针刺联合桂枝龙骨牡蛎汤治疗原发性不宁腿综合征的临床研究

夏冬　李跃兵　刘建芳

[摘要] 目的 探討针刺联合桂枝龙骨牡蛎汤治疗原发性不宁腿综合征疗效及不良反应。 方法 选取2015年6月～2016年12月在我院门诊治疗的符合纳入标准的患者40例，随机数字表法将其分为观察组（CO组）和加巴喷丁组（GA组），每组各20例。GA组：采用单纯的加巴喷丁治疗；CO组：针刺联合桂枝龙骨牡蛎汤治疗。观察两组患者治疗前、后RLS严重程度评分、匹兹堡睡眠质量指数（Pittsburgh sleep quality index，PSQI）积分情况、治疗中的药物不良反应情况。 结果 治疗后两组RLS严重程度评分、PSQI积分与治疗前比较均有显著差异（P<0.01）；治疗后RLS严重程度评分和PSQI积分组间比较，无显著性差异（P>0.05）；治疗中药物不良反应包括恶心呕吐、头晕、嗜睡和神经性水肿，CO组发生率少于GA组，均有显著差异性（P<0.01）。 结论 针刺联合桂枝龙骨牡蛎汤治疗原发性不宁腿综合征疗效佳、副作用少，值得推广。

[关键词] 针刺；桂枝龙骨牡蛎汤；联合治疗；加巴喷丁；原发性不宁腿综合征

[中图分类号] R256.3 [文献标识码] B [文章编号] 1673-9701（2018）12-0123-04

Clinical study on treatment of primary restless leg syndrome with acupuncture combined with Ramulus Cinnamomi Keel Oyster decoction

XIA Dong1 LI Yuebing1 LIU Jianfang2 CHEN Wei1 FU Wenming3

1.Department of Anesthesiology， the Second Affiliated Hospital of Zhejiang Traditional Chinese Medicine University， Hangzhou 310005， China； 2.Department of Neurology， the Second Affiliated Hospital of Zhejiang Traditional Chinese Medicine University， Hangzhou 310005， China； 3.Department of Traditional Chinese Medicine， the Second Affiliated Hospital of Zhejiang Traditional Chinese Medicine University， Hangzhou 310005， China

[Abstract] Objective To observe the curative effect and adverse reactions of acupuncture and Ramulus Cinnamomi Keel Oyster Decoction in treating restless legs syndrome. Methods Forty patients who met the inclusion criteria in our hospital from June 2015 to December 2016 were selected and randomly divided into observation group（CO group） and gabapentin group（GA group） by random number table， 20 cases in each group. Patients in GA group was treated with gabapentin alone； Patients in CO group took acupuncture combined with Ramulus Cinnamomi Keel Oyster Decoction. The scores of RLS severity score and Pittsburgh sleep quality index（PSQI） scores before and after treatment were observed in two groups of patients，and the adverse drug reactions in the treatment were observed. Results After treatment，there were significant differences in RLS severity scores and PSQI scores between the two groups（P<0.01）. After treatment， there was no significant difference between RLS severity scores and PSQI scores （P>0.05）. The adverse reactions during the treament included nausea and vomiting， dizziness， drowsiness and neurogenic edema， the incidence of CO group was less than that of GA group（P<0.01）， and there were significant differences. Conclusion Acupuncture plus Ramulus Cinnamomi Keel Oyster Decoction showed better effect， fewer side effects in restless leg syndrome.it is worth promoting.

[Key words] Acupuncture； Ramulus Cinnamomi Keel Oyster Decoction； Combination therapy； Gabapentin； Primary restless legs syndrome

不宁腿综合征（Restless legs syndromes，RLS）是一种与睡眠相关的感觉-运动性疾病[1，2]。患者常有下肢酸、麻、胀、疼、灼热、蚁行等不适感，并且严重影响睡眠，临床上虽多见，但误诊率较高，给患者带来极大的困惑和痛苦，甚至继发焦虑、抑郁等精神疾病。确诊的原发性RLS临床上常使用多巴胺能、多巴胺受体激动剂或抗惊厥药物治疗[3-5]，虽然有一定的疗效，但副作用大并且容易复发，患者常常自行停药，影响疗效，目前已有指南不主张长期使用左旋多巴[6]治疗RLS。本研究采用针刺患侧夹脊穴联合桂枝龙骨牡蛎汤治疗原发性RLS，取得了较好的临床疗效，并且副作用少，现报道如下。

1 资料与方法

1.1 一般资料

选取2015年6月～2016年12月在我院疼痛科、针灸科和中医科门诊治疗的符合国际不宁腿综合征研究组制定的诊断标准[7]的患者共40例，用随机数字表法将其分为观察组（CO组）和加巴喷丁组（GA组），各20例。……