三部推拿法对原发性失眠患者单胺类神经递质和睡眠质量的影响  

Effect of Three-part Massage on Monoamine Neurotransmitters and Sleep Quality in Patients with Primary Insomnia

作　　者：王娜[1] 周小元 WANG Na;ZHOU Xiaoyuan(The Third Affiliated Hospital to Henan University of Chinese Medicine,Zhengzhou Henan China 450008)

机构地区：[1]河南中医药大学第三附属医院,河南郑州450008

出　　处：《中医学报》2024年第3期665-670,共6页Acta Chinese Medicine

基　　金：河南省科技攻关项目(222102310214)。

摘　　要：目的:观察三部推拿法对原发性失眠(primary insomnia,PI)患者单胺类神经递质和睡眠质量的影响。方法:将72例PI患者随机分为治疗组(36例)和对照组(36例)。两组均给予耳迷走神经区穴位压豆疗法。治疗组给予三部推拿法治疗,连续治疗4周;对照组给予归脾丸口服治疗,连续治疗4周。观察两组患者治疗前后的匹兹堡睡眠质量指数量表(pittsburgh sleep quality index,PSQI)评分、失眠严重程度指数量表(insomnia severity index,ISI)评分、简易智能精神状态检查量表(mini-mental state examination,MMSE)评分、多导睡眠图参数(总睡眠时间、觉醒时间、睡眠潜伏期时间、睡眠效率)以及外周血单胺类神经递质γ-氨基丁酸(gamma-aminobutyric acid,GABA)、5-羟吲哚乙酸(5-hydroxyindole acetic acid,5-HIAA)和多巴胺(dopamine,DA)水平。结果:与治疗前比较,治疗组和对照组患者PSQI、ISI评分降低(P<0.05),MMSE评分升高(P<0.05),治疗组PSQI、ISI、MMSE评分改善情况优于对照组(P<0.05)。多导睡眠图参数提示,与治疗前比较,治疗组和对照组患者总睡眠时间、睡眠效率增加(P<0.05),睡眠潜伏期时间、觉醒时间降低(P<0.05)。治疗后,治疗组总睡眠时间、睡眠效率、睡眠潜伏期时间以及觉醒时间改善均优于对照组(P<0.05)。单胺类神经递质结果提示,与治疗前比较,治疗组和对照组GABA、5-HIAA、DA水平升高(P<0.05),治疗组GABA、5-HIAA、DA改善情况均优于对照组(P<0.05)。治疗组临床疗效优于对照组(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:三部推拿法治疗PI临床疗效显著,可通过调节单胺类神经递质释放,从而有效改善睡眠质量,增加睡眠时间,提升认知功能,且安全性良好。Objective:To observe the effect of three-part massage on monoamine neurotransmitters and sleep quality in patients with primary insomnia(PI).Methods:72 patients with PI were randomly divided into treatment group(36 cases)and control group(36 cases).Both groups of patients were given bean pressing therapy at auricular vagus nerve points.The treatment group was given three-part massage for 4 weeks.The control group was given Guipi Pill orally for 4 weeks.The Pittsburgh sleep quality index(PSQI)score,Insomnia Severity Index(ISI)score,mini-mental state examination(MMSE)score,polysomnography parameters(total sleep time,awakening time,sleep latency time,sleep efficiency)and the levels of monoamine neurotransmitters γ-gamma-aminobutyric acid,GABA),5-hydroxyindole acetic acid(5-HIAA)and dopamine(DA)in peripheral blood.Results:Compared with before treatment,the scores of PSQI and ISI in the treatment group and the control group significantly decreased(P<0.05),while the scores of MMSE significantly increased(P<0.05).The improvement of PSQI,ISI and MMSE in the treatment group was significantly better than that in the control group(P<0.05).The parameters of polysomnography showed that compared with before treatment,the total sleep time and sleep efficiency of patients in the treatment group and the control group significantly increased(P<0.05),while the sleep latency time and awakening time decreased(P<0.05).After treatment,the total sleep time,sleep efficiency,sleep latency time and awakening time in the treatment group were significantly better than those in the control group(P<0.05).The results of monoamine neurotransmitters showed that compared with before treatment,the levels of GABA,5-HIAA and DA in the treatment group and the control group significantly increased(P<0.05),and the degree of increase in the treatment group was significantly better than that in the control group(P<0.05).After treatment,the improvement of GABA,5-HIAA and DA in the treatment group was significantly better than that in the control group(P<0

关 键 词：原发性失眠 三部推拿法 耳迷走神经区穴位压豆疗法 睡眠质量 单胺类神经递质 

分 类 号：R256.23[医药卫生—中医内科学]