| 肿瘤伴失眠患者的热敏腧穴分布情况及热敏灸临床疗效观察 |
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| 作者姓名： | 宗婷婷 梅瀚文 祝永福 吴生兵 |
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| 作者单位： | 1.安徽中医药大学，安徽 合肥 230012；2.安徽中医药大学第一附属医院，安徽 合肥 230031；3.新安医学教育部重点实验室，安徽 合肥 230038 |
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| 基金项目： | 安徽省中医药领军人才建设项目（ZYYLJRC201911）；滁州市科技计划项目（2022ZN007） |
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| 摘 要： | 目的 观察热敏灸和口服艾司唑仑治疗肿瘤患者失眠的临床疗效，统计肿瘤伴失眠患者高频热敏化腧穴分布。方法 将70例肿瘤伴失眠患者随机分为对照组35例和试验组35例。对照组采用口服艾司唑仑治疗方案，该组于药物治疗展开前进行1次热敏化腧穴探查，并对热敏化腧穴予以记录；试验组进行热敏化腧穴探查并记录其热敏化腧穴后，依据探查结果选取灸感较好的两个穴位进行为期2周、每日1次的热敏灸治疗。比较两组患者治疗前后匹兹堡睡眠质量指数（Pittsburgh sleep quality index，PSQI）、焦虑自评量表（self-rating anxiety scale，SAS）、抑郁自评量表（self-rating depression scale，SDS）评分，治疗后以及随访时基于两组患者PSQI评分进行疗效比较。结果 两组患者治疗后PSQI评分均较治疗前显著减少（P＜0.05）；两组患者随访时PSQI评分以及治疗前与随访时PSQI评分的差值比较，差异均有统计学意义（P＜0.05）。两组患者治疗后SAS评分、SDS评分均较治疗前显著减少（P＜0.05）；两组患者治疗后SAS评分、SDS评分差值比较，差异均无统计学意义（P＞0.05）。治疗后两组患者基于PSQI评分的疗效比较，差异无统计学意义（P＞0.05）；随访时两组患者基于PSQI评分的疗效比较，差异有统计学意义（P＜0.05）。两组热敏化腧穴共计347个，其中高发热敏穴区敏感的腧穴有261个。其中位于前五的高频热敏腧穴分布区域包括内关穴（旁）、阴陵泉穴（旁）、手三里穴（旁）、曲池穴(旁)、阳陵泉穴（旁）。结论 热敏灸能有效改善患者睡眠情况，同时也可缓解患者的焦虑症状以及抑郁症状；在停止治疗后，热敏灸能维持较长期的疗效；肿瘤伴失眠患者的热敏腧穴为内关穴（旁）、阴陵泉穴（旁）、手三里穴（旁）、曲池穴（旁）、阳陵泉穴（旁）。
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| 关 键 词： | 热敏灸 肿瘤 失眠 匹兹堡睡眠质量指数 焦虑自评量表 抑郁自评量表 |
Distribution of Heat-sensitive Acupoints and Clinical Effect of Heat-sensitive Moxibustion in Tumor Patients with Insomnia |
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| Affiliation: | 1. Anhui University of Chinese Medicine,Anhui Hefei 230012, China; 2.The First Affiliated Hospital of Anhui University of Chinese Medicine, Anhui Hefei 230031, China; 3. Key Laboratory of Xin''an Medicine, Ministry of Education, Anhui Hefei 230038, China |
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| Abstract: | Objective To investigate the clinical efficacy of heat-sensitive moxibustion versusoral estazolamin the treatment of insomnia in tumor patients and the distribution of high-frequency heat-sensitized acupoints by exploring the heat-sensitized acupoints in tumor patients with insomnia. Methods A total of 70 tumor patients with insomnia were randomly divided into control group (oral estazolam) and experimental group (heat-sensitive moxibustion), with 35 patients in each group. The patients in the control group were givenoral estazolam and received the exploration of heat-sensitized acupoints once before pharmacotherapy to record the heat-sensitized acupoints; after heat-sensitized acupoints were explored and recorded, the patients in the experimental group were given heat-sensitive moxibustion, once a day for 2 weeks, at the two acupoints with the best sense of moxibustion based on the results of exploration. The two groups were compared in terms of Pittsburgh sleep quality index (PSQI),self-rating anxiety scale (SAS), and self-rating depression scale(SDS) scores, and treatment outcome was compared between the two groups based on PSQI score after treatment and at follow-up. Results Both groups had a significant reduction in PSQI score after treatment (P<0.05), and there were significant differences between the two groups in PSQI score at follow-up and the change in PSQI score from before treatment to at follow-up (P<0.05). Both groups had significant reductions in SAS and SDS scores after treatment (P<0.05), and there were no significant differences in the changes in SAS and SDS scores after treatment between the two groups (P>0.05). There was no significant difference between the two groups in treatment outcome based on PSQI score after treatment (P>0.05), while there was a significant difference between the two groups in treatment outcome based on PSQI score at follow-up (P<0.05). There were 347 heat-sensitized acupoints in the two groups, among which 261 were the most sensitive acupoints in the heat-sensitive areas, and the top 5 high-frequency distribution areas of heat-sensitized acupoints included Neiguan (side), Yinlingquan (side),Shousanli (side), Quchi (side), and Yanglingquan (side). Conclusion Heat-sensitive moxibustion can effectively improve sleep and relieve anxiety and depression symptoms, and after heat-sensitive moxibustion is stopped, it can maintain the effect for a longer period of time than estazolam. Heat-sensitized acupoints include Neiguan (side), Yinlingquan (side), Shousanli (side), Quchi (side), and Yanglingquan (side) in tumor patients with insomnia. |
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| Keywords: | Heat-sensitive moxibustion Tumor Insomnia Pittsburgh sleep quality index Self-rating anxiety scale Self-rating depression scale |
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