針刺治療失眠症的研究思路

The Ideology of Acupuncture Treatment on Insomnia

江裕陽(Yu-Yang Chiang) ； 蔡盧浚(Lu-Jiunn Tsay) ； 徐坤銘(Kuen-Ming Shyu) ； 黃伯瑜(Pa-Yu Hwang)

《台灣中醫臨床醫學雜誌》 14卷2期 (2008/06) Pp. 128-140

https://doi.org/10.6968/TJCCM.200806.0128

摘要

失眠是一種因睡不好而可能影響白天工作或心情的主觀感受。睡眠障礙包括睡眠時間不足、入睡困難或睡中易醒、醒後難以再睡、睡眠品質差或白天精神不佳、欲寐，晚上上床卻睡不著等症狀。服用助眠藥物是治療睡眠障礙最常用的方法，但不一定有效，且有其副作用。針刺(Acupuncture)是中醫治療疾病的常用方法，因其具有簡易、經濟、有效的特點，古來即為華人社會所接受，目前並廣泛為西方國家應用於神經性疾患的替代療法(alternative treatment approach)。目標：1．為探討針刺療法是否可改善睡眠品質2．中西醫結合治療失眠症是否更具療效，乃提出本研究計畫構想。方法：以隨機臨床對照試驗(Randomized Controlled Trial, RCT)方式，將病患隨機分為西藥組（僅使用西藥治療）、中西結合組（西藥配合針刺療法）及針刺組（僅使用針刺療法）三組，實際治療期間4周，並隨訪4週。西藥組由院區精神科醫師治療，中西結合組則分別由院區精神科及中醫科醫師共同治療，針刺組由院區中醫科醫師治療。並利用匹茲堡睡眠品質量表(PSQI)，依統計學的重複測量單因子變異數分析(one way ANOVA for repeated measurements)方法，檢定失眠患者，除經西藥治療外，再配合針刺療法，與僅接受西藥或針刺治療者作比較，兩者在治療前後，彼此的PSQI量表分數是否有統計上的差異，以評估針刺療法治療失眠症的有效性及安全性。結論：本計畫業經台北市立聯合醫院人體試驗委員會審查通過，顯示以匹茲堡睡眠品質量表(PSQI)的客觀評估方式，來探討「針刺療法治療失眠症」的療效，是可行的。

關鍵字

失眠 ； 匹茲堡睡眠品質量表PSQI ； 針刺

並列摘要

Insomnia is a subjective perception that affects mood and work performance in the daytime when sleep quality is not satisfying. Insomnia includes insufficient sleep time, difficulty falling asleep, frequent waking up, and difficult to fall asleep again, bad sleeping quality, low energy. sleepy during day time, but can't fall asleep at night. The most common method of treating insomnia is to take sleeping pills although its not always effective and has side effects. Acupuncture a common TCM treatment because of its simplicity, economy, and effectiveness. It has been accepted by Chinese societies since ancient time, and is now used extensively in Western societies as the alternative treatment approach in neurological problems.
Subject
1. To find out whether acupuncture can improve sleep quality
2. To find out whether Integration of TCM and Western can be more effective in treating insomnia
Method
Randomized Controlled Trial (RCT) is used to divide subjects randomly into WM group (Western medication only), ITW group (Integration of TCM and Western medication), and acupuncture group (only acupuncture is used). The actual treatment duration is 4 weeks with 4 weeks of followup. WM group is treated by psychiatric doctors in the hospital; ITW group is treated by psychiatric doctors and TCM doctors together in the hospital; acupuncture group is treated by TCM doctors in the hospital.
PSQI and one way ANOVA for repeated measurements are used to analyze the data between these three groups to see if there is any statistical significance in the PSQI, and to assess whether acupuncture treatment is effective and safe in treating insomnia.
Conclusion
This research has been approved by Taipei City Hospital Human Test Committee. It shows the subjective assessment of PSQI to probe into the effectiveness of acupuncture on insomnia is feasible.

並列關鍵字

Insomnia ； PSQI ； acupuncture