针刺配合药物对脑梗死后失眠症患者血清5-HT、BDNF及Orexin-A水平的影响  

Effect of Acupuncture plus Medication on the Serum Levels of 5-HT, BDNF and Orexin-A in Patients with Insomnia After Cerebral Infarction

作　　者：王焱平[1] 张钦昌[1] 王振焕[1] WANG Yan-ping;ZHANG Qin-chang;WANG Zhen-huan(First People’s Hospital of Nanyang,Nanyang 473000,China)

机构地区：[1]南阳市第一人民医院,南阳473000

出　　处：《上海针灸杂志》2018年第11期1254-1258,共5页Shanghai Journal of Acupuncture and Moxibustion

摘　　要：目的观察针刺配合药物对脑梗死后失眠症患者血清5-羟色胺(5-HT)、脑源性神经营养因子(BDNF)及食欲素-A(Orexin-A)水平的影响。方法将152例脑梗死后失眠症患者随机分为治疗组和对照组,每组76例,对照组给予右佐匹克隆片睡前口服治疗,治疗组在对照组基础上给予针刺治疗。观察两组治疗前后匹兹堡睡眠质量量表(PSQI)评分、美国国立卫生院神经功能缺损量表(NIHSS)评分、综合医院焦虑抑郁量表(HADS)评分、多导睡眠图(PSG)参数和血清5-HT、BDNF、Orexin-A水平的变化,并比较两组的临床疗效。结果治疗组临床疗效优于对照组(P<0.05),复发率低于对照组(P<0.05)。两组治疗前后PSQI、NIHSS、HADS评分比较,差异有统计学意义(P<0.05);治疗组治疗后PSQI、NIHSS及HADS评分均低于对照组(P<0.05)。两组治疗前后总睡眠时间、睡眠潜伏期、REM睡眠时间、觉醒时间、睡眠效率比较,差异有统计学意义(P<0.05);治疗组治疗后总睡眠时间、REM睡眠时间和睡眠效率高于对照组(P<0.05),睡眠潜伏期、觉醒时间短于对照组(P<0.05)。两组治疗前后血清5-HT、BDNF、Orexin-A比较,差异有统计学意义(P<0.05);治疗组治疗后血清5-HT、BDNF水平高于对照组(P<0.05),血清Orexin-A水平低于对照组(P<0.05)。结论针刺治疗配合药物可显著提高脑梗死后失眠症患者血清5-HT、BDNF水平,降低血清Orexin-A水平,改善睡眠质量和焦虑抑郁状态,促进神经功能恢复。Objective To observe the effect of acupuncture plus medication on the serum levels of 5-hydroxytryptamine(5-HT),brain-derived neurotrophic factor(BDNF)and orexin-A in patients with insomnia after cerebral infarction.Method A total of 152 patients with insomnia after cerebral infarction were randomized into a treatment group and a control group,with 76 cases in each group.The control group was given oral administration of eszopiclone tablets before sleep,while the treatment group was additionally given acupuncture.After the intervention,changes in the scores of Pittsburgh Sleep Quality Index(PSQI),National Institute of Health Stroke Scale(NIHSS)and Hospital Anxiety and Depression Scale(HADS),polysomnogram(PSG),and serum levels of 5-HT,BDNF and orexin-A were observed.The clinical efficacies were compared between the two groups.Result The treatment group had a better clinical efficacy than the control group(P<0.05)and its relapse rate was lower than that in the control group(P<0.05).The changes in the scores of PSQI,NIHSS and HADS were statistically significant after the treatment in both groups(P<0.05).The scores of PSQI,NIHSS and HADS were lower in the treatment group than in the control group(P<0.05).The total sleep duration,sleep latency,rapid eye movement(REM)sleep duration,wakening time and sleep efficiency changed significantly after the treatment in both groups(P<0.05);after the treatment,the total sleep duration,REM sleep duration and sleep efficiency were better in the treatment group than in the control group(P<0.05),and the sleep latency and awakening time were shorter in the treatment group than in the control group(P<0.05).The serum levels of 5-HT,BDNF,orexin-A changed significantly after the treatment in the two groups(P<0.05);the levels of 5-HT and BDNF were higher in the treatment group than in the control group after the treatment(P<0.05),and the level of orexin-A in the treatment group was lower than that in the control group(P<0.05).Conclusion Acupuncture plus medication can significantly enhance

关 键 词：针刺疗法 针药并用 中风并发症 失眠症 5-HT BDNF OREXIN-A 

分 类 号：R246.6[医药卫生—针灸推拿学]