耳穴揿针联合体针对脑卒中后失眠患者血清细胞因子及神经递质表达的影响  

Effect of Sputum Acupuncture on Ear Acupuncture Point Combined with Body Acupuncture on the Expression of Serum Cytokines and Neurotransmitters in Patients with Insomnia After Stroke

作　　者：孙瑶[1] 李柏霖 胡楠 SUN Yao;LI Bolin;HU Nan(The Second Affiliated Hospital of Liaoning University of Traditional Chinese Medlicine,Shenyang 110034,Liaoning,China;General Hospital of Northern Theater Command of the Chinese People's Liberation Army,Shenyang 100191,Liaoning,China;Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,Liaoning,China)

机构地区：[1]辽宁中医药大学附属第二医院,辽宁沈阳110034 [2]北部战区总医院,辽宁沈阳100191 [3]辽宁中医药大学附属医院,辽宁沈阳110032

出　　处：《辽宁中医药大学学报》2020年第12期160-163,共4页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：国家自然科学基金(81702622);辽宁省教育厅一般项目(L201907)。

摘　　要：目的探讨耳穴揿针联合体针治疗脑卒中后失眠的临床疗效。方法选取于我院接受治疗的88例缺血性脑卒中后失眠患者,随机进行分组,包括对照组和治疗组,各44例。两组均给予西医常规治疗手段,治疗组在其基础上应用耳穴揿针联合体针,两组均治疗2个月。治疗结束后,计算两组临床总有效率;比较两组患者睡眠质量评分及血清细胞因子、神经递质表达变化情况。结果治疗组总有效率93.18%,对照组总有效率79.55%,治疗组显著优于对照组(P<0.05);两组治疗后匹茨堡睡眠质量指数(PSQI)、汉密顿抑郁量表(HAMD)评分均有明显下降(P<0.05),但治疗组下降幅度明显大于对照组(P<0.05);两组治疗后血清细胞因子指标白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)的水平均明显下降(P<0.05),且治疗组较对照组改善更显著(P<0.05);两组患者治疗后神经递质指标乙酰胆碱(ACh)、5-羟色胺(5-HT)、去甲肾上腺素(NE)活动信号均明显升高(P<0.05),且治疗组升高程度更为明显(P<0.05)。结论耳穴揿针联合体针具有调和气血、交通阴阳的作用,可以改善脑卒中后失眠患者临床症状和体征,缓解患者失眠情况,提高患者睡眠质量,调节血清细胞因子和神经递质表达失常,对于脑卒中后失眠有较好的的治疗效果,值得临床推广应用。Objective The purpose of this study was to investigate the effect of sputum acupuncture on ear acupuncture point combined with body acupuncture on the insomnia after stroke. Methods 88 patients with insomnia after ischemic stroke who received treatment in our hospital were randomly divided into control group and treatment group,with 44 cases in each group. Both groups were given conventional western medicine treatment methods,and the treatment group was administered with sputum acupuncture on ear acupuncture point combined with body acupuncture on the basis of the control group. Both groups were treated for 2 months. After the treatment,the clinical total effective rate of the two groups was calculated. The sleep quality score,changes of level of serum cytokine and neurotransmitter expression were compared between the two groups. Results The total effective rate of the treatment group was 93.18%,and that of the control group was 79.55%,which was significantly better than that of the control group(P<0.05). After treatment,the scores of Pittsburgh Sleep Quality Index(PSQI)and Hamilton Depression Scale(HAMD)in the two groups decreased significantly(P<0.05),but the decrease in the treatment group was significantly larger than that in the control group(P<0.05). After treatment,the levels of serum cytokines such as interleukin-1β(IL-1β),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in the two groups decreased significantly(P<0.05),and the improvement in the treatment group was more significant than that in the control group(P<0.05). After treatment,the activity signals of ACh,5-HT and NE in the two groups were significantly increased(P<0.05),and the increase degree in the treatment group was more obvious(P<0.05). Conclusion Sputum acupuncture on ear acupuncture point combined with body acupuncture has the functions of regulating Qi and blood and communicating Yin and Yang,can improve the clinical symptoms and signs of insomnia patients after stroke,relieve the insomnia situation,improve the sleep quality,and

关 键 词：耳穴揿针 体针 脑卒中 失眠 血清细胞因子 神经递质信号 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R256.23[医药卫生—临床医学]