浅针治疗原发性失眠的临床疗效及对脑内神经递质的影响

发布时间：2018-06-20 16:49

本文选题：原发性失眠 + 浅针　；参考：《福建中医药大学》2017年硕士论文

【摘要】：研究目的观察浅针治疗原发性失眠的临床疗效,分析其对脑内神经递质的影响,为浅针的临床应用提供理论依据。研究方法将60例原发性失眠患者随机分为试验组与对照组,每组30例。试验组采用浅针干预,每日一次,每次30分钟;对照组给予艾司唑仑1mg,每日一次,临睡前30分钟服用。共干预20天。干预前后采用匹兹堡睡眠质量指数量表(Pittsburgh sleep qu ality index,PSQI)和埃普沃思嗜睡量表(Epworth Sleepiness Scale,ESS)评估两组的睡眠质量及临床疗效,应用脑涨落图(Encephalofluctuograph,EFG)评定脑内神经递质的变化情况。研究结果1、试验组总有效率为78.5%,对照组为74.0%,两组疗效相当(P0.05)。2、与干预前比较,干预后两组的匹兹堡睡眠质量指数(PSQI)评分均明显低于干预前,差异有统计学意义(P0.05);干预后两组PSQI评分组间比较,试验组略高于对照组;干预结束时治疗组PSQI量表七个子项目治疗前后的差值分别与对照组比较,入睡时间和催眠药物两项的差值评分高于对照组,差异均有统计学意义(P0.05),睡眠障碍、睡眠质量、睡眠时间、睡眠效率及日间功能障碍五项的差值分别与对照组比较,分值相当,差异无统计学意义(P0.05);干预结束一个月后随访,两组的匹兹堡睡眠质量指数(PSQI)与治疗结束时比较,均略有提高,组间比较差异无统计学意义(P0.05)。3、与干预前比较,干预后两组的埃普沃思嗜睡量表(ESS)评分均低于干预前,差异均有统计学意义(P0.05);干预结束时两组(ESS)评分组间比较,试验组略高于对照组,差异无统计学意义(P0.05)。4、干预后两组患者脑内神经递质的相对功率与干预前比较,两组γ-氨基丁酸(γ-aminobutyric acid,GABA)、五羟色胺(5-hydroxytryptamine,5-HT)、乙酰胆碱(Acetylcholine,Ach)及多巴胺(Dopamine,DA)均高于干预前,其中对照组5-HT、Ach和试验组的GABA、Ach在干预前后有统计学意义(P0.05);干预后组间比较,试验组GABA、5-HT高于对照组,差异有统计学意义(P0.05);干预后两组的去甲肾上腺素(Norepinephrine,NE)、谷氨酸(Glutamate,Glu)均降低,对照组Glu、NE和试验组NE在干预前后差异有统计学意义(P0.05),干预后组间比较均无显著差异(P0.05)。结论1、浅针治疗原发性失眠症临床疗效较好,不逊于艾司唑仑。2、浅针刺激镇静穴、山根穴能够提高脑内GABA和5-HT的相对功率。
[Abstract]:Objective to observe the clinical effect of superficial acupuncture on primary insomnia and to analyze its effect on neurotransmitters in brain, and to provide theoretical basis for clinical application of shallow acupuncture. Methods 60 patients with primary insomnia were randomly divided into experimental group and control group with 30 cases in each group. The experimental group was treated with shallow needle once a day for 30 minutes, while the control group was given 1 mg of oxazolam once a day for 30 minutes before bedtime. The intervention lasted 20 days. The sleep quality and clinical efficacy of the two groups were evaluated by Pittsburgh sleep qu ality Index (Pittsburgh sleep qu ality) and Epworth Sleepiness scale (ESSs) before and after intervention, and the changes of neurotransmitters in the brain were assessed by cerebral fluctuation map. Results 1. The total effective rate was 78.5 in the trial group and 74.0 in the control group. The efficacy of the two groups was similar to that before intervention. Compared with the pre-intervention, the Pittsburgh Sleep quality Index (PSQI) scores of the two groups were significantly lower than those before the intervention. After intervention, the difference of PSQI score between the two groups was slightly higher than that of the control group, and the difference between the seven sub-items of PSQI scale before and after treatment in the treatment group was compared with that in the control group at the end of the intervention. The difference scores of sleep time and hypnotic drugs were higher than those of the control group (P 0.05). The difference values of sleep disorder, sleep quality, sleep time, sleep efficiency and daytime dysfunction were similar to those of the control group. The Pittsburgh Sleep quality Index (PSQI) of the two groups was slightly higher than that at the end of the treatment, and there was no significant difference between the two groups. After the intervention, the ESS scores of the two groups were lower than those before the intervention, and the differences were statistically significant (P 0.05), and at the end of the intervention, the scores of ESSs in the two groups were slightly higher than those in the control group. The relative power of neurotransmitters in the brain of the two groups after intervention was higher than that before intervention. The levels of 纬 -aminobutyric acid (GABA), serotonin 5-hydroxytrypine (5-HT), acetylcholine Acetylcholine (Acetylcholine) and dopamine dopamineDAA (DAA) were higher than those before intervention. The 5-HT Ach in the control group and the GABA Ach in the experimental group before and after intervention were significantly higher than those in the control group (P 0.05), and the levels of norepinephrinene-glutamate (Glutamate) in the two groups were significantly lower than those in the control group (P 0.05). There was significant difference between the control group and the test group before and after intervention (P 0.05), but there was no significant difference between the control group and the test group before and after intervention (P 0.05). Conclusion 1. Shallow acupuncture can improve the relative power of GABA and 5-HT in the brain of patients with primary insomnia, which is not inferior to that of eszolam. 2. Shallow acupuncture can stimulate sedation points and Shangen acupoint can increase the relative power of GABA and 5-HT in the brain.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.6

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