浅针山根穴治疗原发性失眠的疗效观察及其对血清褪黑素的影响

Clinical Reserach in Primary Insomnia with the Treatment of Superficial Needling at Extra-point Shangen and Its Impact on Serum Melatonin

[目的]观察浅针山根穴治疗原发性失眠(PI)患者的临床疗效及其对血清褪黑素(MT)的影响。[方法]36例PI患者为治疗组,运用浅针手法刺激山根穴治疗,采用放射免疫法测定血清MT水平,观察其治疗前后的变化;同时于治疗前、后及治疗结束3个月后评定患者的匹兹堡睡眠质量指数(PSQI)及疗效评价,并对患者治疗前的血清MT与PSQI的相关性进行分析;36例健康人为健康组,不做任何治疗,仅检测血清MT水平以及PSQI评分。[结果]患者治疗后的PSQI总分低于治疗前(P<0.01),疗程结束3个月后PSQI总分较治疗后升高(P<0.01),但低于治疗前(P<0.01);患者治疗后的疗效高于疗程结束3个月后(P<0.01);患者治疗前的血清MT水平低于健康组(P<0.01),治疗后的血清MT水平高于治疗前(P<0.01),并且接近健康组(P>0.05);治疗前血清MT水平与PSQI总分、睡眠质量因子分值、睡眠效率因子分值、催眠药物因子分值、日间功能因子分值分别呈负相关关系(P<0.05或P<0.01)。[结论]浅针山根穴治疗PI疗效显著,其作用机制可能与MT水平调节有关。

[Objective] To observe the clinical curative effect in primary insomnia（PI） with the treatment of superficial needling at Ext-point Shangen and its influence on serum melatonin（MT）.[Method] 36 cases of PI patients were clad as treatment group, to use superficial needle at Extra-point Shangen to stimulate the acupuncture point, to use the ria method for determine the serum MT level, to observe the serum MT lever ＇s change before and after treatment, and to evaluate the patients＇ Pittsburgh sleep quality index（PSQI） and curative effect evaluation at the three priods of before and after the treatment and after three months;and 36 cases of normal healthy persons were clad as normal healtihy group, without any treatment, only to determine the serum MT level and evaluate PSQI.[Result] The patients＇ PSQI score after the treatment was lower than the patients＇ before treatment（P〈0.01）, the PSQI score after three months increased（P 0.01）, but was also lower than the PSQI score before treatment（P 0.01）.The patients＇ effective rate after the treatment was higher than the patients＇ after three months（P〈0.01）. The patients＇ serum MT level before treatment below the normal healthy group＇s（P〈0.01）; the patients＇ serum MT level after the treatment was higher than the patients＇ before treatment（P〈0.01）, and close to normal healthy group＇s（P〈0.05）.The serum MT level before treatment with the PSQI score, sleep quality factor score, sleep efficiency factor score and hypnotic drug factor score,daytime function factor score were negatively related respectively（P〈0.05 or P〈0.05）.[Conclusion] The clinical curative effect in PI with the treatment of superficial needling at Extra-point Shangen was distinct, and its mechanism may be related to MT level adjustment.