针刺对OSAHS患者呼吸紊乱指数、血氧饱和度及血清炎症因子的影响

Effect of acupuncture on respiratory disorder index,blood oxygen saturation and serum inflammatory factors in patients with obstructive sleeping apnea hypopnea syndrome

目的探讨针刺对阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)的治疗效果及对患者呼吸紊乱指数、血氧饱和度及血清炎症因子浓度的影响。方法将2016年1月—2018年12月丽水市中医院收治的172例OSAHS患者按随机数字法分为nCPAP组与针刺组,各86例,分别给予经鼻持续气道正压通气疗法和针刺疗法。比较2组治疗前后睡眠呼吸紊乱指数、血氧饱和度和血清细胞因子浓度及临床疗效。结果治疗后,2组睡眠呼吸紊乱指数各指标均改善(均P<0.05),且针刺组改善效果优于nCPAP组(均P<0.05);针刺组AHI水平[(14.35±1.21)次/h]低于nCPAP组[(16.49±1.08)次/h,t=12.240,P<0.001]。治疗后2组LSaO2、MSaO2升高(均P<0.05),且针刺组高于nCPAP组(均P<0.05),2组SaO2<90%时间、TRTSaO2<90%、TNF-α、CRP、IL-8、aICAM-1、NF-κB均降低(均P<0.05),且针刺组低于nCPAP组(均P<0.05)。治疗后针刺组有效率为91.86%,nCPAP组为94.19%,差异无统计学意义(χ^2=0.358,P=0.549)。治疗后针刺组各时点证候积分均低于nCPAP组(均P<0.05)。结论针刺治疗OSAHS可改善患者呼吸紊乱指数、血氧饱和度,降低血清细胞炎症因子浓度,治疗效果显著,且针刺治疗效果更持久。

Objective To investigate the effects of acupuncture on respiratory disturbance index,oxygen saturation and serum inflammatory factors in patients with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods A total of 172 OSAHS patients admitted to Lishui Hospital of Traditional Chinese Medicine from January 2016 to December 2018 were randomly divided into the nCPAP group and the acupuncture group,with 86 patients in each group receiving tran-snasal continuous positive airway pressure ventilation and acupuncture respectively.The two groups of patients before and after the treatment of sleep disordered breathing index,blood oxygen saturation and serum cytokine concentration and clinical efficacy.Results After treatment,the indexes of sleep and respiratory disorders in both groups improved(all P<0.05),and the improvement effect of acupuncture group was better than that of nCPAP group(all P<0.05).The AHI level in the acupuncture group(14.35±1.21)was lower than that in the nCPAP group(16.49±1.08,t=12.240,P<0.001).After treatment,LSaO2 and MSaO2 increased in the two groups(P<0.05),and the acupuncture group was higher than the nCPAP group(all P<0.05),and the SaO2<90%time,TRTSaO2<90%,TNF-α,CRP,IL-8,aICAM-1,and NF-κB decreased in the two groups(all P<0.05),and the acupuncture group was lower than the nCPAP group(all P<0.05).The effective rate was 91.86%in the acupuncture group and 94.19%in the nCPAP group(χ^2=0.358,P=0.549).After treatment,the syndrome score of acupuncture group at each time point was lower than that of nCPAP group(all P<0.05).Conclusion Acupuncture and nCPAP therapy in the treatment of OSAHS can improve the respiratory disturbance index and blood oxygen saturation of patients,and reduce the concentration of serum inflammatory cytokines.The therapeutic effect is significant,and the effect of acupuncture therapy is more lasting.