耳穴贴压联合耳部铜砭刮痧对卒中后失眠患者睡眠质量的影响研究  

Effect of Auricular Point Sticking Combined with Auricular Copper Scraping on Sleep Quality of Post-stroke Insomnia Patients

作　　者：谭畅 何花[1] TAN Chang;HE Hua(Department of Cardiology,The Second Affiliated Hospital of Hunan University of Chinese Medicine,Hunan Hospital of Traditional Chinese Medicine,Changsha Hunan 410005)

机构地区：[1]湖南中医药大学第二附属医院/湖南省中医院心血管内科,湖南长沙410005

出　　处：《世界中西医结合杂志》2025年第3期580-585,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：湖南省中医药科研计划项目(C2022031)。

摘　　要：目的探讨耳穴贴压联合耳部铜砭刮痧对卒中后失眠患者睡眠质量的影响。方法选取2022年6月—2024年2月期间湖南中医药大学第二附属医院收治的卒中后失眠患者108例作为研究对象,依据简单随机数字表法分为对照组和研究组,每组各54例。对照组采取常规治疗,研究组在对照组基础上采取耳穴贴压联合耳部铜砭刮痧,均干预4周。观察比较两组患者治疗效果,治疗前后中医证候积分、睡眠质量(Pittsburgh sleep quality index,PSQI)、睡眠情况(觉醒次数、觉醒时间、睡眠效率、睡眠潜伏期)、生化指标[脑源性神经营养因子(Brain-derived neurotrophic factor,BDNF)、去甲肾上腺素(Norepinephrine,NE)、5-羟色胺(5-hydroxytryptamine,5-HT)]水平、生活质量综合评定量表(Comprehensive quality of life rating scale,GQOLI-74)评分。结果治疗后研究组临床总有效率94.44%(51/54)高于对照组81.48%(44/54),差异有统计学意义(P<0.05)。治疗后两组患者入寐困难或睡而易醒、醒后不寐、目赤太息、多梦健忘、神疲乏力、急躁易怒、头晕头痛分值均较治疗前降低,差异有统计学意义(P<0.05);且研究组中医证候积分低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者日间功能障碍、催眠药物用量、睡眠障碍、睡眠效率、睡眠时间、入睡时间、睡眠质量分值均较治疗前降低,差异有统计学意义(P<0.05);且研究组睡眠质量评分低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者觉醒次数、觉醒时间、睡眠潜伏期较治疗前减少,睡眠效率较治疗前增高,差异有统计学意义(P<0.05);且研究组觉醒次数、觉醒时间、睡眠潜伏期短于对照组,睡眠效率高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者BDNF、5-HT水平较治疗前升高,NE水平较治疗前降低,差异有统计学意义(P<0.05);且研究组BDNF、5-HT水平高于对照组,NE水平低于对照组,差异有统计Objective To investigate the effect of auricular point sticking combined with auricular copper scraping on the sleep quality of post-stroke insomnia patients.Methods A total of 108 patients with post-stroke insomnia admitted to the Second Affiliated Hospital of Hunan University of Chinese Medicine from June 2022 to February 2024 were selected as research objects and divided into a study group and a control group by simple random number table method,with 54 patients in each group.The control group received conventional treatment while the study group,except for the conventional treatment,additionally received auricular point sticking combined with auricular copper scraping.Both groups were treated for 4 weeks.The effects of treatment in both groups were observed and compared before and after treatment according to the following criteria:traditional Chinese medicine(TCM)syndrome score,sleep quality(Pittsburgh sleep quality index,PSQI),sleep conditions(numbers of awakening,duration of awakening,sleep efficiency,sleep latency),biochemical indexes[brain-derived neurotrophic factor(BDNF),norepinephrine(NE),5-hydroxytrypsin(5-HT)]levels,and the comprehensive quality of life rating scale(GQOLI-74).Results After treatment,the total effective rate of the study group(94.44%,51/54)is higher than that of the control group(81.48%,44/54)(P<0.05).Compared to the situation before treatment,both groups have lower scores of difficulty in falling asleep/easy to wake up from sleep,insomnia of early awakening,red eyes and sighing,dreaminess and forgetfulness,spiritlessness and fatigue,irritability,dizziness,and headache(P<0.05).Specifically,the study group has lower TCM syndrome scores than the control group(P<0.05).Besides,both groups have lower scores in daytime dysfunction,hypnotic drug dosage,sleep disorder,sleep efficiency,sleep time,time to fall asleep,and sleep quality(P<0.05)while the study group has lower scores in PSQI(P<0.05).Also,the two groups have reduced numbers of awakening,duration of awakening,and sleep latency,which

关 键 词：耳穴贴压 耳部铜砭刮痧 卒中后失眠 睡眠质量 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R256.23[医药卫生—临床医学]