基于5-HT、DA、NE、5-HIAA及睡眠质量评估腹针联合调神解郁针法治疗围绝经期失眠患者的疗效  

Evaluation of the therapeutic eff ect of abdominal acupuncture combined with Tiaoshen Jieyu acupuncture in the treatment of patients with perimenopausal insomnia based on 5-HT,DA,NE,5-HIAA and sleep quality

作　　者：韩宇樱 吴小玲 李杏昌 冯吉源 周超敏 HAN Yuying;WU Xiaoling;LI Xingchang;FENG Jiyuan;ZHOU Chaomin(Department of Acupuncture and Moxibustion,Qinzhou Hospital of Traditional Chinese Medicine,Qinzhou 535009,China)

机构地区：[1]广西钦州市中医医院针灸科,广西钦州535009

出　　处：《吉林中医药》2023年第6期728-732,共5页Jilin Journal of Chinese Medicine

基　　金：广西壮族自治区中医药管理局自筹经费科研课题(GXZYN20220561)。

摘　　要：目的分析腹针联合调神解郁针法对围绝经期失眠患者血清5-羟色胺(5-HT)、多巴胺(DA)、去甲肾上腺素(NE)、5-羟吲哚乙酸(5-HIAA)水平及睡眠质量的改善效果。方法选取2021年3月-2022年3月广西钦州市中医医院收治的围绝经期失眠患者76例随机分为西药治疗组和联合针刺治疗组,各38例。西药治疗组采用艾司唑仑片、谷维素片进行治疗,联合针刺治疗组采用腹针联合调神解郁针法进行治疗,2组均治疗8周。统计2组治疗8周后的临床疗效,比较2组治疗前和治疗8周后中医证候积分、血清神经递质水平、多导睡眠图检测指标及症状情况、睡眠质量、心理状况。结果治疗8周后,联合针刺治疗组总有效率为92.11%,高于西药治疗组(73.68%,P<0.05)。治疗8周后,2组头晕目眩、神疲乏力、睡眠不安、腰膝酸软、急躁易怒、心烦心悸、潮热盗汗评分、血清DA、NE、5-HIAA水平、觉醒次数(AT)及Kupperman指数(MI)、匹兹堡睡眠质量指数(PSQI)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评分较治疗前降低,联合针刺治疗组低于西药治疗组(P<0.05)。治疗8周后,2组血清5-HT水平及快波睡眠(REM)、睡眠维持率(SE)较治疗前升高,联合针刺治疗组高于西药治疗组(P<0.05);2组睡眠潜伏期(SL)缩短,联合针刺治疗组短于西药治疗组(P<0.05);2组睡眠总时间(TST)延长,联合针刺治疗组长于西药治疗组(P<0.05)。结论腹针联合调神解郁针法对围绝经期失眠患者进行治疗,可有效改善患者中医证候、心理状况,调节神经递质水平,提高患者睡眠质量、生活质量,具有较好的治疗效果。Objective To analyze the improvement effects of abdominal acupuncture combined with Tiaoshen Jieyu acupuncture on the levels of serum 5-hydroxytryptamine(5-HT),dopamine(DA),norepinephrine(NE),5-hydroxyindoleacetic acid(5-HIAA)and the sleep quality in patients with perimenopausal insomnia.Methods A total of 76 patients with perimenopausal insomnia admitted to the Qinzhou Hospital of Traditional Chinese Medicine in Guangxi from March 2021 to March 2022 were selected as the research subjects and divided into a western medicine treatment group(38 cases)and a combination acupuncture treatment group(38 cases)by the random number table method.The western medicine treatment group was treated with estazolam tablets and oryzanol tablets,while the combination acupuncture treatment group was treated with abdominal acupuncture combined with Tiaoshen Jieyu acupuncture,both for 8 weeks.The clinical effi cacy of the two groups after 8 weeks of treatment was statistically analyzed,and the TCM syndrome scores,levels of serum neurotransmitters,polysomnography detection indexes and symptoms,sleep quality and psychological status were compared between the two groups before and after 8 weeks of treatment.Results After 8 weeks of treatment,the total eff ective rate of the combination acupuncture treatment group(92.11%)was higher than that of the western medicine treatment group(73.68%,P<0.05).After 8 weeks of treatment,the scores of dizziness,fatigue,sleep disturbance,waist and knee tenderness,impatience and irritability,upset palpitations,hot fl ashes and night sweats,the levels of serum DA,NE,5-HIAA,the arousal times(AT),the scores of the Kupperman Index(KMI),Pittsburgh Sleep Quality Index(PSQI),Hamilton Anxiety Scale(HAMA)and Hamilton Depression Scale(HAMD)in the two groups decreased,and those in the combination acupuncture treatment group were lower than those in the western medicine treatment group(P<0.05).After 8 weeks of treatment,the serum levels of 5-HT,rapid eye movement(REM)and sleep effi ciency(SE)of the two groups increase

关 键 词：围绝经期失眠 腹针 调神解郁针法 神经递质 睡眠质量 

分 类 号：R246[医药卫生—针灸推拿学]