靳三针疗法治疗脑卒中后睡眠障碍的临床疗效研究

Therapeutic Effect of Jin's Three-needle Therapy for Post-stroke Sleep Disorder

【目的】观察靳三针疗法治疗脑卒中后睡眠障碍的临床疗效,并分析睡眠质量在神经功能康复过程中的影响。【方法】将99例脑卒中后睡眠障碍患者分为靳三针治疗组(治疗组)49例和催眠药物对照组(对照组)50例。2组患者均给予基础药物治疗和康复训练,治疗组同时给予靳三针治疗(采用四神针配合手智针治疗),对照组给予催眠药物治疗(睡前服用艾司唑仑片)。治疗前后对2组患者分别进行匹兹堡睡眠质量指数量表(PSQI)评分、阿森斯失眠量表(AIS)评分、功能综合评定量表(FCA)评分和神经功能缺损程度评分(NDS),评价睡眠改善情况及神经功能康复情况,疗程结束1个月再对患者进行随访观察。【结果】(1)治疗后,2组PSQI评分和AIS评分均显著改善,与治疗前比较,差异均有统计学意义(P<0.05),但治疗后2组比较差异均无统计学意义(P>0.05),表明2组在改善睡眠质量的近期疗效方面差异不明显。(2)治疗后,2组FCA和NDS评分均显著改善,与治疗前比较,差异均有统计学意义(P<0.05),但治疗后2组比较差异均无统计学意义(P>0.05),表明2组在改善神经功能的近期疗效方面差异不明显。(3)疗程结束后1个月随访,2组的PSQI评分和AIS评分比较,差异均有统计学意义(P<0.05),表明治疗组在改善睡眠质量的远期疗效方面优于对照组。(4)疗程结束后1个月随访,2组的FCA和NDS评分比较,差异均无统计学意义(P>0.05),表明2组在改善神经功能的远期疗效方面差异不明显。(5)PSQI评分变化与FCA评定结果变化之间呈正向直线相关(r=0.478,P<0.01)。【结论】靳三针治疗组对患者睡眠质量改善和神经功能恢复的近期疗效与催眠药物对照组相仿,对患者睡眠质量改善的远期疗效则优于对照组;脑卒中后睡眠障碍患者的睡眠质量对神经功能的康复有直接影响。

Objective To observe the therapeutic effect of Jin＇s three-needle therapy for post-stroke sleep disorder, and to analyze the effect of sleep quality on rehabilitation of neurological function. Methods Ninety- nine qualified patients with post-stroke sleep disorder were randomly divided into Jin＇s three-needle therapy group （N=49） and hypnotic agents control group （N=50） . Both groups received basic medicine treatment and rehabilitation training. Additionally, Jin＇s three-needle therapy group received Jin＇s three-needle therapy （Sishen needles combined with hand mental triple needles） , and hypnotic agents control group received estazolam tablets before sleep. Pittsburgh sleep quality index （PSQI） scoring, Athens insomnia scale （AIS） scoring, functional comprehensive assessment （FCA） scoring, neurological function deficit scale （NDS） scoring, sleep quality and neurological function rehabilitation of patients in both groups were evaluated before and after treatment. After one month, the patients in both groups were followed up. Results （1） PSQI and AIS scores of both groups were improved after treatment （P〈0.05 compared with those before treatment）, but the differences were insignificant between the two groups （P〉0.05） . It was indicated that the two groups had similar short-term effect on the improvement of sleep quality. （2） FCA and NDS scores of both groups were improved after treatment （P〈0.05 compared with those before treatment）, and the differences were insignificant between the two groups （P〉0.05） , indicating that the two groups had similar short-term effect on the improvement of neurological function. （3） During the follow-up, the differences of PSQI and AIS scores of both groups were significant （P〈0.05）, indicating that the long-term therapeutic effect on sleep quality of the treatment group was superior to that of the control group. （4） During the follow-up, FCA and NDS scores in both groups had no statistic difference （P〉0.05） , indicating that the long-term therapeutic effect on neurological function of the treatment group was similar to that of the control group. （5） There was linear correlation between the changes of PSQI and FCA scores of all patients （r = 0.478, P〈0.01 ） . Conclusion The short-term therapeutic effect on sleep quality and neurological function on sleep quality of Jin＇s three-needle therapy group is similar to that of hypnotic agents control group, but the long-term therapeutic effect of Jin＇s three-needle therapy group is better than that of the control group. And the sleep quality of post-stroke sleep disorder patients can affect the rehabilitation of neurological function directly.