醒脑开窍针刺法对卒中后阻塞性睡眠呼吸暂停综合征患者口咽部形态及睡眠呼吸参数的影响  

Impact of Xing Nao Kai Qiao acupuncture on oropharyngeal morphology and sleep respiratory parameters in patients with post-stroke obstructive sleep apnea syndromes

作　　者：杨道海[1] 缪永娟 许莎莎 林小琪 解丹 蒋同伯 YANG Daohai;MIAO Yongjuan;XU Shasha;LIN Xiaoqi;XIE Dan;JIANG Tongbo(Huai’an Hospital of Traditional Chinese Medicine,Huai’an 223001,China;Lianshui County Second People’s Hospital,Huai’an 223400,China)

机构地区：[1]淮安市中医院,淮安223001 [2]涟水县第二人民医院,淮安223400

出　　处：《上海针灸杂志》2023年第6期565-569,共5页Shanghai Journal of Acupuncture and Moxibustion

基　　金：全国中医药创新骨干人才项目[国中医药人教函(2019)128号];江苏省中医药科技发展计划项目(YB201965)。

摘　　要：目的观察醒脑开窍针刺法对卒中后阻塞性睡眠呼吸暂停综合征(obstruccive sleep apnea syndromes,OSAS)患者口咽部肌肉形态、睡眠呼吸相关参数及认知功能的影响。方法选取60例卒中后OSAS患者,用随机数字表法分为两组(治疗组和对照组),每组30例。对照组予口舌咽肌训练、站床及侧卧位睡眠训练,治疗组在对照组各项康复训练基础上采用醒脑开窍针刺法治疗。观察两组治疗前后口咽部腭后距离、舌后距离和软腭长度的变化,比较两组治疗前后睡眠呼吸相关参数和简易精神状态评价量表(mini-mental state examination,MMSE)评分。观察两组治疗前后血常规、尿常规、大便常规和肝肾功能指标的变化,评价安全性。结果与治疗前比较,两组治疗后口咽部的腭后距离、舌后距离和软腭长度以及睡眠呼吸相关参数、MMSE评分均有所改善(P<0.05);且治疗组治疗后上述观察指标均优于对照组(P<0.05)。与治疗前比较,两组治疗后血常规、尿常规、大便常规和血肝肾功能指标均未见明显变化(P>0.05),且治疗过程中两组均无不良事件发生。结论在康复治疗基础上,醒脑开窍针刺法可进一步改善卒中后OSAS患者口咽部形态,改善睡眠中低氧血症,缓解大脑缺氧状态,提高患者认知功能。Objective To observe the impact of Xing Nao Kai Qiao acupuncture on oropharyngeal muscle morphology,sleep respiratory parameters and cognitive ability in patients with post-stroke obstructive sleep apnea syndromes(OSAS).Method Sixty patients with post-stroke OSAS were allocated,using a random number table,to two groups(a treatment group and a control group),with 30 cases in each group.The control group received oroglossopharyngeal muscle training,bed standing training and lateral position sleep training and the treatment group received Xing Nao Kai Qiao acupuncture in addition.Oropharyngeal retropalatal distance,retrolingual distance and soft palate length were measured in the two groups before and after treatment.Sleep respiratory parameters and the mini-mental state examination(MMSE)scores were compared between the two groups before and after treatment.The findings of blood,urine and stool routine examinations,and liver and kidney function indicators in blood were observed in the two groups before and after treatment.The safety was assessed.Result After treatment,oropharyngeal retropalatal distance,retrolingual distance and soft palate length,and sleep respiratory parameters and the MMSE score improved to some extent in the two groups compared with before(P<0.05)and were better in the examination group than in the control group(P<0.05).After treatment,the findings of blood,urine and stool routine examinations,and liver and kidney function indicators in blood did not change significantly in the two groups compared with before(P>0.05).No adverse events occurred in the two groups during treatment.Conclusion On the basis of rehabilitation training,Xing Nao Kai Qiao acupuncture can further ameliorate oropharyngeal morphology,reduce hypoxemia during sleep,relieve cerebral hypoxia and improve cognitive ability in the patients with post-stroke OSAS.

关 键 词：针刺疗法 康复训练 醒脑开窍 睡眠呼吸暂停综合征 口咽部 认知功能 

分 类 号：R246.6[医药卫生—针灸推拿学]