摘要
目的:评估养肝安魂推拿法治疗肝郁脾虚证肝不藏魂型不寐的临床疗效。方法:选取2023年4月1日—2024年3月31日就诊于新疆医科大学附属中医医院的80例肝郁脾虚证肝不藏魂型不寐患者随机分为推拿组、西药组,每组40例,西药组予艾司唑仑片治疗,推拿组予以养肝安魂推拿法治疗,治疗周期为28 d;评价比较基线资料、两组患者治疗前后匹兹堡睡眠质量指数(PSQI)评分、阿森斯失眠量表(AIS)评分、中医证候积分、血清多巴胺(DA)及5-羟色胺(5-HT)含量。结果:治疗后推拿组PSQI总分、AIS总分以及中医证候积分总分较对照组降低更显著(P<0.01,P<0.05),其改善梦扰纷纭、胸胁隐痛、头晕耳鸣、心烦易怒、乏力倦怠、大便溏薄症状优于对照组(P<0.01)。推拿组治疗后DA含量降低、5-HT含量增加,差异具有统计学意义(P<0.01),且推拿组优于西药组(P<0.01)。结论:养肝安魂推拿法可改善肝郁脾虚证肝不藏魂型不寐患者睡眠质量,其作用机制可能是通过调节神经递质5-HT、DA达到改善肝不藏魂型不寐的作用。
Objective:To evaluate the clinical efficacy of liver nourishing and soul calming Tuina therapy in the treatment of insomnia with liver depression and spleen deficiency syndrome and liver not storing soul type.Methods:A total of 80 patients with liver depression and spleen deficiency syndrome and liver not storing soul type insomnia who were treated at the Affiliated Traditional Chinese Medicine Hospital of Xinjiang Medical University from April 1,2023 to March 31,2024 were randomly divided into a Tuina group and a western medicine group,with 40 patients in each group.The western medicine group was treated with Escitalopram Tablets,and the Tuina group was treated with liver nourishing and soul calming tuina therapy.The treatment period was 28 days.Evaluate and compare baseline data,PSQI scores,AIS scores,TCM syndrome scores,serum DA and 5-HT levels between two groups of patients before and after treatment.Results:After treatment,the total scores of PSQI,AIS,and traditional Chinese medicine syndrome in the Tuina group were significantly lower than those in the western medicine group(P<0.01,P<0.05).Its improvement in symptoms such as scattered dreams,chest and rib pain,dizziness,tinnitus,irritability,fatigue,and loose stools were better than those in the western medicine group(P<0.01).After treatment,the DA content decreased and the 5-HT content increased in the Tuina group,with statistical significance(P<0.01),and the Tuina group was superior to the western medicine group(P<0.01).Conclusion:The liver nourishing and soul calming Tuina therapy can improve the sleep quality of patients with liver depression and spleen deficiency syndrome and liver not storing soul type insomnia Its mechanism of action may be achieved by regulating neurotransmitters 5-HT and DA to improve liver not storing soul type insomnia.
作者
屈玉疆
张彦峰
卢旭昇
马鑫文
陈旭
张星平
QU Yujiang;ZHANG Yanfeng;LU Xusheng;MA Xinwen;CHEN Xu;ZHANG Xingping(The Fourth Clinical Medical College of Xinjiang Medical University,Urumqi 830000,China;Traditional Chinese Medicine College of Xinjiang Medical University,Urumqi 830017,China)
出处
《中华中医药杂志》
北大核心
2025年第10期5098-5102,共5页
China Journal of Traditional Chinese Medicine and Pharmacy
基金
国家自然科学基金项目(No.82160873,No.81960837)
全国名老中医药专家传承工作室(No.国中医药人教函﹝2022﹞75号)
新疆“十四五”中医学重点学科(No.国中医药人教函﹝2023﹞85号)
新疆维吾尔自治区自然科学基金重点项目(No.2022D01D48)
新疆医科大学研究生创新项目(No.CXCY2023006)。
关键词
不寐
养肝安魂推拿法
中医不寐五神分型
肝不藏魂
Insomnia
Liver nourishing and soul calming Tuina therapy
TCM insomnia five emotion typing
Liver not storing soul
