【目的】 观察通督调任针刺联合五音疗法治疗心脾两虚型失眠的临床疗效。【方法】 选取2023年1月至2024年6月安徽 中医药大学第二附属医院康复一科住院部及门诊部收治的60例明确诊断为心脾两虚型失眠的患者为研究对象。按随机数字 表将患者随机分为观察组和对照组，每组各30例。对照组给予甜梦胶囊治疗，观察组给予通督调任针刺联合五音疗法进行 治疗，2组均治疗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（PSQI）评分的变化情 况，以及中医证候积分的情况。比较2组患者治疗前后血清5-羟色胺（5-HT）和多巴胺（DA）含量的变化情况。评价2组的安 全性及不良反应的发生情况。【结果】（1）研究过程中，观察组无失访，对照组失访1例。最终观察组30例、对照组29例纳入 疗效统计。（2）观察组总有效率为 93.33%（28/30），对照组为 72.41%（21/29）。观察组疗效优于对照组，差异有统计学意义 （P＜0.05）。（3）治疗后，2组患者的PSQI评分、中医证候积分均明显改善（P＜0.05），且观察组在改善PSQI评分、中医证候积 分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组患者的血清 5-HT、DA 水平明显改善（P＜0.05）， 且观察组在改善血清5-HT、DA水平方面明显优于对照组，差异有统计学意义（P＜0.05）。【结论】 通督调任针刺联合五音疗 法治疗心脾两虚型失眠，能明显改善患者的临床症状，提高患者的睡眠质量，从而提高患者生活质量，疗效显著。

Objective To evaluate the clinical efficacy of Tongdu Tiaoren Acupuncture Method combined with fiveelement music therapy in treating insomnia of heart-spleen deficiency type. Methods Sixty patients diagnosed with insomnia of heart-spleen deficiency type were enrolled from the Rehabilitation Department and Outpatient Clinic of the Second Affiliated Hospital of Anhui University of Chinese Medicine between January 2023 and June 2024. Patients were randomly divided into an observation group and a control group using a random number table with 30 cases in each group. The control group received Tianmeng Capsules， while the observation group received Tongdu Tiaoren Acupuncture Method combined with five-element music therapy. Both groups were treated for 4 weeks. After one month of treatment， clinical efficacy was evaluated， and the Pittsburgh Sleep Quality Index（PSQI） scores，traditional Chinese medicine（TCM） syndrome scores were observed，and serum levels of 5-hydroxytryptamine（5-HT）and dopamine（DA） were compared before and after treatment. Safety and adverse events were also assessed. Results （1） During the study，no dropouts occurred in the observation group，while one patient was lost to follow-up in the control group. Ultimately，30 cases in the observation group and 29 cases in the control group were included in the efficacy analysis.（2） The total effective rate was 93.33%（28/30） in the observation group and 72.41%（21/29） in the control group， with statistically significant superiority in the observation group（P＜0.05）.（3） After treatment，both groups showed significant improvements in PSQI scores and TCM syndrome scores（P＜0.05），with the observation group demonstrating significantly greater improvements than the control group，the difference being statistically significant（P＜0.05）.（4） Serum 5-HT and DA levels were significantly improved in both groups（P＜0.05），with the observation group showing superior outcomes compared to the control group（P＜0.05）， the difference being statistically significant. Conclusion Tongdu Tiaoren Acupuncture Method combined with five-element music therapy significantly improves clinical symptoms， enhances sleep quality，and increases quality of life in patients with insomnia of heart-spleen deficiency type， demonstrating notable therapeutic efficacy.

R246.9

中央财政中医药事业传承与发展专项资助项目（编号：皖中医药发展秘[2023]23号）；安徽省中医药传承创新科研资助项目（编号： 2024CCCX254）