迷走神经节埋线结合脐针十二地支进针法治疗单纯性失眠症的疗效及对神经递质水平的影响  

Efficacy of Vagal Ganglion Catgut Embedding Combined with Twelve Earthly Branches Umbilical Needling in Treatment of Primary Insomnia and Its Effect on Neurotransmitter Levels

作　　者：黄思敏 赵炬禹 兰蕾 HUANG Simin;ZHAO Juyu;LAN Lei(Guangxi University of Chinese Medicine,Nanning 530001,China;International Zhuang Medical Hospital Affiliated to Guangxi University of Chinese Medicine,Nanning 530201,China)

机构地区：[1]广西中医药大学,广西南宁530001 [2]广西中医药大学附属国际壮医医院,广西南宁530201

出　　处：《针灸临床杂志》2024年第10期50-55,共6页Journal of Clinical Acupuncture and Moxibustion

基　　金：广西中医药重点学科壮医经筋推拿学,编号:GZXK-Z-20-61;桂派中医大师项目,编号:桂中医药科教发[2022]6号;广西中医药自筹经费科研项目,编号:GXZYA20220178;广西中医药大学教育教学改革与研究项目,编号:2019A037。

摘　　要：目的:观察迷走神经节埋线结合脐针十二地支进针法治疗单纯性失眠症患者的临床疗效及对血清中神经递质水平的影响。方法:选取2023年6月—2023年9月在广西国际壮医医院治疗的单纯性失眠症患者72例,随机分为治疗组36例,对照组36例与对照组以脐针十二地支进针法治疗,治疗组以迷走神经节埋线结合脐针十二地支进针法治疗,脐针治疗5次/周,共治疗4周,埋线1次/10 d,共埋3次。比较两组患者治疗前后的嗜睡症状[匹兹堡睡眠质量指数量表(PSQI)、爱普沃斯嗜睡量表(ESS)]、神经递质水平[多巴胺(DA)、谷氨酸(Glu)、去甲肾上腺素(NE)、γ-氨基丁酸(GABA)、5-羟色胺(5-HT)和乙酰胆碱(Ach)]及其临床疗效。结果:治疗后两组患者的PSQI评分及ESS评分均较治疗前下降,治疗组下降更为显著(P<0.05);治疗后,两组患者血清Glu、GABA及5-HT水平均较治疗前有所升高,治疗组升高更显著,差异有统计学意义(P<0.01);而血清中的Ach、NE及DA水平均较治疗前有所降低,治疗组下降更显著,差异有统计学意义(P<0.01);治疗组的临床总有效率为94.29%(33/35),明显高于对照组的85.30%(29/34),差异有统计学意义(P<0.05);两组患者治疗过程中均未出现不良反应,安全性好。结论:两组治疗方法均可有效缓解单纯性失眠症患者的临床证候,通过提高血清中的Glu、GABA及5-HT水平,降低血清中的Ach、NE及DA水平,提高其睡眠质量,其中以迷走神经节埋线结合脐针十二地支进针法组疗效更为突出,且具有良好安全性,值得临床应用及推广。Objective:To observe the clinical effect of vagal ganglion catgut embedding combined with Twelve Earthly Branches umbilical needling in treatment of primary insomnia and its effect on serum neurotransmitters levels.Methods:72 patients with primary insomnia were randomly divided into the treatment group(n=36)and the control group(n=36).The control group was treated with Twelve Earthly Branches umbilical needling;on which basis,the treatment group was also treated with vagus ganglion catgut embedding.The umbilical needling was five times a week for a total of 4 weeks,and the catgut embedding was once every 10 days for a total of 3 times.The sleepiness symptoms[Pittsburgh Sleep Quality Index(PSQI),Epworth Sleepiness Scale(ESS)],neurotransmitter levels[dopamine(DA),glutamate(Glu),norepinephrine(NE),γ-aminobutyric acid(GABA),5-hydroxytryptamine(5-HT),acetylcholine(Ach)],and clinical efficacy were compared between the two groups.Results:The scores of PSQI and ESS were decreased after the treatment compared with those before the treatment in the two groups,and the decreases were more significant in the treatment group(P<0.01).The serum levels of Glu,GABA and 5-HT were increased after the treatment compared with those before the treatment in the two groups,and the increases were more significant in the treatment group(P<0.05);the serum levels of Ach,NE and DA were decreased after the treatment compared with those before the treatment in the two groups,and the decreases were more significant in the treatment group(P<0.01).The total effective rate of the treatment group was 94.29%(33/35),which was significantly higher than 85.30%(29/34)of the control group(P<0.05).There were no adverse reactions in the two groups during the treatment with high safety.Conclusion:Both therapies can effectively alleviate the clinical syndromes of patients with primary insomnia by increasing the serum levels of Glu,GABA and 5-HT,reducing the serum levels of Ach,NE and DA,and improving sleep quality.The therapeutic effect of vagal ganglion cat

关 键 词：单纯性失眠症 迷走神经节 埋线 脐针 十二地支进针法 

分 类 号：R246.6[医药卫生—针灸推拿学]