“三焦针法”改善慢性肾脏病患者失眠症的临床观察

Clinical observation of “Sanjiao acupuncture” to improve insomnia and depression in patients with chronic kidney disease

关键词:  三焦针法  慢性肾脏病  失眠症  抑郁状态

Key words:  Sanjiao acupuncture  chronic kidney disease  insomnia  depression

摘要:

[目的] 通过"三焦针法"对慢性肾脏病合并不寐患者辨证施治，探讨"三焦针法"治疗慢性肾脏病患者失眠症的临床疗效。[方法] 对天津市第一中心医院慢性肾脏病管理中心长期随访的89例慢性肾脏病3、4期未透析患者以匹兹堡睡眠质量指数量表（PSQI）评价睡眠质量。筛选出失眠症患者为研究对象，并随机选取30例患者实施"三焦针法"针灸治疗，其余患者作为对照组给予综合治疗。针灸治疗总疗程为3个月，继续随访至6个月。全部患者治疗前、3个月疗程结束、6个月随访结束后记录患者一般情况、实验室指标、PSQI评分、中医症状评分、SF-36生活质量评分以及评估的肾小球滤过率（eGFR），评价干预前后上述各项指标的变化。[结果] 全部患者中男性占60.7%，平均年龄52.5岁，平均eGFR 48.9 mL/（min·1.73 m²）。至6个月随访结束，针灸治疗组PSQI评分与基线评分比较下降值明显高于对照组。针灸治疗组各项中医症状评分改善情况优于对照组，失眠缓解率明显高于对照组。两组之间eGFR及SF-36评分变化无明显差异。[结论] "三焦针法"可以显著改善CKD3、4期未透析患者的失眠症，各项中医症状也得到相应改善。

Abstract:

[Objective] To investigate the clinical efficacy of "Sanjiao acupuncture" in treating insomnia and depression in patients with chronic kidney disease.[Methods] The quality of sleep and Beck Depression Self-Assessment Scale (BDI) were evaluated in the Pittsburgh Sleep Quality Index (PSQI) for 89 patients with chronic kidney disease in the 3rd to 4th stage of chronic kidney disease management in the First Centrer Hospital of Tianjin. The patients with insomnia were selected as the study subjects,and 30 patients were randomly selected to carry out "Sanjiao acupuncture" treatment,and the other patients were given comprehensive treatment as the control group. The total course of acupuncture treatment was 3 months and continued to follow up to 6 months. All patients were recorded before treatment,3 months of treatment,and 6 months follow-up. General conditions,laboratory parameters,PSQI and BDI scores,traditional Chinese medicine (TCM) symptom scores,SF-36 quality of life scores,and assessed glomerular filtration rate (eGFR) were recorded before and after the intervention.[Results] Males accounted for 60.7% of all patients,with the average age of 52.5 years and the average eGFR of 48.9 mL/(min·1.73 m²). By the end of 6 months of follow-up,the decrease in PSQI score and baseline score in the acupuncture treatment group was significantly higher than that in the control group,and the decrease in BDI score was also higher than that in the control group. The improvement of TCM syndrome scores in the acupuncture treatment group was better than that of the control group,and the insomnia remission rate was significantly higher than that of the control group. There were no significant differences in eGFR and SF-36 scores between the two groups.[Conclusion] The "Sanjiao acupuncture" can significantly improve the insomnia and depression of patients with CKD 3,4 dialysis,and the TCM syndromes of insomnia have also been improved accordingly.