针刺与nCPAP治疗OSAHS患者疗效差异对比研究

A study on differences of curative effects of acupuncture and nCPAP for treatment of OSAHS

目的:比较针刺治疗与经鼻持续气道内正压通气(nCPAP)治疗对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者疗效的差异,分析针刺治疗对该病的疗效特点和优势。方法:将66例OSAHS患者按比例随机分为针刺组(44例,穴取廉泉、天容等)和nCPAP组(22例)进行治疗,并监测治疗前、中、后各项呼吸、血氧及睡眠指标。结果:与治疗前相比,针刺组在治疗进行中,各指标无明显差异(P>0.05),治疗结束后,对低通气指数(HI)、呼吸暂停低通气指数(AHI)、最长呼吸暂停时间、最长呼吸低通气时间、血氧饱和度低于90%的时间(SaO2<90%T)和微觉醒指数有明显改善作用,差异有显著性或非常显著性意义(P<0.05或P<0.01);而nCPAP组在治疗进行中,各指标均发生显著改善(P<0.01),治疗结束后,疗效未能维持,与治疗前差异无显著性意义(P>0.05)。2组比较,nCPAP组在治疗过程中疗效优于针刺组(P<0.05或P<0.01),治疗结束后疗效并无优势(P>0.05)。结论:nCPAP治疗对OSAHS患者的疗效发生在治疗过程中,针刺的疗效发生在治疗结束后,两者疗效体现方式的不同,可能与其作用机制的不同有关。

Objective To compare curative effects of acupuncture and nasal continuous positive airway pressure （nCPAP） on obstructive sleep apnea-hypopnea syndrome（OSAHS）, and to explore the characteristics and advantages of acupuncture in treatment of this disease. Methods Sixty-six cases of OSAHS were randomly divided into an acupuncture group （n=44） treated by acupuncture at Lianquan （CV 23） and Tianrong （SI 17） etc. , and a nCPAP group （n=22） treated by nCPAP. Indexes of respiration, blood oxygen and sleep were monitored before, during and after treatment. Results Compared with those before treatment, no significant differences of these indexes were found in the acupuncture group during treatment （P〉0.05）, but hypopnea index （HI）, apnea-hypopnea index （AHI）, the maximal apnea duration, the maximal hypopnea duration, sleep time spent when SaOz was below 90% （SaO2〈90%T） and the microarousal index improved significantly at the end of treatment （P〈0.05 or P〈0.01） ; while all the indexes improved significantly in the nCPAP group during treatment （P〈0.01）, but the therapeutic effect was not maintained at the end of treatment with no significant difference as compared with those before treatment. The therapeutic effect in the nCPAP group was better than that in the acupuncture group during the treatment （P〈0. 05 or P〈0. 01）, but no significant difference of the therapeutic effect was found between the two groups at the end of treatment （P〉0.05）. Conclusion The therapeutic effect of nCPAP on OSAHS produces during treatment and the therapeutic effect of acupuncture produces after treatment, indicating they possibly have different mechanisms.