针刺联合刺五加治疗心脾两虚型失眠临床观察

Clinical Observation on Acupuncture Combined with Acanthopanax Senticosus for the Treatment of Insomnia Due to Deficiency of Both the Heart and Spleen

摘要: 目的：观察针刺联合口服刺五加治疗心脾两虚型失眠的临床疗效，探究该方案对患者睡眠质量、中医证候积分及血清神经递质水平的改善情况，为失眠的临床治疗提供参考依据。方法：选取2024年2月~2025年10月黑龙江中医药大学附属第二医院针灸科门诊收治的80例心脾两虚型失眠患者为研究对象，采用随机数字表法分为对照组与观察组，各40例。对照组采用单纯针刺治疗，观察组在对照组针刺方案基础上，联合口服刺五加片，两组均连续干预4周。分别于干预前1 d、干预4周结束后次日，采用匹兹堡睡眠质量指数(PSQI)、中医证候积分量表评估患者睡眠及证候改善情况，采集空腹静脉血检测血清5-羟色胺(5-HT)、γ-氨基丁酸(GABA)水平，同时监测干预期间不良事件发生情况。结果：干预前两组基线资料差异无统计学意义(P > 0.05)，具备可比性；干预4周后，观察组临床总有效率为92.50%，显著高于对照组的72.50%，组间差异存在统计学意义(P < 0.05)；两组PSQI总分及各维度分项评分、中医证候总分及单项证候评分均较干预前显著降低，血清5-HT、GABA水平均较干预前显著升高，且观察组各项指标改善幅度均显著优于对照组(P < 0.05)。结论：针刺联合刺五加治疗心脾两虚型失眠，可有效改善患者的睡眠质量，缓解心脾两虚相关症状，调节神经递质水平，且临床安全性良好，值得临床推广应用。

Abstract: Objective: To observe the clinical efficacy of acupuncture combined with oral acanthopanax senticosus in the treatment of insomnia due to deficiency of both the heart and spleen, and to explore the improvement of sleep quality, TCM syndrome scores, and serum neurotransmitter levels in patients treated with this regimen, providing a reference for the clinical treatment of insomnia. Methods: A total of 80 patients with insomnia due to deficiency of both the heart and spleen were selected from the outpatient department of acupuncture and moxibustion in Outpatient Department of Acupuncture and Moxibustion, The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine from February 2024 to October 2025. They were divided into a control group and an observation group using a random number table method, with 40 cases in each group. The control group received simple acupuncture treatment, while the observation group received oral acanthopanax senticosus tablets in addition to the acupuncture regimen used in the control group. Both groups underwent continuous intervention for 4 weeks. The Pittsburgh Sleep Quality Index (PSQI) and TCM syndrome score scale were used to assess patients’ sleep and syndrome improvement 1 day before intervention and the day after the end of 4 weeks of intervention, respectively. Fasting venous blood was collected to detect serum levels of 5-hydroxytryptamine (5-HT) and γ-aminobutyric acid (GABA), and adverse events during the intervention were monitored. Results: There was no significant difference in baseline data between the two groups before intervention (P > 0.05), indicating comparability. After 4 weeks of intervention, the total clinical efficacy rate in the observation group was 92.50%, significantly higher than that in the control group (72.50%), with a statistically significant difference between the groups (P < 0.05). The total PSQI score and each dimension score, as well as the total TCM syndrome score and individual syndrome scores, were significantly reduced compared to before intervention. Serum levels of 5-HT and GABA were significantly increased compared to before intervention, and the improvement in each indicator in the observation group was significantly better than that in the control group (P < 0.05). Conclusion: Acupuncture combined with acanthopanax senticosus can effectively improve patients’ sleep quality, alleviate symptoms related to deficiency of both the heart and spleen, regulate neurotransmitter levels, and has good clinical safety, making it worthy of clinical promotion and application.