针刺对原发性失眠症患者过度觉醒干预作用及其相关神经电生理学机制研究

发布时间：2018-07-25 13:48

【摘要】：目的:比较针刺与唑吡坦干预原发性失眠症患者觉醒状态的差异,并探讨其相关神经电生理学机制。方法:将61例原发性失眠症患者随机分为药物组(30例)和针刺组(31例),连续治疗4周。比较两组治疗前后匹兹堡睡眠质量指数(Pittsburgh Sleep Quality Index,PSQI)评分、多导睡眠监测仪(polysomnography,PSG)监测睡眠结构相关指标及多次睡眠潜伏时间试验(multiple sleep latency test,MSLT)的平均睡眠潜伏时间(mean sleep latency,MSL)变化。结果:两组治疗后PSQI评分较本组治疗前明显降低(均P0.01)。针刺组治疗后PSQI评分较药物组降低(P0.05)。两组治疗后较本组治疗前睡眠潜伏期(sleep onset latency,SOL)缩短、觉醒次数(number of awake1nings,NWAK)、入睡后清醒时间(wake after sleep onset,WASO)减少,总睡眠时间(total sleep time,TST)增多、睡眠效率(sleep efficiency,SE)明显增高(均P0.01),药物组治疗后非快速眼动3期(non-rapid eye movement period 3,N3)较本组治疗前增多,N1、N2和快速眼动睡眠期(rapid eye movement period,REM)比例较本组治疗前比较无统计学意义(均P0.05),而针刺组治疗后较本组治疗前N1、N2比例减少,N3、REM比例增多(均P0.01)。两组治疗后SOL、NWAK、WASO、TST、SE比较差异无统计学意义(均P0.05),针刺组治疗后较药物组N1、N2比例减少,N3、REM比例增多(均P0.01)。两组治疗后MSLT的MSL较治疗前明显缩短(均P0.01)。针刺组治疗后MSLT的MSL较药物组缩短(P0.05)。结论:针刺较唑吡坦能够更有效地改善原发性失眠症患者的睡眠质量,并更有利于调节其过度觉醒状态。
[Abstract]:Aim: to compare the effects of acupuncture and zolpidem on the arousal state of patients with primary insomnia and to explore its neurophysiological mechanism. Methods: 61 patients with primary insomnia were randomly divided into drug group (30 cases) and acupuncture group (31 cases) for 4 weeks. The scores of Pittsburgh Sleep quality Index (Pittsburgh Sleep Quality), polysomnography monitor (PSG) and the mean sleep latency (mean sleep latencies) of the two groups before and after treatment were compared. Results: the PSQI score of the two groups after treatment was significantly lower than that before treatment (P0.01). The PSQI score in the acupuncture group was lower than that in the drug group (P0.05). The sleep latency (sleep onset latencies) of the two groups was shorter than that of the patients before treatment. The number of wakefulness was (number of awake1ningsnwak), the (wake after sleep onsette WASO) was decreased, and the total sleep time (total sleep time was increased. Sleep efficiency (SE) was significantly increased (P0.01). There was no significant difference in the proportion of non-rapid eye movement stage 3 (non-rapid eye movement period 3N 3) before treatment and (rapid eye movement periodontic sleep stage (P < 0.01) in the drug group compared with that before treatment. P 0.05), but the proportion of N _ 1 N _ 2 decreased after acupuncture treatment compared with that before treatment in this group (P < 0.05), and the REM ratio of N _ 3N _ 3 in acupuncture group was higher than that before treatment (all P 0.01). After treatment, there was no significant difference between the two groups (P0.05), but the proportion of N _ 1N _ 2 in the acupuncture group decreased than that in the drug group (P < 0.01), but the ratio of N _ 1N _ 2 in the acupuncture group was significantly lower than that in the drug group (P < 0.05), but the ratio of N _ 1N _ 2 in the acupuncture group was lower than that in the drug group. The MSL of MSLT in both groups was shorter than that before treatment (P 0.01). The MSL of MSLT in acupuncture group was shorter than that in drug group (P 0.05). Conclusion: acupuncture is more effective than zolpidem in improving sleep quality of patients with primary insomnia and regulating their overawakening.
【作者单位】：杭州市第七人民医院心理科;杭州市红十字会医院;
【基金】：浙江省中医药科技计划项目(2013ZB107,2014ZB090) 杭州市卫生科技计划重点项目(2015Z08)
【分类号】：R246.6

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