| ObjectiveThis study will be after a stroke patients with insomnia as the research object, for the treatment of acupuncture combined with auricular application, observe the clinical effects of insomnia after stroke with treatment, discuss whether combined with drug intervention will enhance the curative effect of acupuncture combined with acuricular application treatment insomnia after stroke, bring up an experimental basis of safe for clinical treatment to insomnia after stroke.Methods150 patients with post-stroke insomnia from Chengdu University of TCM Hospital、 Chengdu Integrated TCM&Western Medicine Hospital、The Third Affiliated Hospital of Chengdu University of TCM during the priod from October 2014 to February 2016 were randomly divided into needling-auricular group, drug group and needling-drug-auricular group respectively for 47 cases,50 cases,53 cases. The needling-auricular group is the treatment of acupuncture and auricular points therapy, drug groups for oral estazolam 1 mg before going to bed,needling-drug-auricular group by acupuncture and auricular point therapy and oral estazolam 1 mg bedtime,1 times a day, a total of 20 days of treatment. After treatment with Pittsburgh sleep quality index (PSQI) scale to judge the curative effect. Data analysis uses the SPSS22.0 software analysis.Results1. Comparison between the therapeutic groups.(1) Comparison between the three groups:Needle-auricular group cured 9 cases,16 cases had marked effect, effectively and 19 cases,3 had no effect, total effective rate was 93.6%. Drug group cure 1 cases,9 cases were markedly effective, effective 30 cases,10 cases were invalid, the total effective rate was 80%. Needle-drug-auricular group of 4 cases were cured,14 cases were markedly effective, effective 32 cases, ineffective in 3 cases, total effective rate was 94.3%.Three groups of curative effect of the overall comparison, has the effect of three treatment group (P<0.05)。(2) Comparison between the two groups:Needle-auricular curative effect is higher than the drug group (P< 0.05); The needle-drug-auricular curative effect is not higher than the needle-auricular group (P> 0.05).Needle-drug-auricular group was higher than drug group (P<0.05).2. PSQI scale score difference between the group of comparison before and after the treatment.(1) Comparison between the three groups:Three groups of PSQI components have curative effect。To improve sleep quality, time for failing asleep, sleep and daytime dysfunction has no obvious differences (P> 0.05). In improving sleep time, sleep efficiency, sleep disturbance, hypnotic drugs and PSQI scores have significant difference (P<0.05).(2) Comparison between the two groups:Needle-auricular group and drug group, in improving the sleep time, sleep efficiency, sleep disturbance, hypnotic drugs and PSQI scores of needle-auricular is better than that of drug group (P< 0.05).Needle-auricular group and needle-drug-auricular group, improving its hypnotic drugs and PSQI scores of needle-auricular group is better than that of the needle-drug-auricular group (P< 0.05). Needle-drug-auricular group and drug group, in improving sleep quality, time for failing asleep,sleep time and daytime dysfunction in needle ear medicine group is better than that of drug group (P< 0.05).3. PSQI scale before and after treatment comparison within the group itself: Three groups in the scores of PSQI scale are significantly lower after treatment than before treatment. needling-auricular group and drug group the score difference was statistically significant (P< 0.05), but needling-drug-auricular group in the aspect of improving sleep disorders, there was no statistically significant difference (P> 0.05). and in improving the other six aspects:difference was statistically significant (P< 0.05).4. Needling-auricular group, drug group and needling-drug-auricular group of treatment adherence and follow-up compliance.5. Follow-up to compare.(1) Comparison between the three groups:Three groups of patients for the follow-up than the PSQI scores and each component score before treatment were significantly lower. In improving sleep efficiency, sleep medication, sleep disorder, daytime dysfunction and PSQI scores have differences (P< 0.05).(2) Comparison between the two groups:Needling-auricular and drug group, in improving hypnotic drugs and PSQI scores, needling-auricular is better than that of drug group (P< 0.05). Needling-drug-auricular group and drug group, In improving sleep disorders and PSQI scores needling-drug-auricular group is better than that of drug group (P< 0.05). Needling-auricular group and needling-drug-auricular group, In improving the sleep disorders and hypnotic drugs, daytime dysfunction and PSQI scores on needling-auricular group is better than the needling-drug-auricular group (P< 0.05).(3) Comparison between themselves:Three group after treatment, the PSQI scale difference after treatment than before treatment were significantly lower, two follow-up were increased obviously after treatment, but two follow-up was still has the obvious drop, all have significant difference (P< 0.05).6. Safety comparison.(1) Comparison between the three groups:These three groups in terms of security have little difference.(2) Comparison between the two groups:Needling -auricular and drug group comparison, the ear security is not superior to drug group (P> 0.05); Ear needle group and drug group comparison, needle ear medicine group security no ear strong group (P> 0.05); Drug group compared with the needling-drug-auricular group, needling-drug-auricular safety is better than that of drug group (P< 0.05).ConclusionThree methods of treatment for insomnia has good effect after stroke, but needle-drug-auricular group not better than needle-auricular group. Combined with drug intervention in the treatment of post-stroke insomnia curative effect enhancement is not obvious. In the follow-up effect of three groups decreased obviously, but still better, compared with before treatment effect to maintain time is shorter. |
