睡眠质量指数(PSQI)、夜间觉醒次数、入睡时间、中医症状评分,血清5-羟色胺(5-HT)、脑源性神经营养因子(BDNF)、肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(1L-1β)、核转录因子-κB(NF-κB)水平变化以及两组临床疗效。结果治疗后两组匹兹堡睡眠质量指数入睡时间、睡眠时间、睡眠障碍、睡眠质量、睡眠效率评分与本组治疗前比较均不同程度降低(P <0.05),且观察组各项评分下降幅度明显低于对照组(P <0.05)。治疗后两组入睡时间、夜间觉醒次数均明显少于本组治疗前(P <0.05),睡眠时间则明显长于本组治疗前(P <0.05);且观察组睡眠质量各项指标改善情况均明显优于对照组(P <0.05)。治疗后两组患者失眠、口苦、头晕、胸闷、苔黄腻、多痰等各项中医症状评分均显著低于本组治疗前(P <0.05),且观察组中医症状各项评分下降更明显(P <0.05)。治疗后两组5-HT、BDNF、TNF-α、1L-1β、NF-κB与本组治疗前比较均明显降低(P <0.05),且观察组各项指标改善情况均明显优于对照组(P <0.05)。治疗后观察组总有效率为90.0%(36/40),对照组总有效率为70.0%(28/40),两组比较差异有统计学意义(P <0.05)。结论毕氏神针结合心理疗法治疗痰热扰神型失眠症疗效较好,临床能够极大程度地改善患者的睡眠质量,并可以调节血清5-HT,BDNF,TNF-α,1L-1β,NF-κB水平。更多还原

【Abstract】 Objective To observe the clinical effect of Bi’s magic needle combined with psychotherapy in phlegm-heat disturbing mental insomnia. Method From January 2020 to January 2021,80 patients with phlegm-heat disturbing mental insomnia were selected from the Department of Mental Health of Henan Academy of Traditional Chinese Medicine from January 2020 to January 2021. All patients were divided into observation group and control group according to the random number table method. Group,40 patients in each group,of which patients in the control group were treated with conventional western medicine,while patients in the observation group were treated with Bi’s magic needle combined with psychotherapy on the basis of the treatment in the control group. Both groups were treated for 4 consecutive weeks. The Pittsburgh Sleep Quality Index( PSQI),number of night awakenings,time to fall asleep,TCM symptom score,serum 5-HT,BDNF,TNF-α,1 L-1β,NF-κB level changes and the clinical efficacy of the two groups were compared. Results After treatment,the Pittsburgh sleep quality index scores of the two groups of patients fell asleep,sleep time,sleep disturbance,sleep quality,and sleep efficiency compared to those before treatment( P < 0. 05),and the observation group’s scores decreased significantly Lower than the control group( P < 0. 05). After treatment,the time to fall asleep and the number of night awakenings of the two groups of patients were significantly less than before treatment( P < 0. 05),and the sleep time was significantly longer than before treatment( P < 0. 05); and the improvement of various indicators of sleep quality in the observation group was significantly better than that before treatment. Control group( P < 0. 05). After treatment,the scores of insomnia,mouth pain,dizziness,chest tightness,yellow and greasy fur,and phlegm were significantly lower in the two groups of patients than before treatment( P < 0. 05),and the scores of TCM symptoms in the observation group decreased more significantly( P < 0. 05). After treatment,the tumor necrosis factor-α( TNF-α),interleukin-1β( 1 L-1β) and nuclear transcription factor-κB( NF-κB) indexes of the two groups were significantly reduced compared with those before treatment( P < 0. 05),And the improvement of various indicators of the observation group was significantly better than that of the control group( P < 0. 05). After treatment,the total effective rate of the observation group was 90%( 36/40),and the total effective rate of the control group was 70%( 28/40). The difference between the two groups was statistically significant( P < 0. 05). Conclusion Bi’s acupuncture combined with psychotherapy has a good therapeutic effect on insomnia of phlegm-heat disturbance,which can greatly improve the sleep quality of patients. It can greatly improve the patient’s sleep quality and can regulate serum 5-HT,BDNF,TNF-,1 L-1,NF-b,which is worthy of further promotion and application.更多还原