摘要
目的:观察耳穴联合温针灸对顽固性失眠患者睡眠质量的影响。方法:70例顽固性失眠患者按照随机数字表法分为温针组和联合耳穴组各35例。所有患者均给予安神养血汤进行常规治疗,温针组给予温针干预,联合耳穴组在温针组治疗基础上给予耳穴干预。比较两组患者匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)量表评分、睡眠情况(觉醒次数、睡眠时间、睡眠潜伏期时间及睡眠期时间)、炎症因子[肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-1β(interleukin-1β,IL-1β)、IL-6]水平、单胺类神经递质[5-羟吲哚乙酸(5-hydroxyindoleacetic acid,5-HIAA)、5-羟色胺(5-hydroxytryptamine,5-HT)]水平、临床疗效、不良反应及随访结果。结果:治疗后,联合耳穴组PSQI量表评分为(6.83±0.38)分,温针组PSQI量表评分为(9.21±0.78)分,联合耳穴组低于温针组(P<0.05)。治疗后,两组患者总睡眠、睡眠期均高于治疗前,睡眠潜伏期、觉醒次数低于治疗前(P<0.05);联合耳穴组治疗后总睡眠、睡眠期均高于温针组,睡眠潜伏期、觉醒次数均低于温针组(P<0.05)。两组患者IL-1β、TNF-α、5-HT以及5-HIAA水平均高于治疗前,IL-6水平低于治疗前(P<0.05);联合耳穴组治疗后IL-1β、TNF-α、5-HT以及5-HIAA水平均高于同期温针组,IL-6低于同期温针组(P<0.05)。联合耳穴组有效率为100.00%,温针组有效率为88.57%,两组有效率比较,差异有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。随访发现,两组PSQI总分均呈下降趋势,且联合耳穴组PSQI总分在治疗后1个月、2个月、3个月均低于温针组(P<0.05)。结论:耳穴联合温针治疗顽固性失眠患者临床疗效显著,可有效改善患者睡眠质量,其改善机制可能与降低炎症反应、调节神经递质水平有关。
Objective:To observe the effect of auricular acupoint combined with warm acupuncture on sleep quality in patients with intractable insomnia.Methods:70 patients with intractable insomnia were divided into a warm needling group and a combined auricular point group with 35 cases in each group according to the random number table method.All patients received Anshen Yangxue Decoction for routine treatment,the warm needling group was given warm needling intervention,and the combined auricular point group was given auricular acupoint intervention on the basis of warm needling treatment.The Pittsburgh sleep quality index(PSQI)scale score,sleep status(number of awakenings,sleep time,sleep latency time and sleep period time),inflammatory factors[tumor necrosis factor-αwere compared between the two groups of patients,TNF-α,interleukin-1β(interleukin-1β,IL-1β),IL-6]levels,monoamine neurotransmitter[5-hydroxyindoleacetic acid(5-hydroxyindoleacetic acid,5-HIAA),5-hydroxytryptamine(5-HT)]levels,clinical efficacy,adverse reactions and follow-up results.Results:After treatment,the PSQI scale score of the combined auricular point group was(6.83±0.38)points,and the PSQI scale score of the warm acupuncture group was(9.21±0.78)points,and the combined auricular point group was lower than the warm acupuncture group(P<0.05).After treatment,the total sleep and sleep period in the two groups were higher than those before treatment,and the sleep latency and the number of awakenings were lower than those before treatment(P<0.05).The incubation period and the number of awakenings were lower than those in the warm acupuncture group(P<0.05).The levels of IL-1β,TNF-α,5-HT and 5-HIAA in the two groups were higher than those before treatment,and the levels of IL-6 were lower than those before treatment(P<0.05).The levels ofα,5-HT and 5-HIAA were higher than those in the warm acupuncture group at the same time,and IL-6 was lower than that in the warm acupuncture group at the same time(P<0.05).The effective rate of the combined auricular point group was 100.00%,and the effective rate of the warm acupuncture group was 88.57%,and the difference was statistically significant between the two groups(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Follow-up showed that the total PSQI scores of both groups showed a downward trend,and the total PSQI scores of the combined auricular point group were lower than those of the warm acupuncture group at 1 month,2 months,and 3 months after treatment(P<0.05).Conclusion:Auricular acupuncture combined with warm acupuncture has a significant clinical effect in the treatment of intractable insomnia,and can effectively improve the sleep quality of the patients.The improvement mechanism may be related to reducing the inflammatory response and regulating the level of neurotransmitters.
作者
黄银凤
高希言
HUANG Yinfeng;GAO Xiyan(The Third Affiliated Hospital to Henan University of Chinese Medicine,Zhengzhou Henan China 450008;School of Acupuncture and Massage,Henan University of Chinese Medicine,Zhengzhou Henan China 450046)
出处
《中医学报》
CAS
2022年第7期1541-1546,共6页
Acta Chinese Medicine
基金
河南省中医药科学研究专项项目(2019Y1021,2022ZY1097)
河南省高等学校重点科研项目(21B360005)。
关键词
顽固性失眠
耳穴
温针灸
安神养血汤
睡眠质量
炎症因子
神经递质
intractable insomnia
auricular acupoint
warm needling moxibustion
Anshen Yangxue Decoction
sleep quality
inflammatory factors
neurotransmitters
