通督调神针法治疗脑卒中后失眠的疗效及其对神经递质水平的影响

Efficacy of Tongdu Tiaoshen Acupuncture on Post-Stroke Insomnia and Its Effect on Neurotransmitter Level

目的:观察通督调神针法与西药治疗脑卒中后失眠患者的临床疗效及其对神经递质水平的影响,并探讨其作用机制。方法:选取2013年3月至2018年5月青海大学附属医院收治的脑卒中后失眠症患者100例作为研究对象,按随机对照原则,根据就诊日期的单双号随机分为对照组和观察组,每组50例,对照组给予口服艾司唑仑治疗,观察组在对照组基础上给予通督调神针法,比较2组的临床疗效、匹兹堡睡眠质量指数(PSQI)、改良爱丁堡-斯堪的那维亚评分(MESSS评分)、血清神经递质水平变化(5-HT、NE)及不良反应,数据采用SPSS 22.0统计软件进行统计分析。结果:治疗后,2组的PSQI、MESSS评分及血清NE水平降低(P<0.05),观察组低于对照组(P<0.05);2组的血清5-HT水平增加(P<0.05),观察组高于对照组(P<0.05);观察组治疗后中医证候疗效优于对照组(P<0.05);2组不良反应率差异无统计学意义(P>0.05)。结论:通督调神针法联合药物治疗卒中后失眠可以提高患者的睡眠质量和神经功能缺损的改善程度,其效果优于单纯艾司唑仑治疗,安全性较好,对机体神经递质水平的影响可能是其疗效途径之一。

Objective:To observe the clinical efficacy of Tongdu Tiaoshen Acupuncture and Western medicine in the treatment of post-stroke insomnia and its effect on neurotransmitter level,and to explore its mechanism.Methods:From March 2013 to May 2018,100 patients with post-stroke insomnia were randomly assigned to a control group and an observation group according to the visiting date,with 50 cases in each group.The control group was given oral estazolam treatment,while the observation group was given Tongdu Tiaoshen needle therapy on the basis of the control group.The clinical efficacy,Pittsburgh Sleep Quality Index(PSQI)and the modified Edinburgh-Scandinavia score(MESSS),serum neurotransmitter levels(5-HT,NE)and adverse reactions of the 2 groups were compared and analyzed by SPSS 22.0 statistical software.Results:After treatment,the PSQI,MESSS score and serum NE level of the 2 groups decreased(P<0.05),while that of the observation group was lower than that of the control group(P<0.05);the serum 5-HT level of the 2 groups increased(P<0.05),and that of the observation group was higher than that of the control group(P<0.05);the curative effect of TCM syndrome in the observation group was better than that in the control group(P<0.05);there was no significant difference in the adverse reaction rate between the 2 groups(P>0.05).Conclusion:Tongdu Tiaoshen Acupuncture combined with medication can improve the sleep quality and neurological deficits of patients with post-stroke insomnia.Its effect is better than that of Estazolam alone,and its safety is better.The effect on the level of neurotransmitters may be one of its therapeutic approaches.