本文選題：原發(fā)性失眠 + 淺針　； 參考：《福建中醫(yī)藥大學》2017年碩士論文

【摘要】：研究目的觀察淺針治療原發(fā)性失眠的臨床療效,分析其對腦內神經遞質的影響,為淺針的臨床應用提供理論依據。研究方法將60例原發(fā)性失眠患者隨機分為試驗組與對照組,每組30例。試驗組采用淺針干預,每日一次,每次30分鐘;對照組給予艾司唑侖1mg,每日一次,臨睡前30分鐘服用。共干預20天。干預前后采用匹茲堡睡眠質量指數(shù)量表(Pittsburgh sleep qu ality index,PSQI)和埃普沃思嗜睡量表(Epworth Sleepiness Scale,ESS)評估兩組的睡眠質量及臨床療效,應用腦漲落圖(Encephalofluctuograph,EFG)評定腦內神經遞質的變化情況。研究結果1、試驗組總有效率為78.5%,對照組為74.0%,兩組療效相當(P0.05)。2、與干預前比較,干預后兩組的匹茲堡睡眠質量指數(shù)(PSQI)評分均明顯低于干預前,差異有統(tǒng)計學意義(P0.05);干預后兩組PSQI評分組間比較,試驗組略高于對照組;干預結束時治療組PSQI量表七個子項目治療前后的差值分別與對照組比較,入睡時間和催眠藥物兩項的差值評分高于對照組,差異均有統(tǒng)計學意義(P0.05),睡眠障礙、睡眠質量、睡眠時間、睡眠效率及日間功能障礙五項的差值分別與對照組比較,分值相當,差異無統(tǒng)計學意義(P0.05);干預結束一個月后隨訪,兩組的匹茲堡睡眠質量指數(shù)(PSQI)與治療結束時比較,均略有提高,組間比較差異無統(tǒng)計學意義(P0.05)。3、與干預前比較,干預后兩組的埃普沃思嗜睡量表(ESS)評分均低于干預前,差異均有統(tǒng)計學意義(P0.05);干預結束時兩組(ESS)評分組間比較,試驗組略高于對照組,差異無統(tǒng)計學意義(P0.05)。4、干預后兩組患者腦內神經遞質的相對功率與干預前比較,兩組γ-氨基丁酸(γ-aminobutyric acid,GABA)、五羥色胺(5-hydroxytryptamine,5-HT)、乙酰膽堿(Acetylcholine,Ach)及多巴胺(Dopamine,DA)均高于干預前,其中對照組5-HT、Ach和試驗組的GABA、Ach在干預前后有統(tǒng)計學意義(P0.05);干預后組間比較,試驗組GABA、5-HT高于對照組,差異有統(tǒng)計學意義(P0.05);干預后兩組的去甲腎上腺素(Norepinephrine,NE)、谷氨酸(Glutamate,Glu)均降低,對照組Glu、NE和試驗組NE在干預前后差異有統(tǒng)計學意義(P0.05),干預后組間比較均無顯著差異(P0.05)。結論1、淺針治療原發(fā)性失眠癥臨床療效較好,不遜于艾司唑侖。2、淺針刺激鎮(zhèn)靜穴、山根穴能夠提高腦內GABA和5-HT的相對功率。
[Abstract]:Objective to observe the clinical effect of superficial acupuncture on primary insomnia and to analyze its effect on neurotransmitters in brain, and to provide theoretical basis for clinical application of shallow acupuncture. Methods 60 patients with primary insomnia were randomly divided into experimental group and control group with 30 cases in each group. The experimental group was treated with shallow needle once a day for 30 minutes, while the control group was given 1 mg of oxazolam once a day for 30 minutes before bedtime. The intervention lasted 20 days. The sleep quality and clinical efficacy of the two groups were evaluated by Pittsburgh sleep qu ality Index (Pittsburgh sleep qu ality) and Epworth Sleepiness scale (ESSs) before and after intervention, and the changes of neurotransmitters in the brain were assessed by cerebral fluctuation map. Results 1. The total effective rate was 78.5 in the trial group and 74.0 in the control group. The efficacy of the two groups was similar to that before intervention. Compared with the pre-intervention, the Pittsburgh Sleep quality Index (PSQI) scores of the two groups were significantly lower than those before the intervention. After intervention, the difference of PSQI score between the two groups was slightly higher than that of the control group, and the difference between the seven sub-items of PSQI scale before and after treatment in the treatment group was compared with that in the control group at the end of the intervention. The difference scores of sleep time and hypnotic drugs were higher than those of the control group (P 0.05). The difference values of sleep disorder, sleep quality, sleep time, sleep efficiency and daytime dysfunction were similar to those of the control group. The Pittsburgh Sleep quality Index (PSQI) of the two groups was slightly higher than that at the end of the treatment, and there was no significant difference between the two groups. After the intervention, the ESS scores of the two groups were lower than those before the intervention, and the differences were statistically significant (P 0.05), and at the end of the intervention, the scores of ESSs in the two groups were slightly higher than those in the control group. The relative power of neurotransmitters in the brain of the two groups after intervention was higher than that before intervention. The levels of 緯 -aminobutyric acid (GABA), serotonin 5-hydroxytrypine (5-HT), acetylcholine Acetylcholine (Acetylcholine) and dopamine dopamineDAA (DAA) were higher than those before intervention. The 5-HT Ach in the control group and the GABA Ach in the experimental group before and after intervention were significantly higher than those in the control group (P 0.05), and the levels of norepinephrinene-glutamate (Glutamate) in the two groups were significantly lower than those in the control group (P 0.05). There was significant difference between the control group and the test group before and after intervention (P 0.05), but there was no significant difference between the control group and the test group before and after intervention (P 0.05). Conclusion 1. Shallow acupuncture can improve the relative power of GABA and 5-HT in the brain of patients with primary insomnia, which is not inferior to that of eszolam. 2. Shallow acupuncture can stimulate sedation points and Shangen acupoint can increase the relative power of GABA and 5-HT in the brain.
【學位授予單位】：福建中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R246.6

【參考文獻】

相關期刊論文 前10條

1 劉曉辰;張蓉;楊云霜;;原發(fā)性失眠癥不同證型與焦慮、抑郁評分的關聯(lián)性研究[J];陜西中醫(yī);2015年06期

2 汪建平;王建兵;王利朝;張一鳴;;針藥結合治療老年性失眠:隨機對照研究[J];中國針灸;2015年06期

3 耿新玲;吳建永;高和;;與睡眠相關的腦結構(一)[J];世界睡眠醫(yī)學雜志;2015年02期

4 鄭美鳳;鄭國堯;何芙蓉;林煜芬;;淺針山根穴治療原發(fā)性失眠靜息態(tài)功能磁共振研究[J];福建中醫(yī)藥大學學報;2014年04期

5 郭田生;;腦漲落圖的技術原理及臨床研究應用[J];國際神經病學神經外科學雜志;2014年02期

6 嚴保平;孫秀麗;桑文華;韓彥超;李建峰;劉永橋;栗克清;江琴普;高良會;楊老虎;崔利軍;;雙重抑郁癥與單一抑郁癥患者睡眠質量及應對方式的研究[J];中國全科醫(yī)學;2014年01期

7 王志忠;王俊峰;張毓洪;余白露;孫艷莉;;寧夏地區(qū)成人失眠現(xiàn)況及影響因素分析[J];寧夏醫(yī)科大學學報;2013年09期

8 滕飛燕;蔣欽云;黃艷娜;;近年來中醫(yī)藥治療失眠進展綜述[J];世界中醫(yī)藥;2013年07期

9 楊來福;劉建武;和青松;王文彪;郭學軍;徐楊青;陳偉;;“調陰陽五臟配穴針刺法”治療頑固性失眠癥[J];中國針灸;2013年07期

10 劉紅;楊勁;唐向東;;原發(fā)性失眠主客觀睡眠質量與日間功能損害的關系[J];華西醫(yī)學;2013年02期

相關會議論文 前1條

1 吳明霞;;淺針療法的臨床總結[A];中華中醫(yī)藥學會第六次民間醫(yī)藥學術年會暨首批民間特色診療項目交流會論文集[C];2013年

相關博士學位論文 前3條

1 蔡昕宏;針藥結合治療肝郁脾虛型失眠的臨床研究[D];廣州中醫(yī)藥大學;2013年

2 王坤;我國精神衛(wèi)生專業(yè)機構經濟運行研究[D];華中科技大學;2012年

3 周頌衡;不寐的六經辨治與情志關系影響的臨床思路探討[D];廣州中醫(yī)藥大學;2012年

相關碩士學位論文 前2條

1 石芳;淺針治療陰虛火旺型失眠的臨床療效觀察[D];福建中醫(yī)藥大學;2014年

2 王鵬;淺針（推針）刺激“山根”穴治療原發(fā)性失眠的臨床研究[D];福建中醫(yī)藥大學;2011年

，

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