天灸疗法治疗恶性肿瘤患者失眠的临床研究
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摘要
目的:观察天灸治疗恶性肿瘤患者失眠的有效性及安全性。方法:将70例失眠的恶性肿瘤患者随机分为天灸组和对照组,每组35例。天灸组使用天灸膏外敷,配合口服谷维素治疗;对照组口服谷维素治疗。天灸穴位处方:①心俞、胆俞、肾俞、水分、三阴交;②中脘、下脘、气海、关元、足三里、涌泉;两组交替取穴。治疗频率为2次/周,共治疗8周。通过PSQI量表、助眠药物量表、WHOQOL-BREF量表,评估临床疗效。结果:经治疗后,天灸组PSQI得分明显低于对照组(P<0.05),助眠药物使用次数低于对照组(P<0.01)。两组均未见严重不良事件报道。结论:天灸疗法可以改善恶性肿瘤患者的失眠症状,减少安眠药的使用次数,且不良反应较小,值得推广。
Objective: To observe the effectiveness and safety of vesiculation moxibustion in the treatment of insomnia in cancer patients. Methods: Seventy cancer patients with insomnia were randomly divided into vesiculation moxibustion group and control group(35 in each group). All patients received oryzanol treatment, patients in the vesiculation moxibustion group also received vesiculation moxibustion treatment. The acupoint prescription: ①Xinshu(BL15), Danshu(BL19), Shenshu(BL23),Shuifen(RN9), Sanyinjiao(SP6); ②Zhongwan(RN12), Xiawan(RN10), Qihai(RN6), Guanyuan(RN4), Zusanli(ST36),Yongquan(KI1). The whole treatment is 8 weeks, twice per week. The outcomes included PSQI questionnaire, frequency of sleeping pills, WHOQOL-BREF scale. Results: The PSQI score of the vesiculation moxibustion group was significantly lower than that of the control group(P<0.05), and they used less sleeping drugs than control group(P<0.01). No serious adverse events were detected. Conclusion: Vesiculation moxibustion treatment can improve the insomnia symptoms of tumor population, reduce the use of sleeping pills, and less side effects, worthy of promotion.
Objective: To observe the effectiveness and safety of vesiculation moxibustion in the treatment of insomnia in cancer patients. Methods: Seventy cancer patients with insomnia were randomly divided into vesiculation moxibustion group and control group(35 in each group). All patients received oryzanol treatment, patients in the vesiculation moxibustion group also received vesiculation moxibustion treatment. The acupoint prescription: ①Xinshu(BL15), Danshu(BL19), Shenshu(BL23),Shuifen(RN9), Sanyinjiao(SP6); ②Zhongwan(RN12), Xiawan(RN10), Qihai(RN6), Guanyuan(RN4), Zusanli(ST36),Yongquan(KI1). The whole treatment is 8 weeks, twice per week. The outcomes included PSQI questionnaire, frequency of sleeping pills, WHOQOL-BREF scale. Results: The PSQI score of the vesiculation moxibustion group was significantly lower than that of the control group(P<0.05), and they used less sleeping drugs than control group(P<0.01). No serious adverse events were detected. Conclusion: Vesiculation moxibustion treatment can improve the insomnia symptoms of tumor population, reduce the use of sleeping pills, and less side effects, worthy of promotion.
引文
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[24]何爱明.中药透皮给药系统的研究进展.中西医结合研究,2014,6(1):46-47
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[2]Mo Y L,Li L,Qin L,et al.Cognitive function,mood,and sleep quality in patients treated with intensity-modulated radiation therapy for nasopharyngeal cancer:A prospective study.Psychooncology,2014,23(10):1185-1191
[3]Kim M,Kim J E,Lee H Y,et al.Electroacupuncture for treating insomnia in patients with cancer:A study protocol for a randomised pilot clinical trial.BMJ Open,2017,7(8):e16269
[4]Garland S N,Gehrman P,Barg F K,et al.Choosing options for insomnia in cancer effectively(CHOICE):Design of a patient centered comparative effectiveness trial of acupuncture and cognitive behavior therapy for insomnia.Contemp Clin Trials,2016,47:349-355
[5]Denlinger C S,Ligibel J A,Are M,et al.Survivorship:Sleep disorders,version 1.2014.J Natl Compr Canc Netw,2014,12(5):630-642
[6]中国睡眠研究会.中国失眠症诊断和治疗指南.中华医学杂志,2017,97(24):1844-1856
[7]Sun Y J,Yuan J M,Yang Z M.Effectiveness and safety of moxibustion for primary insomnia:a systematic review and metaanalysis.BMC Complement Altern Med,2016,16:217
[8]阿九会.艾灸配合失眠贴治疗失眠症40例.光明中医,2016,31(14):2086-2087
[9]史华伟,邢佳,王嘉麟,等.节气穴位贴敷对失眠患者睡眠质量的影响.中医学报,2016,31(1):135-137
[10]乐发国,刘海霞,王彦婷,等.印堂穴和前额贴敷疗法治疗心理生理性失眠症的效果评价.第三军医大学学报,2014,36(17):1856-1857
[11]胡金霞,杨帆.穴位贴敷疗法治疗更年期综合征失眠症临床观察.时珍国医国药,2013(6):1445-1446
[12]张桂盈,李旻颖,符文彬.天灸疗法对中老年慢性失眠患者生活质量的影响.中国老年学杂志, 2018,38(8):1880-1882
[13]吴倩,温秀云,张雪淳,等.岭南传统天灸4号方治疗抑郁症失眠的临床研究.中华中医药杂志,2017,32(3):1059-1063
[14]苏珊娜,苏保育,李晓玲.酸枣仁汤加减联合“天灸”疗法治疗心胆气虚型失眠的临床观察.内蒙古中医药,2016,35(11):21-22
[15]宁余音,韦衡秋,黄沂,等.温阳驱寒天灸法治疗老年失眠临床观察.广西中医药大学学报,2015,18(4):15-17
[16]中华医学会精神科分会.中国精神障碍分类与诊断标准第3版.济南:山东科学技术出版社,2001
[17]郭秀彩,刘霞,徐月红.白芥子涂方穴位与非穴位给药皮肤渗透特性的比较研究.中国中药杂志,2012,37(7):1034-1038
[18]钟珊,吴曦,梁繁荣.天灸的作用机理和展望.西部中医药,2012(3):93-96
[19]Fleming L,Randell K,Harvey C J,et al.Does cognitive behaviour therapy for insomnia reduce clinical levels of fatigue,anxiety and depression in cancer patients?.Psychooncology,2014,23(6):679-684
[20]Mason E C,Harvey A G.Insomnia before and after treatment for anxiety and depression.J Affect Disord,2014,168:415-421
[21]Carney C E,Moss T G,Lachowski A M,et al.Understanding mental and physical fatigue complaints in those with depression and insomnia.Behav Sleep Med,2014,12(4):272-289
[22]Oyane N M,Pallesen S,Moen B E,et al.Associations between night work and anxiety,depression,insomnia,sleepiness and fatigue in a sample of Norwegian nurses.PLoS One,2013,8(8):e70228
[23]徐涵,杨燕,吴穷.乳腺癌药物治疗致肝损害的研究现状.癌症进展,2018,16(1):22-24
[24]何爱明.中药透皮给药系统的研究进展.中西医结合研究,2014,6(1):46-47
[25]Reilly C M,Bruner D W,Mitchell S A,et al.A literature synthesis of symptom prevalence and severity in persons receiving active cancer treatment.Support Care Cancer,2013,21(6):1525-1550