中医经方综合治疗不寐66例疗效观察.docx

    中医经方综合治疗不寐66例疗效观察    2.甘肃省陇南市武都区桔柑镇卫生院 甘肃陇南市742500；3.新疆兵团第十三师红星医院淖毛湖农场医院 新疆哈密市 839303 4.河南省沁阳市人民医院 河南沁阳市 454550[Summary]目的：目前对睡眠障碍（中医之不寐）的治疗主要是应用西医、中成药等一些治疗方法，临床效果不能令人满意中医认为外感、内伤皆可导致不寐中医药治疗失眠疗效确切，副作用少治疗前景广阔，有不可或缺的重要地位本文旨在观察应用中医经方综合治疗失眠的疗效方法：2023年4月-2024年10月来院治疗的睡眠障碍患者66例，随机分组来院治疗的病人每组33人，中医治疗组采用中医汤药口服为主、配合外用以及针刺治疗方法，西医观察对照组采用常规西医治疗口服酒石酸唑吡坦片10mg或阿普唑仑片0.4mg每日1次，及安神补脑液10ml睡前30min服用比较两组患者的临床疗效、睡眠质量及不良反应发生情况结果:两组患者经治疗后均取得了明显疗效，中医治疗组治疗33例，治愈20例，好转10例，未愈3例，总有效率90.0%，西医观察对照组治疗33例，治愈8例，好转20例，未愈5例，总有效率84.8%，治疗后，中医治疗组患者的睡眠质量评分明显高于西医观察对照组（P<0.05），中医治疗组总有效率高于对照组（P＜0.05）。

结论：中医药综合疗法治疗不寐多从火、痰、瘀、热、虚着手，主脏在心，并与肝脾肾关系密切，中医综合治疗组不良反应发生率低于西医观察对照组，中医综合治疗不寐疗效显著，能有效改善患者睡眠质量，且安全性高Keys：中医药疗法、经方、不寐、针刺、临床疗效显著Treatment of 66 cases of Chinese medicineZhang Tingxi1, Sun Xiaojun1, Sun Yijun2, Jia Juan2,Kumusihan·Hami3.(1.Central Health Center of Naomaohu Town, Yiwu County, Xinjiang, Hami 839303; 2. Health Center of Juguangan Town, Wudu District, Longnan City, Gansu Province, Longnan 742500; 2. Naomaohu Farm Hospital, Hongxing Hospital of the 13th pision of Xinjiang Production and Construction Corps, Hami City, 839303；2. qinyang City, Henan Province, qinyang 454550, China;3. Naomaohu Town Central Health Center, Yiwu County, Xinjiang, Hami 839303.).      [Abstract] Objective: At present, the treatment of insomnia (insomnia in traditional Chinese medicine) mainly uses some treatment methods such as Western medicine and Chinese patent medicines, and the clinical effect is not satisfactory. Traditional Chinese medicine believes that both exogenous and internal injuries can lead to insomnia. Traditional Chinese medicine has definite curative effect in treating insomnia, with few side effects and broad treatment prospects, and has an indispensable important position. Observe the curative effect of comprehensive treatment of insomnia with classical prescriptions of traditional Chinese medicine. Methods: From April 2023 to October 2024, 66 patients with sleep disorders who came to the hospital for treatment were randomly pided into groups. There were 33 patients in each group. The traditional Chinese medicine treatment group mainly used oral traditional Chinese medicine decoction, combined with external use and acupuncture treatment. The Western medicine observation control group used conventional Western medicine treatment and took zolpidem tartrate tablets 10mg or alprazolam tablets 0.4mg orally once a day, taken 30 minutes before going to bed. The clinical efficacy, sleep quality and occurrence of adverse reactions of the two groups of patients were compared. Results: After treatment, both groups of patients achieved obvious curative effects. In the traditional Chinese medicine treatment group, 33 cases were treated, 20 cases were cured, 10 cases improved, and 3 cases were not cured. The total effective rate was 90.0%. In the Western medicine observation control group, 33 cases were treated, 8 cases were cured, 20 cases improved, and 5 cases were not cured. The total effective rate was 84.8%. After treatment, the sleep quality score of patients in the traditional Chinese medicine treatment group was significantly higher than that of the Western medicine observation control group (P<0.05), and the total effective rate of the traditional Chinese medicine treatment group was higher than that of the control group (P<0.05). Conclusion: The comprehensive therapy of traditional Chinese medicine for insomnia mostly starts from fire, phlegm, stasis, heat and deficiency. The main organ is the heart and is closely related to the liver, spleen and kidney. The incidence of adverse reactions in the comprehensive traditional Chinese medicine treatment group is lower than that in the Western medicine control observation group. The comprehensive traditional Chinese medicine treatment of insomnia has a significant curative effect, can effectively improve the sleep quality of patients, and has high safety.不寐即失眠，是临床常见的睡眠障碍性疾病。

随着社会节奏的加快和生活压力的增大，不寐的发病率呈逐年上升趋势是以经常不能获得正常睡眠的一类病证其主要表现为睡眠的时间、睡眠的深度不足，轻者入睡困难，或寐而不酣、时寐时醒或醒后不能再寐，重者彻夜不眠，长此以往会影响大脑的功能，引起情绪.、注意力、语言能力、记忆功能以及应变能力的降低等，同时也会引起身体免疫机能降低，原有疾病加重，衰老加速，同时亦是心脑血管等疾病发生的危险因素之一，严重影响身心健康尽管西医治疗失眠已经非常成熟，目前已知有苯二氮卓类、非苯二氮卓类、抗组胺类药、褪黑素、及植物神经调节剂以及心理治疗、物理治疗等，但在疗效、可及性、耐受性等方面评价不一中医最早在《黄帝内经》称不寐为“不得卧”、“目不瞑”，同时认为，不寐是邪气客于脏腑，卫气行于阳，不得入于阴所致《素问》记述“胃不和则卧不安”后引申为凡脾胃不和，痰湿食滞内扰，以致寐寝不安，张仲景《伤寒论》及《金匮要略》中将其病因分为外感和内伤两类，提出“不得卧”、“不能卧”、“卧起不安”“虚劳虚烦不得眠”等论述，至今临床仍有价值，笔者使用伤寒论中方剂用于阴阳失和、营卫失和、心肾不交、气机失调、脾胃不和、虚寒、淤血、阳虚水泛等各型失眠，中医上从心、肝、脾、肾论治，并配合外治或针刺治疗失眠总有效率达90%，中医在治疗不寐方面积累了丰富的经验，采用综合治疗方法往往能取得较好的临床疗效。

现总结如下：1、 资料与方法1.1一般资料选取2023年4月-2024年10月来院治疗的睡眠障碍患者66例，随机分组来院治疗的病人每组33人， 选取病例均为门诊或住院睡眠障碍患者，男 32 例，女34 例，年龄在 25～81 岁，病程3周-5年，均属中医“不寐”范畴随机将66例患者分为中医治疗组和观察对照组两组患者的年龄、性别比例、疾病种类等一般数据无统计学意义，具有可比性（P＞0.05）1.2诊断标准 参照《中医病证诊断疗效标准》相关标准①轻者入寐困难或寐而易醒，醒后不寐，连续3周以上，重者彻夜难眠②常伴有头痛、头昏、心悸、健忘、神疲乏力、心神不宁、多梦等症③本病证常有饮食不节，情志失常，劳倦、思虑过度，病后体虚等病史1.3 治疗方法1.3.1西医观察对照组采用常规西医治疗，给予患者镇静催眠药物采用口服酒石酸唑吡坦片10mg或阿普唑仑片0.4mg每日1次，睡前30min服用1.3.2 中医治疗组采用内服和外洗 针对不寐的。