外金津、玉液不同靶向电针对脑梗死相关阻塞性睡眠呼吸暂停综合征患者颏舌肌收缩的影响

Effect of Different Target Electro-Needling Waijinjin and Waiyuye on Genioglossal Contraction in Cerebral Infarction Related OSA Patients

目的:应用超声比较不同靶向部位的外金津、玉液电针对脑梗死相关阻塞性睡眠呼吸暂停综合征(OSA)患者颏舌肌收缩的影响。方法:纳入60例脑梗死伴OSA患者,随机分为传统组和靶向组。在常规治疗基础上,两组均于外金津、外玉液行电针。传统组进针25~40 mm,得气为度。靶向组进针程度以B超图像显示针的影像为止。应用超声影像中颏舌肌收缩前后的差值ΔMT进行评价,测量位置取距颏棘1 cm、2 cm处,测量时间分别为瓦尔萨尔法用力时、电刺激开始和电刺激10 min后。结果:电刺激即刻,两组的ΔMT值在两个测量位置均升高(P<0.01),靶向组变化大于传统组(P<0.01)。电刺激10 min后,两组ΔMT值均下降(P<0.01),靶向组变化大于传统组(P<0.01)。靶向颏舌肌进针深度与颈围呈正相关关系(r=0.081)。结论:靶向颏舌肌的电针与传统深度电针相比,对脑梗死相关OSA患者颏舌肌的即刻收缩程度和累积疲劳程度影响更大。

Objective:To compare the effect of different target electro-needling Waijinjin and Waiyuye on the degree of genioglossal contraction in patients with cerebral infarction related obstructive sleep apnea-hypopnea syndrome(OSA).Methods:60 patients with cerebral infarction related OSA were randomly divided into the traditional group and the target group.On the basis of routine treatment,both groups were treated with electro-needling Waijinjin and Waiyuye.The needle depth in the traditional group was 25~40 mm with qi obtaining feeling;and the needles were being stopped inserting in the target group until the B-ultrasonic images of needles were shown.The difference of the genioglossus contraction was evaluated withΔMT.The measuring positions were 1 cm and 2 cm away from the chin spine.The measuring time was the time of Valsalva force,the beginning of electrical stimulation and 10 min after electrical stimulation,respectively.Results:Immediately after electrical stimulation,the value ofΔMT in both groups increased(P<0.01),and the change in the target group was greater than that in the traditional group(P<0.01);after 10 minutes of electrical stimulation,the value ofΔMT in both groups decreased(P<0.01),and the change in the target group was greater than that in the traditional group(P<0.01).There was a positive correlation between the depth of targeted genioglossus needles and neck circumference(r=0.081).Conclusion:Compared to traditional deep electro-acupuncture,targeting genioglossus electro-acupuncture has a greater effect on instant contraction and cumulative fatigue of genioglossus in patients with OSA related to cerebral infarction.