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目的 探讨高压氧联合针刺"前四关"治疗失眠患者的疗效.方法 选取2013年11月至2016年11月在解放军第一七四医院康复医学科治疗的失眠患者89例,经患者知情同意,并签署知情同意书后,根据随机数字表法将所有患者随机分为单纯针刺组44例、联合治疗组45例.单纯针刺组给予针刺"前四关"治疗,联合治疗组在针刺"前四关"的基础上给予高压氧治疗.治疗28 d后,比较2组患者的临床疗效、睡眠质量、不良反应.结果 联合治疗组患者的治愈比例(13/45)和总有效率(93.3％)均明显高于单纯针刺组(3/44,65.9％),差异有统计学意义(P<0.05).治疗14 d、28 d后,联合治疗组匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)评分总分明显低于单纯针刺组,差异有统计学意义(P<0.05).联合治疗组患者PSQI评分中入睡时间、睡眠时间、睡眠效率、睡眠障碍、睡眠质量及日间功能评分均明显低于单纯针刺组,差异有统计学意义(P<0.05).2组患者出现嗜睡、头晕、口干、头痛不良反应的发生率,差异无统计学意义(P>0.05).结论 高压氧联合针刺"前四关"治疗失眠患者疗效明显,有效提高了患者睡眠质量,值得临床推广.

Objective To investigate the therapeutic effects of hyperbaric oxygen (HBO) coupled with acupuncture at "Qiansiguan"on the patients with insomnia.Methods Eighty-nine patients with insomnia who received treatment in the hospital from November 2013 to November 2016 were selected as research subjects . The patients were randomly divided into the simple acupuncture group or the control group (n =44) and the combined treatment group (n =45).The simple acupuncture group received acupuncture at "Qiansiguan", while the combined treatment group was treated with HBO , in addition to acupuncture at "Qiansiguan".After 28 days of treatment, therapeutic effects, sleep quality and adverse reactions were compared between the patients of the 2 groups.Results The cure rate (13 /45) and total effective rate (93.3％) of the combined treatment group were significantly higher than those of the control group (3/44, 65.9％), and statistical significance could be noted, when comparisons were made between the 2 groups (P <0.05).After 14 and 28 days of treatment, the total scores of Pittsburgh sleep quality index (PSQI)for the combined treatment group were obviously lower than those of the simple acupuncture group , with statistical significance (P <0.05).Of the PSQI scores for the combined treatment group , the scores of falling asleep time, sleep duration, sleep efficiency, sleep disorder, sleep quality and daytime function for the combined treatment group were all significantly lower than those for the control group , also with statistical significance (P <0.05).There was no statistical significance in the incidence of drowsiness , dizziness, xerostomia, headache and other adverse reactions, when comparisons were made between the 2 groups (P >0.05).Conclusions HBO combined with acupuncture at "Qiansiguan"could produce effective therapeutic results in the treatment of insomnia and obviously improve sleep quality of the patients .For this reason, it was worth further clinical popularization .