针药结合对肾移植术后失眠患者睡眠激素及质量的干预研究  

Intervention Study on the Effects of Combined Acupuncture and Medication on Sleep-Related Hormones and Sleep Quality in Postoperative Renal Transplant Patients with Insomnia

作　　者：李敏莹 陈秋源 顾世杰 崔瑞文 曹荣华 孟凡航 LI Minying;CHEN Qiuyuan;GU Shijie;CUI Ruiwen;CAO Ronghua;MENG Fanhang(School of Basic Medical Sciences of Guangzhou University of Chinese Medicine,Guangzhou 510006,Guangdong,Chian;The Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510120,Guangdong,China)

机构地区：[1]广州中医药大学基础医学院,广东广州510006 [2]广州中医药大学第二附属医院,广东广州510120

出　　处：《辽宁中医杂志》2025年第2期141-144,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(20231110)。

摘　　要：目的探讨揿针联合穴位贴敷对肾移植术后睡眠障碍患者的血清褪黑素(MT)、5-羟色胺(5-HT)水平的调节作用,及其对提升患者睡眠质量的疗效。方法选取2023年9月-2024年6月收治的肾移植术后睡眠障碍患者,按照收治的先后顺序,随机分为对照组和观察组,每组35例。对照组使用右佐匹克隆干预。睡前口服2 mg,隔天一次,共治疗2周;观察组采用揿针联合穴位贴敷治疗,取患者双侧内关、神门、照海,局部消毒后埋入揿针,穴位贴敷选择双侧涌泉、三阴交、肾俞穴。通过记录睡眠质量采用匹兹堡睡眠质量指数(Pittsburgh Sleep Quality Index,PSQI)、失眠严重程度指数(Insomnia Severity Index,ISI)、疗效评估、血清褪黑素、5-HT水平等指标评估治疗前和治疗后2周两组患者的睡眠质量。结果治疗前,两组患者的PSQI、ISI评分、血清MT和5-HT水平差异无统计学意义。治疗后,两组患者的PSQI、ISI评分均显著降低,MT和5-HT水平均显著升高(P<0.001),并且观察组PSQI、ISI评分显著低于对照组(P<0.001),MT和5-HT水平显著高于对照组(P<0.01);对照组治疗后治愈2例、好转21例、无效12例,观察组治疗后治愈9例、好转24例、无效2例。观察组总有效率(94.3%,33/35)显著高于对照组(65.7%,23/35),差异具有统计学意义(P<0.01)。结论揿针联合穴位贴敷能够有效调节肾移植术后睡眠障碍患者的血清褪黑素和五羟色胺水平,显著提升患者的睡眠质量,疗效优于右佐匹克隆干预。Objective To explore the effects of auricular acupuncture combined with acupoint application on serum melatonin and serotonin(5-HT)levels in patients with sleep disorders after kidney transplantation,and its efficacy in improving sleep quality.Methods Patients with sleep disorders after kidney transplantation who were admitted to the department from 2023.9 to 2024.6 were randomly divided into a control group and an observation group,with 35 cases in each group.The control group was treated with eszopiclone,administered orally at 2 mg before bedtime every other day for 2 weeks.The observation group was treated with auricular acupuncture combined with acupoint application,targeting Neiguan(PC6),Shenmen(HT7),and Zhaohai(KI6)on both sides.After local disinfection,the needles were embedded,and acupoint application was performed on Yongquan(KI1),Sanyinjiao(SP6),and Shenshu(BL23)on both sides.Sleep quality was assessed before and after 2 weeks of treatment using the Pittsburgh Sleep Quality Index(PSQI),Insomnia Severity Index(ISI),therapeutic efficacy evaluation,and serum MT and 5-HT levels.Results Before treatment,there were no significant differences in PSQI or ISI scores between the two groups.After treatment,PSQI and ISI scores significantly decreased in both groups(P<0.001),with the observation group showing significantly lower scores than the control group(P<0.001).There were no significant differences in serum MT and 5-HT levels between the two groups before treatment.After treatment,serum MT or 5-HT levels significantly increased in both groups(P<0.001),with the observation group showing significantly higher levels than the control group(P<0.01).In the control group,2 patients were cured,21 improved,and 12 were ineffective,while in the observation group,9 patients were cured,24 improved,and 2 were ineffective.The total effective rate in the observation group(94.3%,33/35)was significantly higher than that in the control group(65.7%,23/35),with a statistically significant difference(P<0.01).Conclusion Auricular ac

关 键 词：揿针 肾俞穴 三阴交 涌泉 肾移植术 睡眠障碍 

分 类 号：R245.31[医药卫生—针灸推拿学] R246.1[医药卫生—中医临床基础]