Gender differences in perpetuating factors,experience and management of chronic insomnia

The higher prevalence of insomnia in women has been attributed to biological factors, which are less likely than cognitive and behavioural factors to play a role in perpetuating insomnia. Gender differences in perpetuating factors have not been extensively examined. This study compared men’s and women’s self-reports of factors that perpetuate insomnia; experience of symptoms, perceived severity and impact on daytime functioning; and use of strategies to manage insomnia. Data were collected at baseline, using reliable and valid measures, in a project that evaluated behavioural therapies for insomnia. The sample (N = 739) consisted of women (62.4%) and men (37.6%). Gender differences were found in: (1) perpetuating factors: men took more naps and held more unhelpful beliefs about insomnia, whereas women experienced higher pre-sleep arousal; (2) perception of insomnia severity: higher among women; (3) perceived impact of insomnia: higher fatigue among women; and (4) use of strategies (higher in women) to manage insomnia. Gender differences were of a small size but could be associated with women’s stress, expression of somatic symptoms, and interest in maintaining their own health to meet multiple role demands.     

智三针治疗原发性失眠35例

目的 观察智三针治疗原发性失眠的疗效。方法 将70例原发性失眠患者分为治疗组和对照组,每组35例。治疗组接受以智三针为主穴的治疗,对照组接受常规针刺治疗。采用匹兹堡睡眠质量指数（Pittsburgh sleep quality index, PSQI）评定疗效。结果 治疗后两组PSQI总分均较治疗前显著降低 (P<0.01),且治疗组在降低PSQI总分方面较对照组无明显优势（P>0.05）。治疗后两组各维度PSQI评分均显著降低（P<0.01）,但治疗组在降低入睡时间、睡眠质量和日间功能障碍评分方面显著优于对照组（P＜0.05,或P＜0.01）。结论 智三针治疗原发性失眠有确切的临床效果,在促进入睡,改善睡眠质量和日间功能方面效果优于传统针刺疗法。     

穴位按压合松弛疗法治疗脑卒中睡眠障碍31例

目的 观察穴位按压加松弛疗法对脑卒中睡眠障碍患者的疗效。方法 将62例脑卒中睡眠障碍患者随机分为治疗组和对照组各31例，治疗组采用穴位按压加松弛疗法，对照组每晚睡前30 min口服艾司唑仑，3周后，采用匹兹堡睡眠质量指数（Pittsburgh sleep quality index，PSQI）评价睡眠质量。结果 与本组治疗前比较，两组患者治疗后PSQI总分及各因子评分均显著减低（P<0.01），且治疗组PSQI总分及各因子评分显著低于对照组（P<0.05，或P<0.01）。结论 穴位按压加松弛疗法对脑卒中睡眠障碍具有较好的疗效。     

针刺配合耳穴压豆治疗失眠36例

目的 观察针刺配合耳穴压豆治疗失眠的疗效。方法 将72例失眠患者随机分为治疗组（针刺配合耳穴压豆）和对照组（口服佐匹克隆）,每组各36例,观察两组的临床疗效。结果 治疗组治愈率和总有效率分别为58.3%、94.4%,对照组分别为30.5%、75.0%,两组治愈率和总有效率比较,差异均有统计学意义（P<0.05）。结论 应用针刺配合耳穴压豆治疗失眠,效果良好。     

加味酸枣仁汤联合经颅微电流刺激治疗肝郁血虚型失眠症临床研究

目的观察加味酸枣仁汤联合经颅微电流刺激治疗肝郁血虚型失眠症的临床疗效。方法将52例肝郁血虚型失眠症患者随机分为联合治疗组和西药对照组,每组26例。联合治疗组患者口服加味酸枣仁汤,并接受经颅微电流刺激疗法,西药对照组患者口服艾司唑仑,两组疗程均为4周。治疗前后,分别采用匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)和睡眠状况自评量表(self rating scale of sleep,SRSS)评价患者的睡眠质量;治疗后观察两组的临床疗效、中医证候疗效及安全性。结果联合治疗组与西药对照组治疗后PSQI总分、SRSS总分均较治疗前显著降低(P0.05);两组治疗前后PSQI和SRSS下降程度比较,差异无统计学意义(P0.05);两组临床疗效比较,差异无统计学意义(P0.05);两组中医证候疗效比较,差异具有统计学意义(P0.05);联合治疗组的不良反应比西药对照组少,且随访无反跳。结论加味酸枣仁汤口服联合经颅微电流刺激疗法在改善失眠症状方面与艾司唑仑相似,但在改善肝郁血虚证候方面明显优于艾司唑仑,其不良反应较少,远期疗效较好。     

耳针辨证治疗脑卒中后失眠40例

目的 观察耳针治疗脑卒中后失眠的疗效。方法 将80例脑卒中后失眠患者随机分为对照组40例和治疗组40例，分别给予安眠药治疗和耳针治疗。结果 对照组和治疗组总有效率分别为67.5%、92.5%，两组总有效率比较，差异具有统计学意义(P<0.05)。结论 耳针辨证治疗脑卒中失眠具有较好的临床疗效。