通脉调神手法治疗心脾两虚型心理生理性失眠临床疗效观察

目的：评价通脉调神手法治疗心脾两虚型心理生理性失眠的临床疗效。方法：将60例本病门诊患者，采用临床随机、对照法研究，按照1：1比例分为手法治疗组和西药对照组，每组30例，疗程为20天，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。观察每组各分期治疗前后和组间客观指标变化，观测各期各项客观指标数值的改善情况。结果：通脉调神推拿手法治疗本病的疗效显著。手法治疗组愈显率为70％，总有效率为96．7％，西药对照组的愈显率为56．67％，总有效率为86．67％，手法治疗组优于西药组，有显著统计学差异（P〈0．01）。经过治疗，两组的评分比较均有显著统计学差异（P〈0．01）。从入组到随访期，匹茨堡睡眠质量指数与SCL-10量表在各阶段均存在较强的相关性（P〈0．01）。随访统计复发率方面，手法治疗组复发率为3．3％，西药组复发率为26．67％，手法治疗组复发率低于西药对照组，有较强的统计学差异（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的疗效显著，有效地避免了西药治疗存在的依赖性、成瘾性。通脉调神手法是治疗心理生理性失眠安全有效的方案，复发率低，是一个简便验廉、规范化、适于推广应用的心理生理性失眠临床治疗方法。

Curative Observation of Tongmai Tiaoshen Technique on Treating Psychophysiologieal Insomnia of Heart-spleen Deficiency

Objective ： To evaluate the clinical efficacy of the Tongmai Tiaoshen Technique on the treatment of Psychophysio- logical Insomnia of heart-spleen deficiency. Methods： 60 patients with this disease were outpatient service, using the method of randomized, controlled clinical study, according to the proportion of 1：1 were divided into treatment group and western medi- cine controlled group, 30 cases in each group, the treatment for 20 days, after 3 month follow-up. With Pittsburgh sleep quality index scale, mental health symptom self-assessment scale （SCL-90） ratings as observation index. Observing each group stage and objective indicators between the two groups before and after treatment, observation periods each objective index numerical value improvement. Results： The Tongmai Tiaoshen Technique on the treatment of the disease curative effect was distinct. The effective rate of the treatment group markedly was 70%, the total effective rate was 96. 7%, the markedly effective rate of the western medicine controlled group was 56. 67% , the total effective rate was 86. 67%, the treatment group was superior to west- ern medicine, there were statistically significant differences （P〈0. 01 ）. After treatment, the scores compare of the two groups have statistically significant differences （P〈0. O1 ）. From into the groups to follow-up, Pittsburgh sleep quality index and SCL- 10 scale in each stage were strong correlative （P〈O. 01 ）. Statistical follow-up recurrence rates, treatment group recurrence rate was 3.3%, the western medicine group recurrence rate was 26. 67%, the recurrence rate of the treatment group was lower than the western medicine controlled group, had the strong statistical difference （P〈0. 05 ）. Conclusion： Tongmai Tiaoshen Tech- nique has significantly curative effect to treat psychological physiology insomnia, can effectively avoid the dependence and addic- tion of western medicine treatment. Tongmai Tiaoshen Technique is a safe and effective treatment of psychological physiology in- somnia and has low relapse rate, it is a simple, normalized test, is suitable for popularization and application of psychological physiology insomnia clinical treatment.