血府逐瘀汤加减配合喉三针对缺血性卒中合并睡眠呼吸暂停低通气综合征患者呼吸紊乱及血氧调节的影响

Xuefu Zhuyu Decoction plus Laryngeal Three-Needling for Ischemic Stroke Combined with Sleep Apnea Respiratory Disorders and Blood Oxygen Regulation in Patients with Hypoventilation Syndrome

目的观察血府逐瘀汤加减配合喉三针对缺血性卒中合并睡眠呼吸暂停综合征患者呼吸紊乱症状及血氧饱和度的影响。方法将72例缺血性脑卒中合并睡眠呼吸暂停综合征患者,随机分为试验组和对照组各36例。两组患者日间均以石学敏院士"醒脑开窍"针刺法及西医对症处理为常规治疗,试验组采用血府逐瘀汤加减配合喉三针[廉泉、旁廉泉(双)],对照组仅采用常规治疗。试验组早晚餐后半小时各服用中药汤剂1袋,同时于夜间8时进行针刺,1次/d,共治疗14 d。两组患者分别于治疗前、治疗后使用睡眠呼吸初筛仪检测呼吸紊乱指数(AHI)、最长呼吸暂停时间(s)、最低血氧饱和度Sa O2、Sa O2<90%的时间占总睡眠时间的百分比(Sa O2<90%T)及ESS嗜睡量表评分的变化。结果治疗后两组患者AHI、最长呼吸暂停时间、最低Sa O2、Sa O2<90%T、日间困倦(ESS)量表评分与治疗前比较差异均有统计学意义(P <0.05);治疗后,试验组患者上述症状改善情况与对照组比较优于对照组,且差异有统计学意义(P <0.05)。治疗期间两组患者血压、心率、体温、呼吸等生命体征均平稳,未出现异常情况。结论血府逐瘀汤加减配合喉三针可有效降低缺血性卒中合并睡眠呼吸暂停综合征患者呼吸紊乱指数,提高夜间睡眠时的最低血氧饱和度,缩短Sa O2<90%T的时长,改善睡眠时的低氧状态,改善嗜睡,提高日间生活质量。

Objective To observe the effects of Xuefu Zhuyu Decoction plus laryngeal three-needling on the symptoms of respiratory disturbance and blood oxygen saturation in patients with ischemic stroke and sleep apnea syndrome. Methods Seventy-two patients with ischemic stroke combined with sleep apnea syndrome were randomly divided into experimental group and control group with 36 cases each. During the day,the two groups were treated with Academician SHI Xuemin’s"Xingnao Kaiqiao"acupuncture method and Western medicine symptomatic treatment as routine treatment. The experimental group used Xuefu Zhuyu Decoction plus laryngeal three-needling[Lianquan,Pinglianquan( bilateral) ]. The control group only used conventional treatment. In the treatment group,one bag of Chinese medicine decoction was taken half an hour after breakfast and dinner,and acupuncture was performed at 8 o’clock at night,once a day,for a total of 14 days of treatment. We tested two groups’ respiratory disorder index( AHI),longest apnea time( s),minimum blood oxygen saturation Sa O2,time of Sa O2< 90% of the total sleep time( Sa O2< 90% T) before and after treatment and changes in ESS sleepiness scale score. Results After treatment,the AHI,the longest apnea time,the lowest Sa O2,Sa O2< 90% T and the daytime sleepiness( ESS) score were significantly different from those before treatment( P < 0. 05). The improvement of the above symptoms in the experimental group was better than that in the control group,and the difference was statistically significant( P < 0. 05). During the treatment period,vital signs such as blood pressure,heart rate,body temperature and breathing were stable without abnormalities. Conclusion Xuefu Zhuyu Decoction combined with laryngeal three-needling can effectively reduce the respiratory disturbance index in patients with ischemic stroke combined with sleep apnea syndrome,increase the minimum blood oxygen saturation during night sleep,shorten the duration of Sa O2< 90% T and improve hypoxia during sleep,drowsiness and quality of life during the day.