吴茱萸穴位贴敷联合耳穴压豆对卒中后失眠患者睡眠质量及血BDNF和NIHSS的影响

Effects of Fructus Evodia Acupoint Sticking and Auricular Points Plaster Therapy on Sleep Quality and Blood BDNF and NIHSS Score in Patients with Insomnia after Stroke

目的研究吴茱萸穴位贴敷联合耳穴压豆对卒中后失眠患者睡眠质量及血脑源性神经因子(BDNF)及美国国立卫生研究院卒中量表评分(NIHSS)的影响。方法将医院2020年1月—2020年5月间收治的60例脑卒中后失眠患者纳为研究对象,采用随机数字表法将其均分为A组(吴茱萸穴位敷贴+耳穴压豆,n=30)与B组(艾司唑仑,n=30),两组均连续治疗1个月,1个月后观察两组治疗效果。结果治疗后,A组患者阿森斯失眠量表(AIS)中除早醒外,其余各项及总得分均较其治疗前显著降低(P <0.05),B组除入睡时间、早醒及总睡眠质量三项外,其余各项及总得分均较治疗前显著下降(P <0.05),治疗后,两组早醒得分无显著性差异(P> 0.05),A组其余各项及总得分均显著低于B组(P <0.05);两组治疗后,NIHSS量表得分均较同组治疗前显著下降(P <0.05),功能综合评定量表(FCA)得分均较同组治疗前显著上升(P <0.05),且A组治疗后NIHSS量表得分显著低于B组(P <0.05),FCA得分显著高于B组(P <0.05);治疗后两组血清BDNF水平均较同组治疗前显著上升(P <0.05),且A组患者治疗后血清BDNF水平显著高于B组(P <0.05);两组治疗期间药物不良反应无显著性差异(P>0.05)。结论吴茱萸穴位敷贴联合耳穴压豆能在改善脑卒中后失眠患者失眠症状,提高其神经躯体功能中具有良好疗效,且药物不良反应少,安全性高,值得临床推广。

Objective To investigate the effect of fructus evodia acupoint sticking and auricular points plaster therapy on sleep quality and blood brain-derived neurotrophic factor( BDNF) and National Institutes of Health Stroke Scale Score( NIHSS) in patients with insomnia after stroke. Methods 60 patients with insomnia after stroke in our hospital from January 2020 to May 2020 were enrolled,and randomly divided into two groups,each with 30 cases. Group A received the fructus evodia acupoint sticking and auricular points plaster therapy,while Group B took Estazolam. After the continuous treatment of one year,the clinical efficacy was compared between the two groups. Results After treatment,the scores of Athens Insomnia Scale( AIS) and items in Group A were decreased except the early-morning waking( P < 0. 05),and the AIS scores and items in Group B were also decreased except the sleep onset,early-morning waking and sleep quality( P < 0. 05);The items and scores in Group A except early-morning waking were lower than in Group B after treatment( P < 0. 05),while the early-morning waking score had no difference between groups( P> 0. 05). NIHSS was decreased in both groups,and the functional comprehensive assessment( FCA) score was increased in both groups after treatment( P < 0. 05),and Group A had lower NIHSS score and higher FCA score than those of group B( P < 0. 05).The serum BDNF levels were increased in both groups after treatment,and were higher in Group A than in group B( P < 0. 05).There were no obvious adverse reactions in both groups during treatment( P > 0. 05). Conclusion Application of fructus evodia acupoint sticking and auricular points plaster therapy can effectively and safely ameliorate the clinical symptoms,and improve the neurosomatic function for patients with insomnia after stroke,with fewer adverse reaction,which is worthy of promotion.