基于“阳主神”理论的改良长蛇灸治疗阳虚型失眠的临床研究

Clinical Study of Enhanced Long Snake Moxibustion Therapy for Yang Deficiency Insomnia Based on the Theory of “Yang Dominates Spirit”

摘要: 目的：观察改良长蛇灸治疗阳虚型失眠的临床疗效。方法：将74例阳虚型失眠患者采用随机数字表法分为改良长蛇灸联合西药组和单纯西药组。西药给予右佐匹克隆片，每晚3 mg。改良长蛇灸每周治疗2次，单次时间为1小时。两组均治疗4周，随访1个月。主要结局为匹兹堡睡眠质量指数(PSQI)；次要结局为失眠严重程度指数(ISI)、焦虑自评量表(SAS)、抑郁自评量表(SDS)、疲劳严重程度量表(FSS)、中医证候积分、西药用量情况、不良事件。结果：治疗后，两组PSQI、ISI、SAS、SDS、FSS和中医证候积分均较治疗前明显改善(P < 0.05)；治疗组PSQI、ISI、SDS和中医证候积分改善程度均优于对照组(P < 0.05)，且在随访1月后仍显著(P < 0.05)；治疗后两组FSS无统计学差异(P > 0.05)，但随访1月后治疗组明显优于对照组(P < 0.05)；治疗组西药用量在治疗后1个月期间有减量情况。结论：改良长蛇灸能有效改善阳虚型失眠，缓解患者的焦虑抑郁情绪、疲劳程度及中医证候表现，且具有较好的持续效应，安全性较高。

Abstract: Objective: To observe the clinical effects of enhanced long snake moxibustion on Yang deficiency insomnia. Methods: 74 participants of Yang deficiency insomnia were divided into enhanced long snake moxibustion combined with western medicine group and simple western medicine group. The Western medicine administered was dexzopiclone tablets, 3 mg per night. Enhanced long snake moxibustion was applied twice a week for 1 hour each session. Both groups were treated for 4 weeks with a 1-month follow-up. The primary outcome was the Pittsburgh Sleep Quality Index (PSQI). Secondary outcomes included the Insomnia Severity Index (ISI), Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Fatigue Severity Scale (FSS), Traditional Chinese Medicine (TCM) syndrome score, dosage of Western medicine, and adverse events. Results: Following treatment, PSQI, ISI, SAS, SDS, FSS, and TCM syndrome scores significantly improved compared to baseline (P < 0.05). The treatment group showed better improvements in PSQI, ISI, SDS, and TCM syndrome scores compared to the control group (P < 0.05), which remained significant at 1-month follow-up (P < 0.05). There was no significant difference in FSS between the groups post-treatment (P > 0.05), but the treatment group showed significant improvement over the control group at 1-month follow-up (P < 0.05). The dosage of Western medicine decreased in the treatment group over the 1-month follow-up period. Conclusion: Enhanced long snake moxibustion effectively alleviates Yang deficiency insomnia, anxiety, depression, fatigue, and TCM syndromes with sustained efficacy and high safety.