艾灸百会联合银杏内酯注射液对卒中后睡眠障碍各中医证型患者的临床研究  

Combined application of moxibustion at Baihui point and ginkgolides injection in poststroke sleep disorder patients with syndrome differentiation

作　　者：李金花[1] 沈燕[2] 汤娟娟 LI Jinhua;SHEN Yan;TANG Juanjuan(Pharmacy Intravenous Admixture Services,Qidong People's Hospital,Qidong,Jiangsu 226200;Department of Traditional Chinese Medicine,Qidong People's Hospital,Qidong,Jiangsu 226200;Department of Nursing,Qidong People's Hospital,Qidong,Jiangsu 226200)

机构地区：[1]江苏省启东市人民医院静配中心,江苏启东226200 [2]江苏省启东市人民医院中医科,江苏启东226200 [3]江苏省启东市人民医院护理部,江苏启东226200

出　　处：《河北中医》2025年第2期300-303,308,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：江苏省中医药管理局2023年度省中医药科技发展计划项目(编号:MS2023117)。

摘　　要：目的观察艾灸百会联合银杏内酯注射液对卒中后睡眠障碍各中医证型患者的临床疗效。方法将108例卒中后睡眠障碍患者辨证分为3组,肝郁气滞型组36例,痰热扰心型组34例,心脾两虚型组38例,均予艾灸百会联合银杏内酯注射液治疗。治疗1周。比较各证型组临床疗效;比较各证型组治疗前后匹兹堡睡眠质量指数(PSQI)评分、Epworth嗜睡量表(ESS)评分、卒中专用生活质量量表(SS-QOL)评分变化;比较各证型组治疗前后睡眠情况;比较各证型组治疗前后大脑动脉血流速度变化。结果肝郁气滞型组总有效率72.22%(26/36),痰热扰心型组总有效率79.41%(27/34),心脾两虚型组总有效率92.11%(35/38),心脾两虚型组临床疗效优于肝郁气滞型组、痰热扰心型组(P<0.05)。治疗后各证型组PSQI评分、ESS评分均较本组治疗前降低(P<0.05),SS-QOL评分较本组治疗前升高(P<0.05);治疗后心脾两虚型组PSQI评分、ESS评分均低于肝郁气滞型组、痰热扰心型组(P<0.05),SS-QOL评分高于肝郁气滞型组、痰热扰心型组(P<0.05)。治疗后各证型组TST、SE均较本组治疗前升高(P<0.05),WASO、SL均较本组治疗前降低(P<0.05);治疗后心脾两虚型组TST、SE高于肝郁气滞型组、痰热扰心型组(P<0.05),WASO、SL低于肝郁气滞型组、痰热扰心型组(P<0.05)。治疗后各证型组大脑前动脉、中动脉、后动脉血流速度均较本组治疗前升高(P<0.05),治疗后心脾两虚型组大脑前动脉、中动脉、后动脉血流速度均高于肝郁气滞型组、痰热扰心型组(P<0.05)。结论艾灸百会联合银杏内酯注射液治疗卒中后睡眠障碍有较好疗效,可改善患者睡眠质量,提高生活质量,增加大脑动脉血流速度,其中心脾两虚型患者疗效优于肝郁气滞型、痰热扰心型。Objective To analyze the combined application of moxibustion at Baihui point and ginkgolides injection in poststroke sleep disorder patients with syndrome differentiation.Methods A total of 108 patients with post-stroke sleep disorders were enrolled.According to the syndrome differentiation,they were divided into liver-qi stagnation type group(n=36),phlegm-heat internal disturbance type group(n=34),and heart-spleen deficiency type group(n=38).All patients were treated with the combination of moxibustion at Baihui point and ginkgolide injection for one week.The clinical efficacy,scores of Pittsburgh Sleep Quality Index(PSQI),Epworth Sleepiness Scale(ESS)and Stroke-Specific Quality of Life Scale(SS-QOL),as well as sleep status and blood flow velocity(BFV)in cerebral artery were included as comparisons before and after treatment between groups.Results The curative effect of heart-spleen deficiency group was better than that of liver-qi stagnation group and phlegm-heat internal disturbance group(92.11%[35/38]vs 72.22%[26/36]vs 79.41%[27/34],P<0.05).Compared with before treatment,the SS-QOL,total sleep time(TST),and sleep efficiency(SE)were significantly increased in the three groups after treatment,while the PSQI,ESS,wake after sleep onset(WASO),and sleep latency(SL)were significantly decreased(all P<0.05);the BFV of the anterior,posterior,and middle cerebral arteries significantly increased after treatment(P<0.05).The heart-spleen deficiency group was better than liver-qi stagnation group and phlegm-heat internal disturbance group for the above indexes(all P<0.05).Conclusion The combination of moxibustion at Baihui point and ginkgolides injection has a better effect on post-stroke sleep disorders patients.It can improve the quality of sleep,improve the quality of life,BFV of accelerate cerebral artery,and the heart-spleen deficiency type is superior to liver-qi stagnation type and phlegm-heat internal disturbance type.

关 键 词：卒中 睡眠障碍 灸法 百会 银杏内酯注射液 

分 类 号：R255.2[医药卫生—中医内科学] R256.23[医药卫生—中医学] R245.8