针刺推拿联合疏肝安神汤对失眠患者5-HT、DA水平及睡眠质量的影响  

Effects of Acupuncture and Tuina Combined with Shugan Anshen Decoction on 5-HT,DA,and Spleep Quality in Insomnia Patients

作　　者：司井夫[1] 刘峰[1] 卜渊[1] 宋濂 马雪飞[1] 袁培 SI Jingfu;LIU Feng;BU Yuan;SONG Lian;MA Xuefei;YUAN Pei(Xuzhou Affiliated Hospital of Nanjing University of Chinese Medicine,Xuzhou 221000,China;Xuzhou Central Hospital,Xuzhou 221000,China)

机构地区：[1]南京中医药大学徐州附属医院,江苏徐州221000 [2]徐州市中心医院,江苏徐州221000

出　　处：《针灸临床杂志》2018年第12期21-25,共5页Journal of Clinical Acupuncture and Moxibustion

摘　　要：目的:探讨针刺、推拿联合疏肝安神汤对失眠患者5-羟色氨酸(5-HT)、多巴胺(DA)水平及睡眠质量的影响。方法:以2015年12月—2016年9月期间于我院就诊的128例失眠患者为研究对象,采用随机数字表法分为研究组和对照组,各64例。对照组仅给予常规治疗,研究组在此基础上应用针刺、推拿联合疏肝安神汤进行治疗,4周为1个疗程,两组均连续治疗2个疗程。统计两组治疗前后睡眠状况、主要中医症状总积分及不良情绪的变化;检测并比较治疗前后两组血清5-HT、DA、脑源性神经营养因子(BDNF)水平。结果:与治疗前比较,治疗后两组匹兹堡睡眠质量指数评定量表(PSQI)各项目评分及总分、主要中医症状总积分、焦虑自评量表(SAS)、抑郁自评量表(SDS)评分均显著下降(P <0. 01),且研究组均显著低于对照组(P <0. 05或P <0. 01)。与治疗前比较,治疗后两组血清5-HT、BDNF水平显著升高、DA水平显著下降(P <0. 01);且研究组5-HT、BDNF水平显著高于对照组、DA水平显著低于对照组(P <0. 05或P <0. 01)。结论:针刺、推拿联合疏肝安神汤治疗失眠可显著改善患者睡眠质量,并缓解其不良情绪,作用机制可能与升高5-HT、BDNF、降低DA水平等有关。Objective:To investigate the effect of acupuncture and tuina combined with Shugan Anshen Decoction on the levels of 5-hydroxytryptophane(5-HT),dopamine(DA)and sleep quality in insomnia patients.Methods:128 insomnia patients were randomly divided into the study group(n=64)and the control group(n=64).The control group was given routine treatment;on which basis,the study group was also treated with acupuncture and tuina combined with Shugan Anshen Decoction.The treatment was eight weeks.The changes of sleep quality,TCM symptom score and bad mood were statistically analyzed before and after the treatment in the two groups.The serum levels of 5-HT,DA,and brain-derived neurotrophic factor(BDNF)were detected and compared in the two groups before and after the treatment.Results:The item and total scores of Pittsburgh Sleep Quality Index(PSQI),TCM symptom score,as well as scores of SAS and SDS significantly decreased after the treatment in the two groups(P<0.01);of which the study group was significantly lower than the control group(P<0.05 or P<0.01).The serum levels of 5-HT and BDNF increased significantly,and the serum level of DA decreased significantly after the treatment in the two groups(P<0.01);the changes were more significant in the study group than those in the control group(P<0.05 or P<0.01).Conclusion:Acupuncture and tuina combined with Shugan Anshen Decoction can significantly improve the sleep quality of the insomnia patients and it can alleviate their bad mood,which action mechanism may be related to increasing the levels of 5-HT and BNDF,and decreasing the level of DA.

关 键 词：失眠 针灸推拿 疏肝安神汤 5-羟色氨酸 多巴胺 睡眠质量 

分 类 号：R246.6[医药卫生—针灸推拿学]