针灸对失眠症患者睡眠质量的影响及其机制研究  

Effect of acupuncture on sleeping pattern and qualities in chronic insomnia

作　　者：阮经文[1] 易玉珍[1] 严英硕[2] 胡跃华[1] 饶忠东[1] 温明[1] 曾小香[3] 廖新学[4] 

机构地区：[1]中山大学附属第一医院针灸科,广东广州510080 [2]中山大学附属第一医院呼吸内科,广东广州510080 [3]珠海市人民医院,广东珠海519000 [4]中山大学附属第一医院心内科,广东广州510080

出　　处：《中国病理生理杂志》2010年第8期1616-1620,共5页Chinese Journal of Pathophysiology

基　　金：广东省科技计划资助项目(No.2004B3300102);广东省中医药局基金资助项目(No.1040058)

摘　　要：目的:探讨针灸对慢性失眠症患者睡眠质量的影响及其改善睡眠质量的主要临床机制和针灸治疗的安全性。方法:采用治疗前后自身对照法,依据针灸处方原则选穴,主穴加接KWD-808Ⅰ型脉冲电疗仪;配穴结合补泄手法,进行治疗,每次治疗时间为30-40 min,10 d为1个疗程,治疗4个疗程后,利用匹兹保睡眠质量指数积分对睡眠质量进行评判;利用多导睡眠图检测患者睡眠结构的变化;利用自拟不良事件和不良反应表对治疗中、治疗后1个月的安全性进行评估。结果:针灸能明显提高失眠症患者的睡眠质量和白天社会功能,能戒减服用安眠药的次数和用量(P<0.05);针灸对断裂破碎的睡眠结构有一定的修复作用(P<0.05),同时,针灸相对或绝对地延长了慢波睡眠的时间和快动眼睡眠时间(P<0.05);没有发生类似安眠药的宿醉、成瘾性、日间警醒下降等不良反应(发生率0%),但1个月内的失眠反跳率达32.14%。结论:针灸能够一定程度地修复睡眠结构,重构睡眠的连续性,并能延长慢波睡眠时间和快动眼睡眠时间,这是针灸提高睡眠质量的主要临床机制;针灸治疗慢性失眠症是安全的、有效的,但其远期疗效还有待进一步探讨。AIM： To investigate the effects of acupuncture on the sleeping qualities in chronic insomnia patients,and to determine the safety of acupuncture therapy in clinical practice.METHODS： Fifty-six chronic insomnia patients were selected in the study according to the expert consensus of insomnia.Pre and post intervention self-evaluation method was used to evaluate the effects of acupunctural therapy.The selection of acupoints was based on the principles of traditional Chinese medicine.All main points were connected to KWD8081 electro-acupuncture device.All supplemen-tary points were stimulated with reinforcing or reducing needling.The treatment duration lasted for about 30 to 40 min,10 daily treatment as one complete course.Pittsburgh sleep quality index（PSQI） was used to determine the sleep quality after 4 courses of treatments.Polysomnogram was used to detect the sleeping patterns of the patients.The adverse effects and safety issues of acupuncture were monitored for one month after the last treatment.RESULTS： Acupunctural treatment significantly ameliorated the sleep quality of the patients with chronic insomnia and reduced the frequency of disturbed sleeps（P0.05）.The activities of their daily life were also improved.Moreover,acupuncture also comparatively prolonged the duration of slow wave sleep（SWS）,as well as the duration of rapid eye movement sleep（REM）.The usage of sleep medications was significantly reduced in both quantity and frequency（P0.05） after acupuncture.The side effects of sleeping medications such as hangover,addiction and drowsiness（incident rate = 0%） were also significantly decreased.However,the rebound rate of insomnia was 32.14% within a month post acupunctural treatment.CONCLUSION： Acupuncture improves the sleeping pattern and the quality of daily life significantly,prolongs the durations of SWS and REM sleeping,and reduces the use of medications.Acupunctural treatment for chronic insomnia is safe and effective.However,long term efficacy of acupuncture needs to

关 键 词：针刺 慢性失眠症 睡眠质量 睡眠结构 

分 类 号：R245[医药卫生—针灸推拿学]