【目的】分析潜阳封髓丹联合飞针针刺治疗不寐症的临床疗效。【方法】采用回顾性研究方法，选取2020年11月至2021年 11月德州市中医院中医内科收治的82例不寐症患者，根据是否运用潜阳封髓丹联合飞针针刺治疗分为观察组和对照组，每 组各41例。对照组给予艾司唑仑治疗，观察组在对照组治疗的基础上给予潜阳封髓丹联合飞针针刺治疗，疗程为1个月。 观察2组患者治疗前后匹兹堡睡眠质量指数（PSQI）评分与爱泼沃斯嗜睡量表（ESS）评分的变化情况，以及多导睡眠图参数的 情况。比较2组患者治疗前后γ-氨基丁酸（GABA）、谷氨酸（GA）、P物质（SP）、神经肽Y（NPY）含量的变化情况。并随访 1年比较2组患者的复发率。【结果】（1）观察组总有效率为95.12%（39/41），对照组为63.41%（26/41），观察组疗效优于对照 组，差异有统计学意义（P＜0.05）。（2）治疗后，2组患者PSQI评分、ESS评分均明显改善（P＜0.05），且观察组在改善PSQI评 分与ESS评分方面明显优于对照组，差异均有统计学意义（P＜0.05）。（3）治疗后，2组患者睡眠效率、觉醒时间、睡眠潜伏 期、REM、睡眠总时间均明显改善（P＜0.05），且观察组在改善睡眠效率、觉醒时间、睡眠潜伏期、REM、睡眠总时间方面 明显优于对照组，差异均有统计学意义（P＜0.05）。（4）治疗后，2组患者血清GABA、GA、SP、NPY水平均明显改善（P＜ 0.05），且观察组在改善血清GABA、GA、SP、NPY水平方面明显优于对照组，差异均有统计学意义（P＜0.05）。（5）治疗后， 随访1年，观察组复发率为0，对照组有7例复发，对照组复发率为17.07%（7/41），观察组复发率低于对照组，差异有统计 学意义（P＜0.05）。【结论】潜阳封髓丹联合飞针针刺可有效缓解不寐症患者失眠、神疲乏力等症状，减轻日间嗜睡感，调节 血清单胺类神经递质释放，降低复发率，其疗效优于单纯西药治疗。

Objective To analyze the clinical efficacy of the Qianyang Fengsui Dan（combined with flying needle therapy） in the treatment of kidney- yang deficiency type of insomnia. Methods A retrospective study was conducted to select 82 patients with insomnia admitted to the Department of Traditional Chinese Medicine of Dezhou Hospital of Traditional Chinese Medicine from November 2020 to November 2021，and they were divided into an observation group and a control group according to whether or not they were treated with Qianyang Fengsui Dan combined with flying needle therapy， with 41 cases in each group. The control group was treated with Estazolam， while the observation group was treated with Qianyang Fengsui Dan combined with flying needle therapy on the basis of the treatment of the control group，and the course of treatment was 1 month. The changes of PittsburghSleepQualityIndex（PSQI）scoresandEpworthSleepinessScale（ESS）scores，aswellaspolysomnographic parameters were observed before and after treatment in the two groups. The changes of γ- aminobutyric acid 广州中医药大学学报 Journal of Guangzhou University of Traditional Chinese Medicine 2024年3月第41卷第3期 664 March 2024，Vol. 41，No. 3 （GABA），glutamate（GA），substance P（SP），and neuropeptide Y（NPY）levels were compared before and after treatment between the two groups. And followed up for 1 year to compare the incidence of relapce of the two groups of patients. Results（1）The total effective rate was 95.12%（39/41）in the observation group and 63.41%（26/41） in the control group，and the efficacy of the observation group was superior to that of the control group，and the difference was statistically significant（P＜0.05）.（2）After treatment，PSQI scores and ESS scores of patients in the two groups were significantly improved（P＜0.05），and the observation group was significantly superior to the control group in improving PSQI scores and ESS scores， and the differences were statistically significant（P＜ 0.05）.（3）After treatment，sleep efficiency，awakening time，sleep latency，REM，and total sleep time were significantly improved in the two groups（P＜0.05），and the observation group was significantly superior to the control group in improving sleep efficiency，awakening time，sleep latency，REM，and total sleep time，and the differences were statistically significant（P＜0.05）.（4）After treatment，the serum GABA，GA，SP，and NPY levels of patients in the two groups were significantly improved（P＜0.05）， and the observation group was significantly superior to the control group in improving the serum GABA，GA，SP，and NPY levels， and the differences were all statistically significant（P＜0.05）.（5）After treatment，follow-up for 1 year，the recurrence rate of the observation group was 0，and there were 7 cases of recurrence in the control group，and the recurrence rate of the control group was 17.07%（7/41），and the recurrence rate of the observation group was lower than that of the control group， and the difference was statistically significant（P＜0.05）. Conclusion The combination of flying needle therapy and Qianyang Fengsui Dan can effectively relieve insomnia and fatigue in patients with insomnia， reduce daytime drowsiness， regulate the release of blood monoamine neurotransmitters， and reduce the relapse rate，and its efficacy is superior to that of simple western medicine treatment.

R246.9

山东省中医药科技资助项目（编号：2020Q122）