针刺联合耳穴治疗抑郁障碍相关性失眠（心脾两虚型）的临床观察

目的 观察针刺联合耳穴贴压对抑郁障碍相关性失眠（心脾两虚型）的临床疗效。方法 选取2016年9月至2017年7月在佛山市中医院针灸科就诊的80例患者，随机分为单纯针刺组和针刺联合耳穴组，每组40例，治疗6个月后两组均进行疗效的比较，同时运用多导睡眠图（PSG）、匹兹堡睡眠质量指数（PSQI）量表、抑郁自评量表（SDS）及汉密顿抑郁量表（HAMD）对患者的睡眠质量及抑郁状况进行评估。结果 联合治疗组总有效率为82.5%，与单纯针刺组比较差异有统计学意义（P<0.05）；与治疗前比较，两组睡眠质量均有改善（P<0.05），与单纯针刺组比较，联合治疗组在TST（总睡眠时间）改善更明显（P<0.05）；治疗后两组患者PSQI总分及各因子评分均有改善（P<0.05），但联合治疗组睡眠效率及日间功能评分改善更明显（P<0.01）；两组患者的SDS评分均有改善（P<0.01），且与单纯针刺组比较，针刺结合耳穴组SDS评分明显降低（P<0.05）。两组患者HAMD总分均较治疗前有所下降（P<0.05），但联合治疗组较单纯针刺组改善更明显（P<0.05），其中单因子中联合治疗组的焦虑/躯体化因子、睡眠障碍因子、绝望感因子也均低于针刺组（P<0.05）。结论 针刺联合耳穴贴压治疗抑郁障碍相关性失眠（心脾两虚型）具有良好疗效，值得临床推广应用。

Clinical Observation of Needling Combined with Ear Acupoint on Depressive Insomnia (Heart-Spleen Deficiency Syndrome)

Objective To observe the clinical effect of acupuncture combined with ear acupoint application on depressive insomnia (heart-spleen deficiency syndrome). Methods The 80 cases hospitalized in department of Acupuncture Department, Foshan Hospital of traditional Chinese medicine, from September 2016 to July 2017 were taken as subjects of the study. Patients were randomly divided into the acupuncture group and simple acupuncture combined with ear acupoint group (combined group), 40 cases in each group. The curative effect of two groups was compared after treatment for 6 months. The sleep quality and depression status of patients were evaluated by polysomnography(PSG), Pittsburgh sleep quality index (PSQI) scale, self rating Depression Scale(SDS) scale and Hamilton Depression Scale(HAMD). Results The total effective rate of combined treatment group was 82.5%, compared with the acupuncture group, the combined group was statistically significant (P<0.05). The sleep quality of two groups after treatment were statistically improved (P<0.05). Compared with acupuncture group, TST of combined group was improved significantly (P<0.05). After treatment, PSQI scale and scores of each factor were improved (P<0.05); the sleep efficiency and day function of combined group were obviouly improved(P<0.01); SDS of two groups was improved(P<0.01). Compared with acupuncture group, SDS of combined group decreased significantly(P<0.05). HAMD of two groups decreased after treatment(P<0.05), but the improvement of combined group was more obvious than the acupuncture group (P<0.05). The anxiety/somatization, sleep disorder factor and hopelessness factor in combined group were also lower than those in acupuncture group(P<0.05). Conclusion Acupuncture combined with ear acupoint application has good curative effect on depressive disorder (heart-spleen deficiency syndrome).