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  

Research on Hyperarousal and Its Associated Nerve Electrophysiology Mechanism in Patients of Primary Insomnia Intervened with Acupuncture

作　　者：刘义[1] 冯慧[2] 莫亚莉[1] 毛洪京[1] 刘文娟[1] 尹岩[1] 徐莲莲[1] 余正和[1] 

机构地区：[1]杭州市第七人民医院心理科,浙江杭州310013 [2]杭州市红十字会医院,浙江杭州310000

出　　处：《中华中医药学刊》2017年第3期665-668,共4页Chinese Archives of Traditional Chinese Medicine

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)

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P<0.01)。针刺组治疗后PSQI评分较药物组降低(P<0.05)。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P<0.01),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P>0.05),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P<0.01)。两组治疗后SOL、NWAK、WASO、TST、SE比较差异无统计学意义(均P>0.05),针刺组治疗后较药物组N1、N2比例减少,N3、REM比例增多(均P<0.01)。两组治疗后MSLT的MSL较治疗前明显缩短(均P<0.01)。针刺组治疗后MSLT的MSL较药物组缩短(P<0.05)。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。Objective：To compare the difference in arousal state between the treatment of acupuncture and zolpidem and explore its associated nerve electrophysiology mechanism in patients of primary insomnia. Methods ： Sixty - one cases of primary insomnia were randomized into drug group （30 cases） and acupuncture group （31 cases）, continuously for 4 weeks. Compare the difference in Pittsburgh Sleep Quality Index （PSQI） scores. Indicators related sleep structurewas tested by polysomnography （PSG） and mean sleep latency （MSL） by multiple sleep latency test （MSLT） between two groups before and after treatment. Results： PSQI scores after treatment were obviously decreased compared with that be- fore treatment in each group（all P 〈0. 01 ）. PSQI scores in acupuncture group after treatment were decreased compared with those of the drug group（ P 〈 0. 05 ）. Sleep onset latency （ SOL）, number of awakenings （ NWAK）, wake after sleep onset （ WASO）, total sleep time （TST） and sleep efficiency （ SE ） after treatment were obviously increased compared with that before treatment in each group （ all P 〈 0. 01 ）. The percentage of non - rapid eye movement period 3 （ 5/3 ） after treatment was increased compared with that before treatment in drug group（ P 〈 0. 05 ）. N1, N2 and rapid eye movement period （REM） after treatment were not statistically significant compared with that before treatment in drug group （ all P 〉 0. 05） , but the percentages of N1, N2 after treatment were decreased. N3 and REM were increased compared with that before treatment in acupuncture group（ all P 〈 0. 01 ）. SOL, NWAK, WASO, TST and SE after treatment were not statistically significant in each group（ all P 〉 0. 05 ）. The percentages of N1 and N2 in acupuncture group after treat- merit were decreased. N3 and REM were increased compared with those of the drug group（ all P 〈 0. 01 ）. Mean sleep la- tency （MSL）of multiple sleep latency test （MSLT） after treat

关 键 词：针刺 原发性失眠症 过度觉醒 神经电生理学 

分 类 号：R256.23[医药卫生—中医内科学]