：【目的】观察针刺鬼穴结合龙胆泻肝汤治疗中风后肝火扰心型失眠的临床疗效。【方法】将60例中风后肝火扰心型失眠 患者随机分为观察组和对照组，每组各30例。对照组给予龙胆泻肝汤加减方口服治疗，观察组在对照组治疗的基础上，给 予针刺鬼穴治疗，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评分（PSQI）的 变化情况，以及阿森斯失眠量表（AIS）评分的情况。比较2组患者治疗前后抑郁自评量表（SDS）评分的变化情况。【结果】（1）治 疗后，2组患者PSQI评分明显改善（P＜0.05），且观察组在改善PSQI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AIS评分明显改善（P＜0.05），且观察组在改善AIS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组患者的SDS评分明显改善（P＜0.05），且观察组在改善SDS评分方面明显优于对照组，差异有 统计学意义（P＜0.05）。（4）观察组的总有效率为86.66%（26/30），对照组为76.66%（23/30）。观察组疗效优于对照组，差异有 统计学意义（P＜0.05）。【结论】针刺鬼穴结合龙胆泻肝汤治疗中风后肝火扰心型失眠，能明显改善患者的临床症状，疗效 显著。

Objective To observe the clinical efficacy of acupuncture on ghost points combined with Longdan Xiegan Decoction in the treatment of post-stroke insomnia of liver-fire disturbing the heart type. Methods Sixty patients with liver-fire disturbing the heart type of post-stroke insomnia were randomly divided into observation group and control group，with 30 patients in each group. The control group was given oral use of modified Longdan Xiegan Decoction， and the observation group was given acupuncture at the ghost points on the basis of the treatment of the control group. Both groups were treated for 4 weeks. 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 Athens Insomnia Scale（AIS）score were observed before and after treatment in the two groups. The changes of Self-Rating Depression Scale（SDS）scores were compared before and after treatment in the two groups of patients. Results（1）After treatment，the PSQI scores of the two groups of patients were significantly improved（P＜0.05）， and the observation group was significantly superior to the control group in improving the PSQI scores， with a statistically significant difference（P＜0.05）.（2）After treatment，the AIS 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 the AIS scores，and the difference was statistically significant（P＜0.05）.（3）After treatment，the SDS 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 SDS scores，and the difference was statistically significant （P＜0.05）.（4）The total effective rate of the observation group was 86.66%（26/30），while that of the control group was 76.66%（23/30）. The efficacy of the observation group was superior to that of the control group，and the difference was statistically significant（P＜0.05）. Conclusion Acupuncture at the ghost points combined with Longdan Xiegan Decoction for the treatment of liver-fire disturbing the heart type of post-stroke insomnia can significantly improve the clinical symptoms of the patients，and the therapeutic effect is remarkable.

R246.9

佛山市“十四五”中医重点专科资助项目（编号：佛卫函[2020]15号）