酸枣仁汤联合子午流注针刺法对颈源性失眠患者椎动脉血流动力学、炎性因子、神经营养因子的影响  

Effect of Suanzaoren Tang Combined with Ziwu Liuzhu Acupuncture on Vertebral Artery Hemodynamics,Inflammatory Cytokines,and Neurotrophic Factors in Patients with Cervical Insomnia

作　　者：秦美影 冯亮 苏晶 林国华 QIN Meiying;FENG Liang;SU Jing;LIN Guohua(The First Clinical Medical School,Guangzhou University of Chinese Medicine,Guangzhou 510000,China;Clinical School of Acupuncture and Rehabilitation,Guangzhou University of Chinese Medicine,Guangzhou 510000,China;Guangdong Peiying Vocational and Technical School,Guangzhou 510000,China)

机构地区：[1]广州中医药大学第一临床医学院,广州510000 [2]广州中医药大学针灸康复临床医学院,广州510000 [3]广东省培英职业技术学校,广州510000

出　　处：《中国实验方剂学杂志》2022年第19期115-120,共6页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：广东省中医药局科研项目(20183014)。

摘　　要：目的:探讨酸枣仁汤联合子午流注针刺法对心脾两虚型颈源性失眠患者椎动脉血流动力学、炎性因子、神经营养因子的影响。方法:选择2018年1月至2021年6月广州中医药大学第一临床医学院收治的164例心脾两虚型颈源性失眠患者,随机数字表法将患者分为两组。对照组给予艾司唑仑片1~2 mg睡前口服,治疗4周,观察组给予酸枣仁汤联合子午流注针刺法治疗4周。观察治疗疗效及安全性,比较治疗前后匹兹堡睡眠质量指数量表(PSQI)评分、多导睡眠监测结果、椎动脉血流动力学参数、血清炎性因子和神经营养因子的差异。结果:164例颈源性失眠患者中4例脱落,余160例每组各80例。观察组治疗后总有效率为92.50%(74/80),高于对照组的80.00%(64/80)(χ2=5.270,P<0.05)。与本组治疗前比较,两组患者治疗后PSQI评分、睡眠潜伏期时间、觉醒时间、觉醒次数、血清白细胞介素-1β(IL-1β)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平降低(P<0.01),快波睡眠占比、椎动脉舒张期血流速度(Vd)、收缩期血流速度(Vs)、平均血流速度(MFV)、血清脑源性神经营养因子(BDNF)、胶质源性神经营养因子(GDNF)水平增高(P<0.05,P<0.01)。与对照组治疗后比较,观察组治疗后PSQI评分、睡眠潜伏期时间、觉醒时间、觉醒次数、血清IL-1β、CRP、TNF-α水平降低(P<0.01),快波睡眠占比、椎动脉Vd、Vs、MFV、血清BDNF、GDNF水平增高(P<0.05,P<0.01)。结论:酸枣仁汤联合子午流注针刺法治疗心脾两虚型颈源性失眠可更有效地改善椎动脉血液循环,降低炎症反应水平,增加神经营养因子水平,提高睡眠质量。Objective:To explore the effect of Suanzaoren Tang combined with Ziwu Liuzhu acupuncture on the vertebral artery hemodynamics,inflammatory cytokines,and neurotrophic factors in the patients with cervical insomnia with syndrome of deficiency of both heart and spleen.Method:The random number table method was employed to assign 164 patients with cervical insomnia with syndrome of deficiency of both heart and spleen treated in the First Clinical Medical School of Guangzhou University of Chinese Medicine from January 2018 to June 2021 into a control group and an observation group.The control group was orally administrated with 1-2 mg estazolam tablets before bed for 4 weeks,and the observation group with Suanzaoren Tang combined with Ziwu Liuzhu acupuncture for 4 weeks.The therapeutic efficacy and safety were observed.The Pittsburgh Sleep Quality Index(PSQI)score,polysomnography monitoring results,hemodynamics parameters of vertebral artery,and serum levels of inflammatory cytokines and neurotrophic factors were compared before and after treatment.Result:Except 4 dropouts,the remaining 160 patients were included in this study,with 80 patients in each group.The observation group had higher total effective rate than the control group[92.50%(74/80)vs.80.00%(64/80),χ2=5.270,P<0.05].Compared with that before treatment,the therapies in both groups decreased the PSQI score,sleep latency time,awakening time,awakening times,serum levels of interleukin-1β(IL-1β),C-reactive protein(CRP),and tumor necrosis factor-α(TNF-α)(P<0.01).Meanwhile,they increased the proportion of rapid-eye-movement(REM)sleep,the diastolic blood flow velocity(Vd),systolic blood flow velocity(Vs),and mean blood flow velocity(MFV)of vertebral artery,as well as the serum levels of brain-derived neurotrophic factor(BDNF)and glial cell-derived neurotrophic factor(GDNF)(P<0.05,P<0.01).Moreover,the observation group had lower PSQI score,sleep latency time,awakening time,awakening times,and serum IL-1β,CRP,and TNF-αlevels(P<0.01)and higher proportion of RE

关 键 词：颈椎病 失眠 针刺 酸枣仁汤 血流动力学 炎性因子 神经营养因子 

分 类 号：R22[医药卫生—中医基础理论] R242[医药卫生—中医学] R2-031R287