“津沽推拿”之通脉调神手法对心脾两虚型心理生理性失眠患者血五羟色胺及去甲肾上腺素的影响

Effects of “Jingu massage” in Tongmai Tiaoshen practices on serumserotonin and norepinephrine in patients with psychophysiological insomnia of heart and spleen insufficiency

关键词:  通脉调神法  心脾两虚  心理生理性失眠  疗效观察  五羟色胺  去甲肾上腺素

Key words:  Tongmai Tiaoshen practices  insufficiency of heart and spleen  psychophysiological insomnia  clinical observation  serum serotonin  serum norepinephrine

摘要:

[目的] 探讨通脉调神手法对心脾两虚型心理生理性失眠的临床疗效及对五羟色胺（5-HT）、去甲肾上腺素（NE）的影响。[方法] 将60 例本病门诊患者，采用临床随机、对照法研究，按照1颐1 比例分为治疗组和对照组，每组30 例，疗程为20 d，治疗后第3 个月末进行随访。以匹茨堡睡眠质量指数量表、心理健康症状自评量表（SCL-90）的评分作为观察指标。于治疗前、疗程结束后检测血5-HT、NE。[结果] 治疗组愈显率为70.0%，总有效率为96.70%，对照组的愈显率为43.3%，总有效率为86.67%，治疗组优于对照组，有统计学差异（P<0.01）。经过治疗，两组的评分比较均有统计学差异（P<0.01）。从入组到研究结束，匹茨堡睡眠质量指数与SCL-90 量表评分存在较强的相关性（P<0.01）。随访复发率统计，治疗组为3.3%，对照组为26.67%，治疗组复发率低于西药对照组，有统计学差异（P<0.05）。两组治疗前后5-HT 均有升高，治疗组升高明显（P<0.01），两组去NE 素均有下降，治疗组下降明显（P<0.05）。[结论] 通脉调神手法治疗心脾两虚型心理生理性失眠疗效显著，是治疗该病安全有效的方案，且复发率低、简便验廉、治疗规范、适于推广应用。

Abstract:

[Objective] To investigate the effect of Tongmai Tiaoshen practices on the levels of serotonin and norepinephrine in patients with psychophysiological insomnia of heart and spleen insufficiency type. [Methods] The 60 cases of the disease outpatients were divided into manual treatment group and Western medicine control group using clinical randomized, controlled study law and in accordance with the ratio of 1:1 with 30 cases in each group. A treatment course was 20 days. At the end of the first three months the results were followed-up. Pittsburgh Sleep Quality Index Scale, mental health symptom checklist (SCL-90) score were taken as the observing indexes. We de-tected serum serotonin and norepinephrine before and after treatment.[Results] In the manual therapy group, the markedly effective rate was 70.00% and the total effective rate was 96.7 %. In the control group the markedly effective rate was 43.30% and the total effective rate was 86.67%. There was a significant difference between manual therapy group and Western medicine group(P<0.01). After treatment, the scores between the two groups were statistically significantly different (P<0.01). From the time of enrollment to follow-up period, a strong correlation was found between the Pittsburgh Sleep Quality Index and SCL-10 scale at all stages (P<0.01). Following-up the statistical re-currence rate it was noted that in the manual therapy group the recurrence rate was 3.3% and in the treatment group the recurrence rate was 26.67%. During the comparative research it was found that in the manual therapy group the recurrence rate was lower than the control group with a strong statistical difference (P<0.05). Before and after treatment the levels of serotonin were increased in the two groups. In the treatment group it was significantly higher than that in the control group (P<0.01). The levels of norepinephrine in the two groups were decreased and the treatment group was significantly lower than that in the control group (P<0.05). [Conclusion] Effect of Tongmai Tiaoshen manipulative on the patients with psychophysiological insomnia of heart and spleen deficiency type is obvious, and it can effec-tively avoid the presence of Western medicine dependence and addiction. The recurrence rate is low, suitable for the popularization and application.