慢性疲劳综合征不同中医证型睡眠脑电特征比较  

Comparison of Sleep Electroencephalogram Characteristics Among Different Chinese Medical Syndrome Types in Chronic Fatigue Syndrome

作　　者：李俊锋 张振贤[1] 阎骅[2] 史佳宁[1] 蒋天君 张春雁[3] 王靖涵 曾雪萍[1] 陈敏[1] 葛文金 LI Jun-feng;ZHANG Zhen-xian;YAN Hua;SHI Jia-ning;JIANG Tian-jun;ZHANG Chun-yan;WANG Jing-han;ZENG Xue-ping;CHEN Min;GE Wen-jin(Department of Traditional Medicine,Yueyang Hospital of Integrated Traditional Chinese Medicine and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai,200437;Special Medical Care Center,Ruijin Hospital,Shanghai Jiaotong University School of Medicine,Shanghai,200025;Department of Specialized Clinic,Yueyang Hospital of Integrated Traditional Chinese Medicine and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai,200437)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院传统医学科,上海200437 [2]上海交通大学医学院附属瑞金医院特需医疗保健中心,上海200025 [3]上海中医药大学附属岳阳中西医结合医院特诊部,上海200437

出　　处：《中国中西医结合杂志》2025年第1期56-63,共8页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金资助项目(No.82274430);上海中医药大学附属岳阳中西医结合医院科研项目(No.2021yygm03);上海市中医药事业发展三年行动计划[No.ZY(2018-2020)-ZWB-1001]。

摘　　要：目的研究不同中医证型慢性疲劳综合征(CFS)患者的睡眠脑电特征。方法从135例CFS受试者中筛选121例患者进行分析,其中CFS气血两虚型40例,CFS肝郁脾虚型41例,CFS脾肾阳虚型40例。另选择健康志愿者20名(健康组)和具有疲劳倾向的慢性疲劳者20名(慢性疲劳组)。应用多导睡眠监测仪采集受试者睡眠参数及脑电信息,包括功率谱密度及多尺度熵,采用疲劳量表-14(FS-14)、匹兹堡睡眠质量指数(PSQI)及蒙特利尔认知评估量表(MoCA)分别评估受试者疲劳程度、睡眠质量以及认知功能,分析睡眠脑电与认知功能之间的相关性。结果与健康组比较,CFS三组FS-14积分、PSQI积分、觉醒次数升高(P<0.01),MoCA积分、睡眠效率降低(P<0.01);气血两虚组N3期β波功率、N1期和REM期熵值升高(P<0.01,P<0.05);肝郁脾虚组W期和N2期β波功率、REM期熵值升高(P<0.05);脾肾阳虚组N3期和REM期熵值降低(P<0.01)。与慢性疲劳组比较,CFS三组疲劳积分升高(P<0.01)、认知功能积分降低(P<0.01),气血两虚组N3期β波功率升高(P<0.05),肝郁脾虚组N2期β波功率升高(P<0.01),脾肾阳虚组W期β波功率、REM期熵值降低(P<0.01)。结论CFS患者脑区功能性改变,睡眠特征变化主要为睡眠效率降低,浅睡眠增加,深睡眠减少,三种证型脑电特征变化存在差异,气血两虚型、肝郁脾虚型主要以β波功率升高、熵值增加趋势为主,脾肾阳虚型表现为β波功率及熵值降低。Objective To investigate sleep electroencephalography characteristics of different patterns in patients with chronic fatigue syndrome(CFS).Methods Totally 121 CFS patients were screened from 135 subjects,including 40 cases of qi and blood deficiency pattern,41 cases of Gan depression and Pi deficiency pattern,40 cases of Pi-Shen yang deficiency pattern.In addition,20 healthy volunteers(healthy group)and 20 patients with fatigue tendencies(chronic fatigue group)were selected.The sleep parameters and EEG information,including power spectral density and multiscale entropy were collected from all subjects by polysomnography.The Fatigue Scale-14(FS-14),Pittsburgh Sleep Quality Score(PSQI)and Montreal Cognitive Assessment(MoCA)were used to assess fatigue,sleep quality and cognitive function,respectively.These scales were also used to analyze the correlation between sleep EEG and cognitive function.Results Compared with the healthy group,the FS-14 score,PSQI score,and number of awakenings elevated(P<0.01),while the MoCA score and sleep efficiency decreased(P<0.01)in all three CFS groups,theβ-wave power of stage N3,the entropy value of stage N1 and the REM stage in the group with qi and blood deficiency was elevated(P<0.01,P<0.05),theβ-wave power of stage W and stage N2,and the entropy value of REM stage in the group with Gan depression and Pi deficiency were elevated(P<0.05);entropy values of N3 and REM periods decreased in the Pi-Shen yang deficiency group(P<0.01).Compared with the chronic fatigue group,the fatigue score was elevated(P<0.01),and the cognitive function score reduced(P<0.01)in all three CFS groups;theβ-wave power in the N3 period of the qi and blood deficiency group elevated(P<0.05);theβ-wave power in the N2 period of the Gan depression and Pi deficiency group was elevated(P<0.01);and theβ-wave power and the entropy value in the REM period of the W period of the Pi-Shen yang deficiency group decreased(P<0.01).Conclusions Patients with CFS exhibit functional alterations in brain regions,with sleep ch

关 键 词：慢性疲劳综合征 认知功能 多导睡眠监测 脑电分析 功率谱密度 多尺度熵 中医证型 中西医结合 

分 类 号：R259[医药卫生—中西医结合]