砭石疗法对中青年慢性失眠患者睡眠质量及伴随症状辅助治疗作用的研究

目的 探讨砭石疗法对中青年慢性失眠患者睡眠质量及伴随症状的辅助治疗作用,并分析相关机制。方法 将92例中青年慢性失眠患者随机分为砭石组与对照组各46例。对照组睡前口服佐匹克隆片7.5 mg;砭石组在对照组治疗基础上接受中医砭石疗法治疗,每周1次、每次40 min、30 d为1个疗程。采用匹兹堡睡眠质量指数（PSQI）评分减少率评估2组患者的失眠改善率,记录治疗前后2组的失眠严重程度指数（ISI）、焦虑自评量表（SAS）评分、抑郁自评量表（SDS）评分,检测治疗前后患者血清的5-羟色胺（5-HT）水平。比较上述各项2组间差异。结果 治疗开始前,砭石组与对照组的ISI、SAS及SDS评分比较差异均无统计学意义（P均> 0.05）。治疗1个疗程后,砭石组的失眠改善率为 93.5%,高于对照组的76.1%（P < 0.05）。治疗1个疗程后,2组患者的ISI、SAS及SDS评分均低于治疗前,血清5-HT水平高于治疗前（P均< 0.05）;砭石组患者的ISI、SAS及SDS评分均低于对照组,血清5-HT水平高于对照组（P均< 0.05）。结论 砭石疗法安全、环保,有助于改善中青年慢性失眠患者的睡眠质量及伴随症状。砭石疗法辅助治疗慢性失眠及其伴随症状的机制可能涉及神经递质5-HT。

Effect of Bian-shi therapy on sleep quality and concomitant symptoms in young and middle-aged patients with chronic insomnia

Objective To evaluate the therapeutic effect of the Bian-shi therapy on young and middle-aged patients with chronic insomnia, and unravel the possible mechanism. Method Ninety-two young and middle-aged patients with chronic insomnia were randomly divided into the Bian-shi group （n = 46） and control group （n = 46）. In the control group, patients were orally given with zopiclone tablets 7.5 mg before sleep, and their counterparts in the Bian-shi group were treated with Bian-shi treatment on the basis of oral intake of zopiclone tablets, once a week, 40 min for each therapy and 30 days for each course. The sleep quality was evaluated by Pittsburgh Sleep Quality Index （PSQI） in two groups. The insomnia severity index （ISI）, self-rating anxiety scale （SAS） and self-rating depression scale （SDS） scores before and after one course treatment were recorded in two groups. The serum levels of 5-hydroxytryptamine （5-HT） before and after treatment were determined. The above items were compared between two groups. Results Before treatment, there was no significant statistical difference in ISI, SAS and SDS scores between two groups （all P > 0.05）. At 4 weeks after treatment, the effective rate of insomnia in the Bian-shi group was 93.5%, higher than 76.1% in the control group （P < 0.05）. In addition, ISI, SAS and SDS scores were significantly lower （all P < 0.05）, and the serum levels of 5-HT were significantly higher compared with those before treatment in two groups （both P < 0.05）. In the Bian-shi group, ISI, SAS and SDS scores were significantly lower, whereas serum 5-HT level was significantly higher compared with those in the control group （all P < 0.05）. Conclusions Bian-shi therapy is safe and green, which can effectively improve the insomnia and accompanying symptoms in young and middle-aged patients with chronic insomnia. The potential mechanism may be involved with neurotransmitters, such as 5-HT.