针刺改善美沙酮维持治疗门诊患者睡眠质量的随机对照研究

作者	单位
李毅	华中科技大学同济医学院附属精神卫生中心
刘学兵	华中科技大学同济医学院附属精神卫生中心
张尧	华中科技大学同济医学院附属精神卫生中心

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中文摘要:

目的探讨针刺治疗改善美沙酮维持治疗(methadone maintenance treatment,MMT)患者睡眠质量的疗效和安全性。方法采用随机双盲对照设计,将75例低睡眠质量[匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)总分≥8分]的MMT门诊患者随机分为针刺组(38例)和伪针刺组(37例)。两组患者均维持原有的MMT治疗;针刺组行针刺治疗,取穴百会、神门(双)、神庭、三阴交(双)和四神聪穴;伪针刺组行非穴点浅刺(取针刺组穴位旁5mm处);均每周5次,连续8周。于治疗前和治疗第2、4、6、8周末进行PSQI评分;比较两组治疗第8周末低睡眠质量的检出率和针刺不良反应发生率。结果整体上针刺组的PSQI评分明显低于伪针刺组,差异有统计学意义(P<0.01)。治疗第8周末,针刺组低睡眠质量的检出率(60.53%,23/38)低于伪针刺组(83.78%,31/37),差异有统计学意义(P<0.05)。针刺组和伪针刺组不良反应发生率分别为5.26%(2/38)和2.70%(1/37),差异无统计学意义(P>0.05)。结论针刺疗法能安全有效地改善MMT门诊患者的睡眠质量。

英文摘要:

Objective To study the efficacy and safety of acupuncture therapy for the improvement of sleep quality of outpatients receiving methadone maintenance treatment(MMT).Methods Using randomized double-blinded controlled design,seventy-five MMT outpatients with low sleep quality [score of Pittsburgh Sleep Quality Index(PSQI)≥8],were randomly assigned to the acupuncture group(38 cases) and the sham-acupuncture group(37 cases).All patients maintained previous MMT.Acupuncture was applied to Baihui(GV20),Shenmen(bilateral,TF4),Shenting(GV24),Sanyinjiao(bilateral,SP6),and Sishencong(EX-HN1) in the acupuncture group.The same procedures were performed in the sham-acupuncture group,but not to the acupoints(5 mm lateral to the acupoints selected in the acupuncture group) with shallow needling technique.The treatment was performed 5 times each week for 8 successive weeks.The PSQI was assessed before treatment,at the end of the 2nd,4th,6th,and 8th week of the treatment.The detection ratio of low sleep quality and the incidence of adverse acupuncture reactions were compared between the two groups at the end of the 8th week.Results The overall PSQI score was obviously higher in the acupuncture group than in the sham-acupuncture group with statistical difference(P<0.01).The detection ratio of low sleep quality at the end of the 8th week was lower in the acupuncture group(60.53%,23/38 cases) than in the sham-acupuncture group(83.78%,31/37 cases) with statistical difference(P<0.05).The rate of adverse acupuncture reaction was 5.26%(2/38 cases) in the acupuncture group and 2.70%(1/37 cases) in the sham-acupuncture group respectively,showing no statistical difference(P>0.05).Conclusion Acupuncture therapy could effectively and safely improve the sleep quality of outpatients receiving MMT.

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