温针灸联合归脾汤治疗心脾两虚型失眠的疗效观察OA

Objective To observe the clinical efficacy of warm acupuncture combined with Guipi Decoction in treating insomnia with heart-spleen deficiency syndrome.Methods A total of 94 patients definitively diagnosed with insomnia of heart-spleen deficiency type,admitted to the wards or outpatient department of the Department of Integrated Traditional Chinese and Western Medicine at the Qinghai University Affiliated Hospital from January 2021 to January 2024,were selected as subjects.Patients were randomly divided into an observation group and a control group using a random number table,with 47 patients in each group.The control group received Guipi Decoction treatment,while the observation group received warm acupuncture in addition to the control group's treatment.The intervention lasted for one consecutive month.After one month of treatment,the clinical efficacy of the two groups was evaluated.Changes in traditional Chinese medicine(TCM)syndrome scores,sleep latency,total sleep time,sleep quality,Pittsburgh Sleep Quality Index(PSQI)scores,and Insomnia Severity Index(ISI)scores were observed before and after treatment.Changes in serum levels of 5-hydroxytryptamine(5-HT)and cortisol(CORT)were compared between the two groups before and after treatment.The safety and incidence of adverse reactions in both groups were also evaluated.Results(1)During the study,3 cases in the observation group were lost to follow-up.Ultimately,44 cases in the observation group and 47 cases in the control group were included in the efficacy analysis.(2)The total effective rate was 93.18%(41/44)in the observation group and 76.60%(36/47)in the control group.The efficacy of the observation group was superior to that of the control group,with a statistically significant difference(P＜0.05).(3)After treatment,TCM syndrome scores were significantly improved in both groups(P＜0.05),and the improvement was significantly greater in the observation group than in the control group,the difference being statistically significant(P＜0.05).(4)After treatment,sleep latency,total sleep time,and sleep quality were significantly improved in both groups(P＜0.05),and the improvements were significantly greater in the observation group than in the control group(P＜0.05).(5)After treatment,PSQI and ISI scores were significantly improved in both groups(P＜0.05),and the improvements were significantly greater in the observation group than in the control group,the difference being statistically significant(P＜0.05).(6)After treatment,serum levels of 5-HT and CORT were significantly improved in both groups(P＜0.05),and the improvements were significantly greater in the observation group than in the control group,the difference being statistically significant(P＜0.05).(7)The incidence of adverse reactions was 2.27%(1/44)in the observation group and 6.38%(3/47)in the control group.There was no statistically significant difference in the incidence of adverse reactions between the observation group and the control group(P＞0.05).Conclusion Warm acupuncture combined with Guipi Decoction in treating insomnia with heart-spleen deficiency syndrome can significantly improve patients'insomnia symptoms,enhance sleep quality,regulate serum levels of 5-HT and CORT,with a favorable safety profile and notable clinical efficacy.