卒中后失眠的影响因素分析及三焦调气针法联合耳穴贴压的治疗效果  

Influencing factors of post-stroke insomnia and the therapeutic effect of Sanjiao regulating Qi acupuncture combined with auricular point sticking

作　　者：王冬梅 郑文杰[2] 唐榕 李陈渝[3] WANG Dongmei;ZHENG Wenjie;TANG Rong;LI Chenyu(Department of Encephalopathy,Jianyang Chinese Medicine Hospital,Jianyang,Sichuan 641400;Third Department of Acupuncture and Moxibustion,Jianyang Chinese Medicine Hospital,Jianyang,Sichuan 641400;Department of Neurology,Chongqing Traditional Chinese Medicine Hospital,Chongqing 400021)

机构地区：[1]四川省简阳市中医医院脑病科,四川简阳641400 [2]四川省简阳市中医医院针灸三科,四川简阳641400 [3]重庆市中医院神经内科,重庆400021

出　　处：《河北中医》2024年第12期2060-2064,共5页Hebei Journal of Traditional Chinese Medicine

摘　　要：目的探究卒中后失眠的影响因素及三焦调气针法联合耳穴贴压的治疗效果。方法前瞻性选取2022年1月至2022年12月简阳市中医医院脑病科收治的卒中患者120例为研究对象,按患者是否存在失眠分为失眠组(54例)与未失眠组(66例),采用二元Logistic回归分析卒中后失眠的影响因素。按随机数字表法将失眠组患者分为治疗组(27例)与对照组(27例),对照组予耳穴贴压治疗,治疗组患者在对照组基础上联合三焦调气针法,均治疗4周。比较2组临床疗效及治疗前、治疗2周、治疗4周匹兹堡睡眠质量指数量表(PSQI)评分、艾普沃斯嗜睡量表(ESS)评分和失眠严重程度指数量表(ISI)评分。结果二元Logistic回归分析显示,卒中部位(皮质下)、高脂血症、发作类型(全面性)、服药数量(2种及以上)、美国国立卫生研究院卒中量表(NIHSS)评分增高、改良Rankin量表(mRs)评分增高是卒中后失眠的危险因素(P<0.05)。2组治疗2周、4周PSQI评分、ISI评分、ESS评分与本组治疗前相比均降低(P<0.05),治疗4周时较治疗2周时降低(P<0.05),且治疗2周、4周治疗组PSQI评分、ISI评分、ESS评分均低于对照组同期(P<0.05)。治疗组总有效率100%(27/27),对照组总有效率85.19%(23/27),治疗组总有效率高于对照组(P<0.05)。结论卒中部位(皮质下)、高脂血症、发作类型(全面性)、服药数量(2种及以上)、NIHSS评分增高、mRs评分增高是卒中后失眠的危险因素。三焦调气针法联合耳穴贴压治疗卒中后失眠具有更好的疗效,可有效改善睡眠质量。Objective To explore the influencing factors of post-stroke insomnia and the therapeutic effect of Sanjiao regulating Qi acupuncture combined with auricular point sticking.Methods A prospective study was conducted on 120 stroke patients admitted to Department of Encephalopathy,Jianyang Chinese Medicine Hospital from January 2022 to December 2022.The patients were divided into insomnia group(54 cases)and non insomnia group(66 cases)based on whether they had insomnia.The influencing factors of post-stroke insomnia was analyzed using binary logistic regression.According to a random number table,the patients in the insomnia group were assigned into a study group(27 cases)and a control group(27 cases).The control group was treated with auricular point sticking,and the study group was additionally treated with Sanjiao regulating Qi acupuncture.Treated for 4 weeks,the clinical efficacy,Pittsburgh Sleep Quality Index(PSQI)score,Epworth Sleepiness Scale(ESS)score and Insomnia Severity Index(ISI)score before treatment,at weeks 2 and 4 of treatment were compared between the two groups.Results Binary logistic regression analysis showed that stroke site(subcortical),hyperlipidemia,seizure type(comprehensive),number of medications taken(2 or more),higher NIHSS score and mRs score were risk factors for post-stroke insomnia(P<0.05).The scores of PSQI,ISI and ESS at weeks 2 and 4 in the both groups decreased significantly compared to before treatment(P<0.05),and the scores at 4 weeks of treatment were lower than those at 2 weeks of treatment.(P<0.05),which were significantly lower in the study group than in the control group(P<0.05).The total effective rate of the study group was significantly higher than that of the control group(100%[27/27]vs 85.19%[23/27],P<0.05).Conclusion Stroke site(subcortical),hyperlipidemia,seizure type(comprehensive),number of medications taken(2 or more),higher NIHSS score and mRs score are risk factors for post-stroke insomnia.The combination of Sanjiao regulating Qi acupuncture and auricular point st

关 键 词：卒中 入睡和睡眠障碍 影响因素分析 针刺疗法 三焦 耳穴贴压疗法 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R256.230.5[医药卫生—临床医学] R245.31