【目的】观察方氏头针联合择时耳穴贴压治疗维持性血液透析失眠患者的临床疗效。【方法】将70例维持性血液透析失 眠患者随机分为观察组和对照组，每组各35例。2组均给予常规治疗，对照组在常规治疗的基础上给予艾司唑仑片口服，观 察组给予方氏头针联合择时耳穴贴压治疗，共治疗4周。治疗1个月后，评价2组临床疗效，观察2组患者治疗前后匹兹堡 睡眠质量指数量表（PSQI）评分与肾脏疾病生活质量简表（KDQOL-SF）评分的变化情况，以及汉密尔顿抑郁量表（HAMD）和汉 密尔顿焦虑量表（HAMA）评分的情况。比较2组患者治疗前后血红蛋白（Hb）、血肌酐（Scr）、血尿素氮（BUN）水平的变化情 况。并评价2组的安全性。【结果】（1）治疗后，2组患者的PSQI、KDQOL-SF评分均明显改善（P＜0.05），且观察组在改善 PSQI、KDQOL-SF评分方面明显优于对照组，差异有统计学意义（P＜0.05）。（2）治疗后，2组患者的HAMD、HAMA评分均明 显改善（P＜0.05），且观察组在改善HAMD、HAMA评分方面明显优于对照组，差异有统计学意义（P＜0.05）。（3）治疗后， 2组患者Hb、Scr、BUN水平均明显改善（P＜0.05），且观察组在改善Hb、Scr、BUN水平方面明显优于对照组，差异均有统 计学意义（P＜0.05）。（4）观察组总有效率为77.14%（27/35），对照组为62.86%（22/35）。观察组疗效优于对照组，差异有统计 学意义（P＜0.05）。（5）2组患者的不良反应发生率比较，差异无统计学意义（P＞0.05）。【结论】方氏头针联合择时耳穴贴压治 疗维持性血液透析失眠，能够有效改善患者的睡眠质量，缓解焦虑抑郁情绪，从而提高患者的生活质量，疗效显著。

Objective To observe the clinical efficacy of FANG’s scalp acupuncture combined with timing auricular point pressing therapy in the treatment of insomnia patients with maintenance hemodialysis（MHD）. Methods A total of 70 patients with insomnia on MHD were randomly divided into observation group and control group，with 35 patients in each group. Both groups were given conventional treatment，the control group was given oral use of Estazolam Tablets on the basis of conventional treatment，and the observation group was given FANG’s scalp acupuncture combined with timing auricular point pressing therapy. Both groups were treated for a total of 4 weeks of treatment. After 1 month of treatment，the clinical efficacy of the two groups was evaluated，and the changes in the Pittsburgh Sleep Quality Index（PSQI）score and the Kidney Disease Quality of Life Short Form （KDQOL-SF）score，as well as the scores of the Hamilton Depression Scale（HAMD）and the Hamilton Anxiety Scale（HAMA）， were observed in the patients of the two groups before and after treatment. The changes in hemoglobin（Hb），serum creatinine（Scr），and blood urea nitrogen（BUN）levels were compared before and after treatment between the two groups，and the safety of the two groups was evaluated. Results（1）After treatment， 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 March 2024，Vol. 41，No. 3 671 the PSQI and KDQOL-SF 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 and KDQOL-SF scores，and the difference was statistically significant（P＜0.05）.（2） After treatment， the HAMD and HAMA 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 HAMD and HAMA scores， and the differences were statistically significant（P＜0.05）.（3）After treatment， the Hb， Scr， BUN 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 Hb，Scr，BUN levels，and the differences were all statistically significant（P＜0.05）.（4）The total effective rate was 77.14%（27/35）in the observation group and 62.86%（22/35）in the control group. The efficacy of the observation group was superior to that of the control group，and the difference was statistically significant （P＜0.05）.（5）Comparison of the incidence of adverse reactions in the two groups of patients，the difference was not statistically significant（P＞0.05）. Conclusion FANG’s scalp acupuncture combined with timing auricular point pressing therapy in the treatment of insomnia patients with MHD can effectively improve the sleep quality of patients and alleviate anxiety and depression， so as to improve the quality of life of patients， with remarkable efficacy.

R246.9

西安市卫生健康委员会科研资助项目（编号：2021yb03）