针刺督脉穴治疗失眠的疗效观察及对患者血清神经递质水平的影响  

Observations on the efficacy of acupuncture at points of Governor Vesesl for insomnia and its effect on serum neurotransmitter levels

作　　者：李虎成 高齐 李永宏 LI Hucheng;GAO Qi;LI Yonghong(Xinjiang Karamay People’s Hospital(Hospital of Traditional Chinese and Western Medicine),Karamay 834000,China)

机构地区：[1]新疆克拉玛依市人民医院(中西医结合医院),克拉玛依834000

出　　处：《上海针灸杂志》2023年第10期1030-1035,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：克拉玛依市创新人才工程项目(2018RC001)。

摘　　要：目的观察针刺督脉穴治疗慢性失眠的临床疗效及其对患者睡眠质量和血清神经递质水平的影响。方法将115例慢性失眠患者分为常规组(55例)和针刺组(60例)。常规组予口服艾司唑仑片治疗,针刺组在常规组治疗基础上另予针刺督脉腧穴为主的治疗。观察两组治疗前后中医证候积分、匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)、汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)和汉密尔顿抑郁量表(Hamilton depression scale,HAMD)评分的变化,观察两组夜间多导睡眠监测指标以及血清5-羟色胺(5-hydroxytryptamine,5-HT)、γ-氨基丁酸(γ-aminobutyric acid,GABA)和皮质醇(cortisol,CORT)水平的变化。比较两组临床疗效和不良反应发生情况。结果针刺组总有效率为93.3%,明显高于常规组的80.0%(P<0.05)。针刺组中医证候积分各项评分、PSQI评分、HAMA评分和HAMD评分明显低于常规组(P<0.05)。针刺组治疗后各项多导睡眠监测指标水平明显优于常规组(P<0.05)。针刺组治疗后血清5-HT和GABA水平高于常规组(P<0.05),CORT水平低于常规组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论在口服西药治疗基础上,针刺督脉腧穴为主治疗慢性失眠的临床疗效优于单纯口服西药治疗,可明显提高患者睡眠质量,且对患者抑郁和焦虑情绪有改善作用,其机制可能与调节血清神经递质水平有关。Objective To observe the clinical efficacy of acupuncture at points of Governor Vesesl for chronic insomnia and its effect on sleep quality and serum neurotransmitter levels in the patients.Method One hundred and fifteen patients with chronic insomnia were randomized to a conventional group(55 cases)and an acupuncture group(60 cases).The conventional group received oral administration of Estazolam tablets and the acupuncture group received acupuncture at points of Governor Vesesl in addition.The TCM syndrome score,the Pittsburgh sleep quality index(PSQI)score,the Hamilton anxiety scale(HAMA)score and the Hamilton depression scale(HAMD)score were recorded in the two groups before and after treatment.Changes in nocturnal polysomnography(PSG)parameters and serum 5-hydroxytryptamine(5-HT),gamma-aminobutyric acid(GABA)and cortisol(CORT)levels were observed in the two groups.The clinical therapeutic efficacy and the incidences of adverse reactions were compared between the two groups.Result The total efficacy rate was 93.3%in the acupuncture group,which was significantly higher than 80.0%in the conventional group(P<0.05).The TCM symptom item scores,and PSQI,HAMA and HAMD scores were significantly lower in the acupuncture group than in the conventional group(P<0.05).After treatment,nocturnal polysomnography parameters were significantly better in the acupuncture group than in the conventional group(P<0.05).After treatment,serum 5-HT and GABA levels were significantly higher(P<0.05)and CORT levels were significantly lower(P<0.05)in the acupuncture group than in the conventional group.There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Acupuncture at points of Governor Vesesl based on oral administration of Western medicine is clinically more effective than oral administration of Western medicine alone in treating chronic insomnia.It can improve sleep quality markedly and relieve depression and anxiety in the patients.Its mechanism may be relate

关 键 词：针刺疗法 针药并用 督脉 睡眠障碍 失眠 焦虑 抑郁 神经递质 

分 类 号：R246.1[医药卫生—针灸推拿学]