摘要
卒中后失眠(PSI)是脑卒中后的常见并发症之一,大约37%~59%的中风患者经历失眠,严重者与中风死亡率直接相关。然而PSI作用机制尚不明确,临床治疗尚无统一标准。近年来针刺治疗PSI的实验及临床研究取得了显著进展。团队研究发现百会、四神聪作为临床中常用的穴组治疗PSI具有良好的临床治疗效果,但其相关机制研究缺乏系统性总结。文章通过回顾近年来百会、四神聪治疗PSI的相关文献,将其作用机制及临床应用进行了分类整理与阐述,发现百会、四神聪可通过改善神经递质水平、抑制免疫因子的表达、减少神经元的凋亡、减少氧化应激、促进脑血流动力学的改变、促进脑源性营养因子表达以及调控脑功能区等来治疗PSI。尽管目前的相关作用机制研究已取得一定进展,但仍存在证据不足、质量不高的问题。基于现有的实验及临床研究,文章对研究不足进行了探讨,以期为未来的实验研究开拓思路及临床治疗提供依据。
Post-stroke insomnia(PSI)is one of the common complications following the onset of stroke,with approximately 37%-59%of stroke patients experiencing insomnia,the severity of which is directly associated with stroke mortality.However,the underlying mechanism of PSI remains unclear,and there is no unified standard for clinical treatment.In recent years,experimental and clinical studies on acupuncture treatment of PSI have achieved notable progress.Our team has found that Baihui(DU20)and Sishencong(EX-HN1),as commonly used acupuncture point combinations in clinical practice for treating PSI,exhibit good clinical therapeutic effects,but the research on their related mechanisms lacks a systematic summary.This paper has reviewed the relevant literature on the treatment of PSI with Baihui(DU20)and Sishencong(EX-HN1)in recent years,categorizes and elucidates their mechanisms of action and clinical applications.It is found that Baihui(DU20)and Sishencong(EX-HN1)can treat PSI by improving neurotransmitter levels,inhibiting the expression of immune factors,reducing neuronal apoptosis,decreasing oxidative stress,promoting alterations in cerebral hemodynamics,enhancing the expression of brain-derived neurotrophic factors,and regulating brain functional areas.Although certain progress has been made in the research on the relevant mechanisms,there are still issues of insufficient evidence and low quality.Based on the existing experimental and clinical studies,we discuss the research deficiencies so as to formulate ideas for upcoming experimental studies and lay the groundwork for clinical therapies.
作者
周紫琳
李嘉玉
李京谕
赵琦
杜宇征
ZHOU Zilin;LI Jiayu;LI Jingyu;ZHAO Qi;DU Yuzheng(First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300193,China;National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion,Tianjin 300193,China)
出处
《辽宁中医药大学学报》
2025年第7期216-220,共5页
Journal of Liaoning University of Traditional Chinese Medicine
基金
国家重点研发计划项目(2019YFC0840709)
国家中医临床研究基地业务建设科研专项课题(JDZΧ2015021)
天津市科技计划项目(18PTLCSY00060)。
关键词
百会
四神聪
卒中后失眠
作用机制
综述
Baihui(DU20)
Sishencong(EX-HNI)
post-stroke insomnia
mechanism of action
review
