多导睡眠监测仪监测不同养生功法干预心脾两虚型抑郁症睡眠障碍患者的临床研究

Clinical Research of Different Health Maintenance Practices on Patients with Depression,Sleep Disorders in Deficiency of Both Heart And Spleen in PSG

目的:研究不同养生功法干预心脾两虚型抑郁症睡眠障碍患者的多导睡眠图(PSG),根据其表现的差异性为PSG在失眠方面的临床应用提供理论依据。方法:将90例辽宁中医药大学附属医院、中国医科大学盛京医院及辽宁中医药大学睡眠门诊就诊的患者随机分为养心组、太极组和西药组,每组30例。3组在基础治疗辅助下,养心组采用养心治神功法干预,太极组采用太极拳干预,对照组不加养生功法干预,各组每日治疗1次,治疗40 d。进行汉密尔顿抑郁量表(HAMD)、匹兹堡睡眠质量指数量表(PSQI)分数评定,并记录实际入睡时间、实际睡眠时间。应用多功能睡眠监测系统,对各组患者于治疗前、治疗后进行睡眠监测,记录相关指标,打印PSG监测报告。所得数据采用SPSS 17.0专业统计软件进行统计分析。结果:养心组、太极组及西药组患者总有效率无显著差异。养心组、太极组及西药组HAMD、PSQI评分治疗前后各组总分差值比较,有统计学意义;太极组对HAMD评分的改善程度优于养心组与西药组(P<0.05),养心组对PSQI评分的改善程度优于太极组与西药组(P<0.05)。治疗前与治疗后相比,3组的觉醒次数都有下降、睡眠效率均有增加(P<0.05),差异有统计学意义,且养心组、太极组均优于西药组;与西药组比较,养心组与太极组睡眠总时间、睡眠潜伏期显著延长,SWS时间、REM时间显著增加,差异有统计意义(P<0.05);与西药组相比养心组及太极组与比例显著增加,治疗后差异有统计意义(P<0.05);与太极组相比,养心组睡眠潜伏期及REM潜伏期显著延长,差异有统计意义(P<0.05)。说明养心组的治疗效果优于太极组。结论:中医养心治神功法、太极拳及西药均对心脾两虚型抑郁症睡眠障碍患者在睡眠结构、睡眠进程及睡眠维持方面均有一定的改善作用,其中养心治神功法在改善心脾两虚型抑郁症睡眠障碍患者睡眠效率方面优于太极拳。

Objective： To study the PSG of different health maintenance practices on patients with depression,sleep disorders in deficiency of both heart and spleen. According to the differences of their performance,it provides the theoretical basis for PSG with sleep disorders in clinical application. Methods： The patients with sleep disorders from Chinese medicine hospital of liaoning province,Shengjing hospital of China medical university,and Liaoning university of traditional Chinese medicine clinic sleep（ n = 90） were randomly divided into the Yangxin group（ group 1）,Taijiquan group（ group2） and control group（ group 3,each n = 30）. On the base of routine treatment group 1 was interfered by Yangxinzhishen Qigong and medicine,group 2 by Taijiquan and medicine,and the control group was not interfered by YangxinzhishenQigong and Taijiquan but medicine,each treatment once a day,40 days treatment. To use the Hamilton depression scale（ HAMD） and the Pittsburgh Sleep Quality Index（ PSQI） was used to score and record the actual time to fall asleep and actual sleep time in all patients. To observe and record the relevant indicators on the patients in each group before and after treatment,and then print the report of PSG. The data obtained were analyzed statistically by SPSS statistical software.Result： Each group total effective rate had no statistical significance. The score of HAMD and PSQI in Taiji group and the score of PSQI in Yangxin group of difference comparison before and after treatment was statistically significant（ P〈0. 01）. Taiji group of HAMD scores were superior to Yangxin group and control group（ P〈0. 05）. Yangxin group PSQI scores were superior to control group（ P〈0. 05）. The awakening of three groups of number dropped,the sleep efficiency increased（ P〈0. 05） in the comparison before and after treatment which was statistically significant,and both Yangxin group and Taiji group were superior to control group. Comparing the control group,the total sleep time and sleep incubation period of Yangxin group and Taiji group was prolonged; SWS and RES time had a significant increase which was statistically significant（ P〈0. 05）. Comparing the control group,the proportion of Yangxin group and Taiji group had a significant increase which was statistically significant（ P〈0. 05）. Comparing the Yangxin group,the sleep incubation period and RES time were significantly prolonged which was statistically significant（ P〈0. 05）. It indicated that the therapy of Yangxin group was superior to Taiji group. Conclusion： Yangxinzhishen Qigong,Taijiquan and medicine have an improvement on structure of sleep,process of sleep and maintaining sleep in patients with depression,sleep disorders in deficiency of both heart and spleen; the improvement of sleep efficiency in patients with depression,sleep disorders in deficiency of both heart and spleen with Yangxinzhishen Qigong is superior to Taijiquan.