Clinical observation on row needling at the Governor Vessel on the head for poststroke insomnia

头部督脉排刺法治疗脑卒中后失眠的临床观察

Objective:To observe the clinical efficacy of row needling at the Governor Vessel on the head for poststroke insomnia,analyze the changes of sleep structure,serum amino acid neurotransmitters,vascular endothelial cell function and cognitive function,in order to explore the mechanism of this therapy.Methods:A total of 41 patients with poststroke insomnia were included in an observation group and treated with row needing at the Governor Vessel on the head;33 patients with poststroke insomnia were included in a control group and given routine acupuncture treatment.The patients in both groups were treated consecutively for one month.The efficacy was observed and the changes of related indicators were compared.Results:After treatment,the efficacy of the observation group was better than that of the control group(P<0.05).The sleep latency in the observation group was shorter than that in the control group(P<0.05);the total sleep duration,deep sleep duration,light sleep duration and rapid eye movement sleep duration in the observation group were significantly longer than those in the control group(P<0.05);the total waking duration and the waking times over 5 min were significantly less than those in the control group(P<0.05).The serum glutamic acid,γ-aminobutyric acid,calcitonin gene-related peptide,brain-derived neurotrophic factor,nerve growth factor and nitric oxide levels were significantly higher than those in the control group(P<0.01).The tumor necrosis factor-α,interleukin-6,bradykinin,and endothelin-1 levels were lower than those in the control group(P<0.01).The Pittsburgh sleep quality index score in the observation group was lower than that in the control group(P<0.01),and the mini-mental state examination score was higher than that in the control group(P<0.05).Conclusion:Row needling at the Governor Vessel on the head can effectively improve the sleep structure,cognitive function,and sleep quality of patients with poststroke insomnia.The possible mechanisms are regulating serum amino acid neurotransmitters and improving the function of vascular endothelial cells.

目的:观察头部督脉排刺法治疗脑卒中后失眠的临床疗效,分析患者睡眠结构、血清氨基酸类神经递质、血管内皮细胞功能及认知功能的变化情况,以探究此疗法的作用机制.方法:接受头部督脉排刺法治疗的脑卒中后失眠患者41例纳入观察组;接受常规针刺治疗的脑卒中后失眠患者33例纳入对照组.两组患者均接受连续1个月治疗后观察疗效,比较相关指标的变化情况.结果:治疗后,观察组疗效优于对照组(P<0.05).观察组入睡潜伏期短于对照组(P<0.05),睡眠总时间、深睡期时间、浅睡期时间及快速动眼睡眠时间均明显长于对照组(P<0.05);觉醒总时间与超过5 min的觉醒次数均明显少于对照组(P<0.05).观察组血清谷氨酸、γ-氨基丁酸、降钙素基因相关肽、脑源性神经营养因子、神经生长因子和一氧化氮水平均高于对照组(P<0.01);肿瘤坏死因子-α、白细胞介素-6、缓激肽及内皮素1水平均低于对照组(P<0.01).观察组匹兹堡睡眠质量指数评分低于对照组(P<0.01),简易智力状态评价量表评分高于对照组(P<0.05).结论:头部督脉排刺法能够有效改善脑卒中后失眠患者的睡眠结构,改善患者的认知功能,提高患者的睡眠质量.调节血清氨基酸类神经递质,改善血管内皮细胞功能可能是其作用途径之一.