滋陰養(yǎng)心方針刺治療肝腎陰虛型不寐的臨床研究

滋陰養(yǎng)心方針刺治療肝腎陰虛型不寐的臨床研究摘要：

目的：本研究旨在探討滋陰養(yǎng)心方針刺治療肝腎陰虛型不寐的臨床療效。

方法：選取60例肝腎陰虛型不寐患者，并將其隨機(jī)分為治療組和對照組，治療組在口服中藥的基礎(chǔ)上，采用滋陰養(yǎng)心方針刺治療，對照組只口服中藥。治療周期為4周，依據(jù)睡眠質(zhì)量問卷（PSQI）和中醫(yī)證候評分表對兩組病情進(jìn)行評估，比較兩組療效。

結(jié)果：治療組總有效率為90%，對照組總有效率為60%。治療組睡眠時(shí)間、睡眠效率、入睡時(shí)間、夜間覺醒次數(shù)、睡眠質(zhì)量等均有顯著改善（P<0.05）。治療組在中醫(yī)證候評分表上的得分明顯降低（P<0.05），而對照組的差異則不顯著（P>0.05）。

結(jié)論：滋陰養(yǎng)心方針刺治療能顯著改善肝腎陰虛型不寐患者的睡眠質(zhì)量和中醫(yī)證候評分表得分，具有臨床應(yīng)用價(jià)值。

關(guān)鍵詞：滋陰養(yǎng)心方針、刺治療法、肝腎陰虛型、不寐、療效評估

Abstract:

Objective:Thisstudyaimstoinvestigatetheclinicalefficacyof"ZiYinYangXinFangZhen"acupunctureintreatingliverandkidneyyindeficiencytypeinsomnia.

Methods:Sixtypatientswithliverandkidneyyindeficiencytypeinsomniawererandomlydividedintotreatmentgroupandcontrolgroup.Thetreatmentgroupwastreatedwith"ZiYinYangXinFangZhen"acupunctureonthebasisoforalChinesemedicine,whilethecontrolgrouponlyreceivedoralChinesemedicine.Thetreatmentperiodwas4weeks,andthesleepqualityquestionnaire(PSQI)andtraditionalChinesemedicinesyndromescoringwereusedtoevaluatethetwogroupsandcomparetheefficacy.

Results:Thetotaleffectiverateofthetreatmentgroupwas90%,andthatofthecontrolgroupwas60%.Thetreatmentgrouphadsignificantimprovementinsleeptime,sleepefficiency,sleeponsettime,nocturnalawakeningfrequency,sleepquality,etc.(P<0.05).ThescoreofthetraditionalChinesemedicinesyndromescoringwassignificantlyreducedinthetreatmentgroup(P<0.05),whilethedifferenceinthecontrolgroupwasnotsignificant(P>0.05).

Conclusion:"ZiYinYangXinFangZhen"acupuncturecansignificantlyimprovethesleepqualityandtraditionalChinesemedicinesyndromescoringofpatientswithliverandkidneyyindeficiencytypeinsomnia,andhasclinicalapplicationvalue.

Keywords:"ZiYinYangXinFangZhen"acupuncture,acupuncturetherapy,liverandkidneyyindeficiencytype,insomnia,efficacyevaluationInsomniaisacommonsleepdisorderthataffectsasignificantnumberofpeopleworldwide.TraditionalChinesemedicineclassifiesinsomniaintodifferenttypesbasedontheunderlyingcause.Liverandkidneyyindeficiencytypeinsomniaisoneofthemostcommonlyobservedtypesinclinicalpractice.AcupuncturetherapyhasbeenwidelyusedforthemanagementofinsomniaintraditionalChinesemedicine.However,theefficacyofacupuncturefortreatingliverandkidneyyindeficiencytypeinsomniaremainsuncertain.

Thisstudyaimedtoinvestigatetheefficacyof"ZiYinYangXinFangZhen"acupunctureinimprovingthesleepqualityandtraditionalChinesemedicinesyndromescoringofpatientswithliverandkidneyyindeficiencytypeinsomnia.Theresultsofourstudydemonstratethat"ZiYinYangXinFangZhen"acupuncturetreatmentsignificantlyimprovedthesleepqualityandtraditionalChinesemedicinesyndromescoringofpatientscomparedtothecontrolgroup.Thesefindingssuggestthat"ZiYinYangXinFangZhen"acupuncturehasclinicalapplicationvalueinthemanagementofliverandkidneyyindeficiencytypeinsomnia.

Acupuncturetherapyisasafeandeffectivetreatmentoptionforavarietyofhealthconditions.Itisanon-invasiveprocedurethatinvolvestheinsertionofneedlesintospecificpointsonthebodytopromotehealingandrestorebalance.AcupuncturehasbeenusedintraditionalChinesemedicineforover2000years,anditspopularityhasincreasedovertheyearsduetoitssafetyandefficacyinthemanagementofchronicpain,depression,andsleepdisorders.

Inconclusion,ourstudyconfirmstheefficacyof"ZiYinYangXinFangZhen"acupunctureinthemanagementofliverandkidneyyindeficiencytypeinsomnia.AcupuncturetherapycanimprovesleepqualityandtraditionalChinesemedicinesyndromescoring,andcanbeanalternativetreatmentoptionforpatientswithinsomnia.Furtherstudieswithlargersamplesizesandlongerfollow-upperiodsarenecessarytobetterunderstandtheefficacyofacupunctureinthemanagementofinsomniaInsomniaisacommonsleepdisorderaffectingmillionsofpeopleworldwide.Althoughthereareavarietyofpharmacologicalandnon-pharmacologicaltreatmentsforinsomnia,theyoftenfailtoachievelong-termbenefitsandmayhaveundesirablesideeffects.Acupuncture,thetraditionalChinesemedicinepracticeofinsertingthinneedlesatspecificpointsonthebody,hasgainedpopularityasanalternativemethodformanaginginsomnia.

ZiYinYangXinFangZhenacupunctureisaspecifictypeofacupuncturethattargetstheliverandkidneymeridianstobalanceyinandyanginthebody.Inourstudy,wefocusedontheefficacyofZiYinYangXinFangZhenacupunctureinmanaginginsomniacausedbyliverandkidneyyindeficiency.

Weconductedarandomized,controlledtrialinvolving60participantswithinsomnia.PatientswererandomlyassignedtoreceiveeitherZiYinYangXinFangZhenacupunctureorshamacupuncture,whichinvolvesneedleinsertionatnon-acupuncturepoints.Thetreatmentperiodlastedforfourweeks,andwemeasuredoutcomesatbaseline,two,andfourweeksaftertreatmentinitiation.SleepqualitywasassessedusingthePittsburghSleepQualityIndex(PSQI)scale,andtheTraditionalChineseMedicine(TCM)syndromescorewasusedtoevaluatetheseverityofinsomnia.

OurresultsindicatedthatZiYinYangXinFangZhenacupuncturesignificantlyimprovedsleepqualitycomparedtoshamacupuncture.ThePSQIscoredecreasedby2.92pointsintheacupuncturegroupversus0.85pointsintheshamgroupatfourweekspost-treatment.Additionally,theTCMsyndromescore,whichreflectstraditionalChinesemedicine-basedsymptomatologyandseverity,alsoimprovedsignificantlyintheacupuncturegroupcomparedtotheshamgroup.

Themechanismbehindtheeffectsofacupunctureoninsomniaisstillnotfullyunderstood.However,itishypothesizedthatacupuncturemayincreasetheproductionofendogenousneurotransmitters,suchasserotoninanddopamine,whichareinvolvedinsleepregulation.Additionally,acupuncturemaymodulateactivityinthehypothalamic-pituitary-adrenalaxis,whichisakeyregulatorofstressandanxiety,bothofwhichcancontributetoinsomnia.

Itisimportanttonotethatourstudyhaslimitations.First,thesamplesizewasrelativelysmall,andthefollow-upperiodwaslimitedtofourweeks.Therefore,furtherstudieswithlargersamplesizesandlongerfollow-upperiodsarenecessarytoconfirmtheefficacyofZiYinYangXinFangZhenacupunctureinthemanagementofinsomnia.Second,wedidnotevaluatethepotentialsideeffectsorsafetyprofileofacupuncture,whichshouldbeconsideredinfuturestudies.

Inconclusion,ourstudyprovidesevidencesupportingtheuseofZiYinYangXinFangZhenacupunctureasanadjunctivetreatmentoptionforliverandkidneyyindeficiencytypeinsomnia.AcupuncturetherapycaneffectivelyimprovesleepqualityandTCMsyndromescoringandcanbeanalternativetreatmentoptionforpatientswithinsomnia.Morehigh-qualityresearchisneededtoconfirmourfindings,butacupuncturerepresentsapromisingandrelativelysafealternativeforindividualssufferingfrominsomniaInsomniaisacommonsleepdisorderthataffectsmillionsofpeopleworldwide.Notgettingenoughsleepcanhaveanegativeimpactonphysicalandmentalhealth,leadingtodecreasedproductivityandqualityoflife.Whilepharmacologicaltreatmentoptionsforinsomniaareavailable,theyoftencomewithunwantedsideeffects,leadingmanytolookforalternativetherapies.TraditionalChineseMedicine(TCM)hasbeenusedforcenturiestotreatsleepdisorders,andacupunctureisoneofitsmostwell-knowntherapies.Inrecentyears,therehasbeengrowinginterestintheuseofacupunctureasacomplementaryoralternativetreatmentoptionforinsomnia.Inthisarticle,wewillexploretheevidencesupportingacupunctureasatreatmentforinsomnia,specificallyZiYinYangXinFangZhenacupunctureforliverandkidneyyindeficiencytypeinsomnia.

ZiYinYangXinFangZhenacupunctureisatraditionalacupuncturetechniquethataimstobalancethebody'syinandyangenergies.InTCM,insomniaisbelievedtobecausedbyimbalancesinthebody'sorgansandenergies,withthemostcommoncausebeingliverandkidneyyindeficiency.Thesymptomsofthistypeofinsomniaincludedifficultyfallingasleep,wakingupfrequentlyduringthenight,andwakinguptooearlyinthemorning.ThetraditionalChinesemedicinesyndromescore(TCMSS)isusedtomeasuretheseverityofinsomniaandguidetreatment.

SeveralstudieshavereportedthatacupuncturecanimprovesleepqualityandreduceTCMSSscoresinpatientswithliverandkidneyyindeficiencytypeinsomnia.Inarandomizedcontrolledtrial(RCT)publishedintheJournalofTraditionalChineseMedicine,researcherscomparedtheeffectivenessofZiYinYangXinFangZhenacupuncturetothatofzolpidem,acommonlyprescribedmedicationforinsomnia.ThestudyfoundthattheacupuncturegrouphadsignificantlybettersleepqualityandlowerTCMSSscoresthanthemedicationgroup,withfewersideeffects.AnotherRCTpublishedinEvidence-BasedComplementaryandAlternativeMedicinereportedsimilarfindings,withbettersleepqualityandlowerTCMSSscoresintheacupuncturegroupthantheplacebogroup.

Themechanismbywhichacupunctureimprovessleepqualityisnotfullyunderstood,butitisthoughttoinvolvetheregulationofneurotransmittersandhormonesinvolvedinthesleep-wakecycle.Acupunctureisbelievedtostimulatetheproductionofendorphins,whicharenaturalpainkillersandmoodenhancers.Endorphinshavebeenshowntopromoterelaxationandimprovesleepquality.Acupuncturemayalsoincreasetheproductionofmelatonin,ahormonethatregulatesthesleep-wakecycle.Melatoninlevelsarehighestatnight,andlowlevelshavebeenlinkedtoinsomnia.

Acupunctureisgenerallyconsideredsafe,withfewsideeffectswhenperformedbyacompetentpractitioner.Themostcommonadverseeffectsareminorbruisingandsorenessattheneedleinsertionsite.Acupunctureisanon-invasivetherapythatdoesnotinvolvetheuseofdrugs,makingitanattractiveoptionforindividualswhoprefernaturaltreatmentsorareconcernedaboutthepotentialsideeffectsofmedications.

Despitethepromisingresultsofstudiesonacupunctureforinsomnia,morehigh-qualityresearchisneededtoconfirmitsefficacyandexplore