局部电针结合咽腔与颏舌肌锻炼改善OSAHS患者夜间通气情况的临床观察

发布时间：2018-03-24 23:18

本文选题：局部电针　切入点：咽腔与颏舌肌锻炼　出处：《黑龙江中医药大学》2017年硕士论文

【摘要】：目的:观察局部电针结合咽腔与颏舌肌锻炼法改善阻塞性睡眠呼吸暂停低通气(Obstructive Sleep Apnea Hypopnea Syndrome,OS-AHS)患者夜间通气情况的临床疗效,为本病的治疗提供一个新的思路和方法。方法:30例符合标准的OSAHS患者采用随机数字表法,分成治疗组15例,对照组15例。治疗组采用局部电针结合咽腔与颏舌肌锻炼治疗,选穴为:廉泉、外金津玉液,外金津玉液连电,波形为断续波,频率为80Hz,脉冲宽度为0.5ms,断续比为1:1,并在每日针刺结束后进行咽腔与颏舌肌锻炼。对照组采用传统针刺治疗,选穴为:百会、水沟、足三里、合谷、三阴交、丰隆、列缺、尺泽、太渊,不连接电针。两组均每天治疗1次,时间为30min,1周为1个疗程,连续治疗4个疗程。分别在治疗前后选用多导睡眠监测(Polysomnography,PSG)中的呼吸暂停低通气指数(Apnea Hypopnea Index,AHI)、最低血氧饱和度(The Lowest Oxygen Saturation,LSaO_2)及爱泼沃斯嗜睡量表(Epworth sleepiness scale,ESS)评分进行疗效评价。治疗结束后采用SPSS17.0统计软件进行统计分析。结果:1.局部电针结合咽腔与颏舌肌锻炼组与传统针刺组患者经治疗后,AHI指数较治疗前明显降低,差异具有统计学意义(P0.01),且局部电针结合咽腔与颏舌肌锻炼组优于传统针刺组(P0.05)。2.局部电针结合咽腔与颏舌肌锻炼组与传统针刺组患者经治疗后,LSaO_2较治疗前明显升高,差异具有统计学意义(P0.01),且局部电针结合咽腔与颏舌肌锻炼组优于传统针刺组(P0.05)。3.局部电针结合咽腔与颏舌肌锻炼组与传统针刺组患者经治疗后,ESS评分较治疗前明显降低,差异具有统计学意义(P0.01),且局部电针结合咽腔与颏舌肌锻炼组优于传统针刺组(P0.05)。结论:1.局部电针结合咽腔与颏舌肌锻炼法可有效改善患者睡眠时的呼吸紊乱程度及低氧状态。2.局部电针结合咽腔与颏舌肌锻炼法可有效改善患者在日间的嗜睡状态。3.局部电针结合咽腔与颏舌肌锻炼法和传统针刺疗法对于OSAHS患者均有一定的临床疗效,且治疗组优于对照组。
[Abstract]:Objective: to observe the clinical effect of local electroacupuncture combined with pharyngeal cavity and genioglossus exercise on nocturnal ventilation in patients with obstructive Sleep Apnea Hypopnea Syndrome.OS-AHS. Methods 30 patients with OSAHS who met the standard were randomly divided into treatment group (n = 15) and control group (n = 15). The treatment group was treated with local electroacupuncture combined with pharyngeal cavity and genioglossus exercise. The selected acupoints were Lianquan, Waijin Jade, Oujin Jade, Waijinjinyu, the waveform was intermittent, the frequency was 80 Hz, the pulse width was 0.5 Ms, the intermittent ratio was 1: 1, and the pharyngeal cavity and genioglossus were exercised at the end of daily acupuncture. The control group was treated with traditional acupuncture. The selected acupoints were: Baihui, Shuigou, Zusanli, Hegu, Sanyinjiao, Fenglong, lack of column, ruler, Taiyuan, not connected with electroacupuncture. Both groups were treated once a day for 30 mins a week as a course of treatment. The apnea Hypopnea index (Apnea Hypopnea index), the Lowest Oxygen saturation (the Lowest Oxygen SaturationLSaOst2) and the Epworth sleepiness scale (ESS) were used to evaluate the efficacy before and after treatment for 4 consecutive courses of treatment. The apnea Hypopnea index and the Lowest Oxygen saturation of the apnea hypopnea index (Apnea Hypopnea index) and the Epworth sleepiness scaleESS (ESS) were used before and after treatment to evaluate the efficacy of the apnea hypopnea index (Apnea Hypopnea index) and the Lowest Oxygen saturation (LSAO _ 2). Results: 1. Local electroacupuncture combined with pharynx and genioglossus exercise group and traditional acupuncture group had lower AHI index after treatment. The difference was statistically significant, and the local electroacupuncture combined with pharyngeal cavity and genioglossus exercise group was better than that of the traditional acupuncture group (P 0.05). The LSaO2 level in the local electroacupuncture combined with genioglossus exercise group and the traditional acupuncture group was significantly higher than that before treatment. The difference was statistically significant (P 0.01), and the local electroacupuncture combined with pharyngeal cavity and genioglossus exercise group was better than that of the traditional acupuncture group (P 0.05). The ESS score of the patients in the local electroacupuncture combined with genioglossus exercise group and the traditional acupuncture group was significantly lower than that before treatment. The difference was statistically significant, and the combination of local electroacupuncture with pharyngeal cavity and genioglossus exercise group was better than that of traditional acupuncture group. Conclusion 1. Local electroacupuncture combined with pharyngeal cavity and genioglossus exercise can effectively improve the degree of respiratory disorder during sleep. Local electroacupuncture combined with pharyngeal cavity and genioglossus exercise can effectively improve the daytime somnolence of patients. Local electroacupuncture combined with pharynx and genioglossus exercise and traditional acupuncture therapy have certain clinical effects on OSAHS patients. The treatment group was superior to the control group.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.81

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