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目的 探究基于脑肠轴理论针刺与安神舒眠方联合治疗心脾两虚证卒中后顽固性失眠的效果。方法 选取2023年1月—2025年1月滁州市中西医结合医院收治的99例心脾两虚证卒中后顽固性失眠患者进行单盲随机对照研究，随机数字表法分为3组，各33例。针刺组采用针刺疗法，方剂组采用安神舒眠方治疗，联合组采用针刺与安神舒眠方联合治疗，疗程均为4周。比较3组临床疗效、中医证候积分、匹兹堡睡眠质量指数（PSQI）评分、失眠严重程度指数（ISI）评分、γ-氨基丁酸（GABA）、5-羟吲哚乙酸（5-HIAA）、5-羟色胺（5-HT）、多巴胺（DA）及不良反应发生情况。结果 联合组总有效率为96.97%(32/33)高于针刺组的72.73%(24/33)、方剂组的75.76%(25/33,P<0.05)。治疗后，联合组各项中医证候积分、ISI评分、PSQI评分低于针刺组、方剂组（P<0.05）。治疗后，联合组血清GABA、5-HIAA、5-HT高于针刺组、方剂组，DA低于针刺组、方剂组，且方剂组高于或低于针刺组（P<0.05）。3组不良反应发生率比较差异无统计学意义（P>0.05）。结论 心脾两虚证卒中后顽固性失眠患者应用基于脑肠轴理论针刺与安神舒眠方联合治疗方案可显著改善失眠症状，提升睡眠质量，效果确切且安全性高。
Abstract：Objective To investigate the efficacy of acupuncture combined with Anshen Shumian formula based on brain-gut axis theory in the treatment of refractory post-stroke insomnia with heart-spleen deficiency syndrome.Methods A total of 99 patients with refractory post-stroke insomnia with heart-spleen deficiency syndrome admitted to Chuzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2023 to January 2025 were enrolled in a single-blind randomized controlled trial.They were divided into three groups by random number table method,with 33 patients in each group.The acupuncture group received acupuncture therapy,the formula group was treated with Anshen Shumian formula,and the combination group was given acupuncture combined with Anshen Shumian formula.The course of treatment in all groups lasted 4 weeks.The clinical efficacy,traditional Chinese medicine(TCM) symptom scores,Pittsburgh Sleep Quality Index(PSQI) score,Insomnia Severity Index(ISI) score,y-aminobutyric acid(GABA),5-hydroxyindoleacetic acid(5-HIAA),5-hydroxytryptamine(5-HT),dopamine(DA),and the incidence of adverse reactions were compared among the three groups.Results The total effective rate of the combination group was 96.97%(32/33),which was higher than 72.73%(24/33) of the acupuncture group and 75.76%(25/33) of the formula group(P<0.05).After treatment,the TCM syndrome scores,ISI scores and PSQI scores in the combination group were lower than those in the acupuncture group and formula group(P<0.05).After treatment,serum levels of GABA,5-HI A A and 5-HT in the combination group were higher,while DA level was lower than those in the other two groups;the formula group was superior to the acupuncture group in the above indicators(P<0.05).There was no significant difference in the incidence of adverse reactions among the three groups(P>0.05).Conclusion For patients with refractory post-stroke insomnia with heart-spleen deficiency syndrome,the combined regimen of acupuncture based on brain-gut axis theory and Anshen Shumian formula can significantly improve insomnia symptoms and sleep quality,with definite therapeutic effect and good safety profile.
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基本信息:
中图分类号:R277.7
引用信息:
[1]李婧,刘超群,许瑞卿.基于脑肠轴理论针刺与安神舒眠方联合治疗心脾两虚证卒中后顽固性失眠的效果[J].临床误诊误治,2026,39(11):78-83.
基金信息:
安徽省中医药传承创新科研项目（2024CCCX188）
2026-06-10
2026-06-10