益心安神汤联合调神针法治疗脑卒中后睡眠障碍

Yixin Anshen Decoction Combined with Tiaoshen Acupuncture on Post-stroke Sleep Disorder

目的:观察益心安神汤联合调神针法治疗脑卒中后睡眠障碍(post-stroke sleep disorder,PSSD)的临床疗效以及其对神经递质及应激状态的影响。方法:92例PSSD患者作为研究对象,按照随机数字表法分为对照组和试验组,各46例。两组患者均给予常规基础治疗,在此基础上对照组给予右佐匹克隆,并施以调神针刺法;试验组在对照组治疗基础上给予益心安神汤。比较两组患者神经递质、应激指标水平,并比较临床疗效。结果:试验组有效率为89.13%,显著高于对照组的71.14%(P<0.05)。治疗后,两组患者中医证候积分、匹兹堡睡眠质量指数量表(Pittsburgh sleep quality index,PSQI)、美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)、斯坦福急性应激反应问卷(Stanford Acute Stress Reaction Questionaire,SASRQ)评分均显著降低(P<0.05),且治疗组明显低于对照组(P<0.05)。治疗后,两组患者血清5-羟色胺、5-羟吲哚乙酸、谷氨酸、γ-氨基丁腺素水平显著升高(P<0.05),且试验组明显高于对照组(P<0.05)。治疗后,两组患者促肾上腺皮质激素水平显著降低,超氧化物歧化酶(superoxide dismutase,SOD)、谷胱甘肽过氧化物酶(glutathione peroxidase,GSH-Px)水平显著升高,且试验组ACTH水平明显低于对照组(P<0.05),SOD、GSH-Px水平明显高于对照组(P<0.05)。结论:益心安神汤联合调神针法治疗PSSD疗效显著,能够调节神经递质紊乱,减轻应激状态,有效改善睡眠障碍症状,促进神经功能恢复。

Objective:To observe the clinical efficacy of Yixin Anshen Decoction Combined with Tiaoshen acupuncture in the treatment of post-stroke sleep disorder(PSSD)and its influence on neurotransmitters and stress state.Methods:92 patients with PSSD were randomly divided into control group and experimental group with 46 cases in each group.Two groups of patients were given conventional basic treatment,on this basis,the control group was given dexzopiclone,and given Tiaoshen acupuncture;the experimental group was given Yixin Anshen Decoction on the basis of the control group.The levels of neurotransmitter and stress index were compared between the two groups,and the clinical efficacy was compared.Results:The effective rate of the experimental group was 89.13%,which was significantly higher than 71.14% of the control group(P<0.05).After treatment,two groups of TCM syndrome scores,Pittsburgh sleep quality index(PSQI),National Institute of Health stroke scale(NIHSS),Stanford Acute Stress Reaction Questionaire(SASRQ)scores were significantly reduced(P<0.05),and the treatment group was significantly lower than the control group(P<0.05).After treatment,the level of 5-hydroxytryptamine(5-HT),5-hydroxyindoleacetic acid(5-HIAA),glutamic acid(Glu),γ-aminobutyric acid(γ-GABA)of the two groups of patients was significantly increased(P<0.05),and the test group was significantly higher than the control group(P<0.05).After treatment,the two groups of adrenocorticotropic hormone(ACTH)levels significantly decreased,and the levels of superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px)increased significantly.The level of ACTH in the test group was significantly lower than that of the control group(P<0.05),and the levels of SOD and GSH-Px were significantly higher than those of the control group(P<0.05).Conclusion:Yixin Anshen Decoction combined with Tiaoshen acupuncture has significant curative effect in the treatment of PSSD,which can regulate neurotransmitter disorders,reduce stress,effectively improve symptoms of sleep disorders,and promote nerve function recovery.