摘要目的:探讨扶阳罐温灸刮疗法联合耳穴埋籽在卒中后失眠患者中的应用效果。方法:采用回顾性研究，选取2021年6月至2025年3月连云港市中医院收治的90例脑卒中后失眠患者，根据干预方式不同分为对照组、观察组，各45例。对照组中男23例、女22例，年龄（65.02±5.09）岁，缺血性卒中28例、出血性卒中17例，美国国立卫生研究院卒中量表（NIHSS）评分（12.34±3.16）分。观察组中男24例、女21例，年龄（64.78±5.27）岁，缺血性卒中26例、出血性卒中19例，NIHSS评分（11.83±3.02）分。对照组给予扶阳罐温灸刮疗法，观察组在对照组的基础上给予耳穴埋籽治疗，比较两组抑郁与焦虑水平、睡眠质量和不良反应发生率。采用 t、 χ2检验进行统计比较。 结果:干预后，观察组抑郁自评量表（SDS）、焦虑自评量表（SAS）、睡眠潜伏期、快速眼动睡眠时间、匹兹堡睡眠质量指数（PSQI）评分［（38.19±5.43）分、（34.35±6.12）分、（27.54±4.24）min、（79.55±5.69）min、（8.99±3.50）分］均低于对照组［（42.36±6.84）分、（40.68±7.54）分、（31.98±3.61）min、（94.17±5.25）min、（11.08±4.67）分］，睡眠总时间［（7.99±0.50）h］长于对照组［（6.28±0.67）h］，差异均有统计学意义（均 P<0.05）。观察组不良反应发生率（22.22%，10/45）高于对照组（20.00%，9/45），但差异无统计意义（ χ2=0.067， P=0.796）。 结论:扶阳罐温灸刮疗法联合耳穴埋籽可以缓解卒中后失眠患者的焦虑、抑郁水平，提高睡眠质量且不会增加不良反应发生率。

abstractsObjective:To explore the effect of Fuyang jar warm moxibustion and scraping therapy combined with auricular acupuncture point seed implantation for patients with post-stroke insomnia. Methods:Ninety patients with post-stroke insomnia treated at Liangyungang Hospital of Traditional Chinese Medicine from June 2021 to March 2025 were selected as the study objects, and were divided in a control group and an observation group according to the intervention methods, with 45 cases in each group. There were 23 males and 22 females in the control group; they were (65.02±5.09) years old; there were 28 cases of ischemic stroke and 17 cases of hemorrhagic stroke; their score of National Institutes of Health Stroke Scale (NIHSS) was 12.34±3.16. There were 24 males and 21 females in the observation group; they were (64.78±5.27) years old; there were 26 cases of ischemic stroke and 19 cases of hemorrhagic stroke; their score of NIHSS was 11.83±3.02. The control group received Fuyang jar warm moxibustion and scraping therapy; in addition, the observation group were treated with auricular acupuncture point seed implantation. The levels of anxiety and depression, sleep quality, and the incidence rates of adverse reactions were compared between the two groups. t and χ2 tests were used for the statistical comparisons. Results:After the intervention, the scores of Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS), sleep latency, rapid eye movement (REM) sleep time, and score of Pittsburgh Sleep Quality Index (PSQI) in the observation group were higher than those in the control group [38.19±5.43 vs. 42.36±6.84, 34.35±6.12 vs. 40.68±7.54, (27.54±4.24) min vs. (31.98±3.61) min, (79.55±5.69) min vs. (94.17±5.25) min, and 8.99±3.50 vs. 11.08±4.67], and the total sleep time was longer [(7.99±0.50) h vs. (6.28±0.67) h, with statistical differences (all P<0.05). There was no statistical difference in the incidence rate of adverse reactions between the observation group and the control group [22.22% (10/45) vs. 20.00% (9/45); χ2=0.067; P=0.796]. Conclusion:Fuyang jar warm moxibustion and scraping therapy combined with auricular acupuncture point seed implantation for patients with post-stroke insomnia can alleviate their anxiety and depression and improve their quality of sleep, and does not increase the incidence rate of adverse reactions.