耳穴排籽结合对压改善不寐症患者睡眠结构的机制研究

Auricular Point Seed Pressing on the Improvement of Sleep Structure in Patients with Insomnia and Its Mechanism

目的:探讨耳穴排籽结合对压对心脾两虚型不寐症患者睡眠结构的改善作用及其机制。方法:将80例心脾两虚型不寐症患者采用随机数字表法平均分为两组,观察组40例接受耳穴排籽结合对压治疗;对照组40例口服中药汤剂治疗。持续治疗4周后,应用多导睡眠监测系统检测患者睡眠结构的变化,评价疗效。结果:两组治疗后总睡眠时间、睡眠潜伏期、快速眼动(rapid eye movement,REM)睡眠潜伏期、睡眠效率(sleep efficiency,SE)、非快速眼动(non-rapid eye movement,NREM)睡眠期时间、REM期睡眠时间、觉醒次数、NREM睡眠各分期均有明显改善(P<0.05)。治疗后观察组总睡眠时间(407.5±61.8)min,长于对照组(371.5±35.2)min;观察组睡眠潜伏期(17.3±8.2)min,短于对照组(25.5±10.3)min;观察组睡眠效率(95.8%±12.1%),高于对照组(78.8%±6.5%);观察组觉醒次数(6.8±3.1)次,少于对照组(9.3±5.1)次;观察组NREM睡眠S1期(23.4±6.5)min,短于对照组(37.3±5.7)min;观察组NERM睡眠S3期(49.4±9.1)min,长于对照组(25.1±5.2)min。两组各项指标比较,差异均有统计学意义(P<0.05)。观察组临床疗效明显优于对照组,差异有统计学意义(P<0.05)。结论:耳穴排籽结合对压对心脾两虚型不寐症有较可靠的疗效,可更有效地延长总睡眠时间、缩短睡眠潜伏期、降低觉醒次数,这可能与其神经刺激作用有关。

Objective： Taking heart-spleen deficiency type insomnia patients as example,to discuss the improvement of sleep structure in patients with insomnia by auricular point seed pressing and its mechanism. Methods： 80 cases with insomnia were defined as heart-spleen deficiency type by TCM syndrome differentiation and typing,were included and divided into 2 groups by random number table. The observation group was treated with auricular point seed pressing,while the control group was treated with oral decoction of Chinese medicine. After 4 weeks of continuous treatment,the changes of sleep structure of the patients were detected by polysomnography. Results： Before treatment,the total sleep time,sleep latency,rapid eye movement（ REM） sleep latency,sleep efficiency（ SE）,non-rapid eye movement（ NREM） sleep time,REM sleep time,number of awakenings,time of each stage of NREM in both groups were close,the differences were not statistically significant（ P〉 0. 05）. After treatment,indexes above all improved significantly. After treatment,the total sleep time in the observation group was（ 407. 5 ± 61. 8） min,which was longer than（ 371. 5 ± 35. 2） min in the control group; sleep latency in the observation group was（ 17. 3 ± 8. 2） min,which was shorter than（ 25. 5 ± 10. 3） min in the control group; SE in the observation group was（ 95. 8% ± 12. 1%）,which was higher than（ 78. 8% ± 6. 5%） in the control group; number of awakenings in the observation group was（ 6. 8 ± 3. 1）,which was less than（ 9. 3 ± 5. 1） in the control group; S1 stage of NREM in the observation group was（ 23. 4 ± 6. 5） min,which was shorter than（ 37. 3 ± 5. 7） min in the control group; S3 stage of NREM in the observation group was（ 49. 4 ± 9. 1） min,which was longer than（ 25. 1 ± 5. 2） min in the control group. The differences above were statistically significant（ P 〈0. 05）. The clinical efficacy of the observation group was significantly better than that of the control group,the difference was statistically significant（ P〈 0. 05）.Conclusion： Auricular point seed pressing has more reliable effect on heart-spleen deficiency type insomnia,it can effectively prolong the total sleep time,shorten sleep latency,decrease the number of awakenings,which may be related to its nerve stimulation.