“五音调神”法对卒中后心脾两虚型不寐及日间疲劳的影响  

Effect of“Five Notes Adjusting Spirit”Method on Post-Stroke Insomnia and Daytime Fatigue of Heart and Spleen Deficiency Type

作　　者：苏佳宁 吴雨静 张梦圆 丹禹钦 李丽[2] SU Jianing;WU Yujing;ZHANG Mengyuan;DAN Yuqin;LI Li(School of Rehabilitation Medicine,Shandong University of Traditional Chinese Medicine,Jinan 250014,China;Rehabilitation Hospital of the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250001,China)

机构地区：[1]山东中医药大学康复医学院,山东济南250014 [2]山东中医药大学第二附属医院康复医院,山东济南250001

出　　处：《中医药学报》2024年第12期108-113,共6页Acta Chinese Medicine and Pharmacology

基　　金：国家重点研发计划项目(2018YFC1706005)。

摘　　要：目的:观察“五音调神”法对卒中后心脾两虚型不寐患者的睡眠质量及日间疲劳的影响。方法:收集2022年8月—2023年8月在山东中医药大学第二附属医院康复医院就诊的68例卒中后心脾两虚型不寐患者,随机分为对照组和治疗组,每组34例。对照组脱落1例,剩余33例患者口服阿普唑仑,治疗组脱落2例,剩余32例患者聆听宫调、徵调五行音乐联合针刺督脉穴位(百会、神庭、印堂)。对比两组患者治疗4周的疗效。观察多导睡眠图(PSG)监测睡眠参数变化,采用匹兹堡睡眠质量指数量表(PSQI)、Flinders疲劳量表(FFS)、汉密尔顿焦虑量表(HAMA)、脑卒中专用生活质量量表(SS-QOL)、心脾两虚型不寐中医证候积分量表测评,并检测两组血清皮质醇(CORT)、5-羟色胺(5-HT)、去甲肾上腺素(NE)水平。结果:治疗后,两组患者的睡眠潜伏期和觉醒时间均降低,睡眠总时间和睡眠效率提高(P<0.01),且治疗组优于对照组(P<0.05,P<0.01)。经治疗,两组患者的PSQI、FFS、HAMA、中医证候评分及血清CORT、NE含量较治疗前显著下降,SS-QOL评分及血清5-HT含量较治疗前显著升高(P<0.05,P<0.01);治疗组患者的PSQI、FFS、HAMA、中医证候评分及血清CORT、5-HT水平优于对照组(P<0.05,P<0.01)。结论:“五音调神”法治疗卒中后心脾两虚型不寐患者疗效更佳,可以改善患者睡眠质量及日间疲劳状态,安全可靠,值得应用。Objective:To observe the effects of the“Five Notes Adjusting Spirit”therapy on sleep quality and daytime fatigue in patients with insomnia due to heart-spleen deficiency after stroke.Methods:Sixty-eight patients with insomnia due to heart-spleen deficiency after stroke who visited the Rehabilitation Hospital of the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine from August 2022 to August 2023 were selected.They were randomly divided into a control group and a treatment group,with 34 cases in each group.One patient dropped out in the control group,leaving 33 patients who received oral administration of zopiclone.In the treatment group,two patients dropped out,leaving 32 patients who listened to music harmonized with the Five Notes of Zhi tone and Gong tone and received acupuncture at the points of Governor Vessel,Baihui(GV20),Shenting(GV24),and Yintang(GV29).The efficacy of the two groups was compared after 4 weeks of treatment.Changes in sleep parameters were observed using polysomnography(PSG).Patients were evaluated through The Pittsburgh Sleep Quality Index(PSQI),Flinders Fatigue Scale(FFS),Hamilton Anxiety Scale(HAMA),Stroke-Specific Quality of Life Scale(SS-QOL),and Traditional Chinese Medicine Syndrome Score Scale for Heart-Spleen Deficiency Insomnia,and serum cortisol(CORT),serotonin(5-HT),and norepinephrine(NE)levels were measured.Results:After treatment,the sleep latency and wake time of patients in both groups decreased,while total sleep time and sleep efficiency increased(P<0.01),with the treatment group being superior to the control group(P<0.05,P<0.01).After treatment,the PSQI,FFS,HAMA,traditional Chinese medicine syndrome scores,and serum CORT and NE levels of patients in both groups significantly decreased compared to before treatment,while SS-QOL scores and serum 5-HT levels significantly increased(P<0.05,P<0.01).The PSQI,FFS,HAMA,traditional Chinese medicine syndrome scores,and serum CORT and 5-HT levels of patients in the treatment group were better than th

关 键 词：卒中 心脾两虚型 不寐 “五音调神”法 睡眠质量 日间疲劳 

分 类 号：R255.2[医药卫生—中医内科学] R256.23[医药卫生—中医学]