雷火灸神阙穴治疗脑梗死后失眠临床研究

Clinical Study on Thunder-Fire Moxibustion at Shenque Point for Insomnia After Cerebral Infarction

目的:观察雷火灸神阙穴治疗脑梗死后失眠的临床疗效。方法:将80例脑梗死后失眠患者按随机数字表法分为对照组和观察组各40例。2组均给予西医常规基础治疗,对照组另加艾司唑仑片治疗,观察组另加雷火灸神阙穴治疗。比较2组临床效果、匹兹堡睡眠质量指数量表(PSQI)评分、中医证候积分以及血清5-羟色胺(5-HT)、脑源性神经营养因子(BDNF)、食欲素-A (Orexin-A)的水平,观察不良反应发生情况。结果:观察组总有效率为92.50%,高于对照组75.00%,差异有统计学意义(P<0.05)。治疗后,2组PSQI各项评分以及总分均较治疗前下降,且观察组PSQI各项评分以及总分低于对照组(P<0.05)。治疗后,2组中医证候积分较治疗前降低,且观察组中医证候积分低于对照组,差异均有统计学意义(P<0.05)。治疗后,2组5-HT、BDNF水平较治疗前升高,观察组5-HT、BDNF水平高于对照组(P<0.05);2组Orexin-A水平较治疗前降低,观察组Orexin-A水平低于对照组(P<0.05)。观察组不良反应发生率为5.00%,低于对照组20.00%,差异有统计学意义(P<0.05)。结论:雷火灸神阙穴治疗脑梗死后失眠效果显著,能够明显改善患者的失眠症状,提高5-HT、BDNF水平,降低Orexin-A水平。

Objective: To observe the clinical effect of thunder-fire moxibustion at Shenque point for patients with insomnia after cerebral infarction. Methods:A total of 80 cases of patients with insomnia after cerebral infarction were divided into the control group and the observation group according to the random number table method,40 cases in each group. Both groups were given routine basic treatment of western medicine;the control group was additionally treated with estazolam tablets, and the observation group was additionally treated with thunder-fire moxibustion at Shenque point. The clinical effect,the scores of Pittsburgh Sleep Quality Index(PSQI),the changes in Chinese medicine syndrome scores and the levels of 5-hydroxyserotonin(5-HT), brain-derived neurotrophic factor(BDNF) and Orexin-A in serum in the two groups were compared;the incidences of adverse reactions were observed. Results: The total effective rate was 92.50% in the observation group, higher than that of 75.00% in the control group, the difference being significant(P<0.05). After treatment,the scores of PSQI and the total scores in the two groups were decreased when compared with those before treatment, and the above scores in the observation group were lower than those in the control group(P<0.05). After treatment, Chinese medicine syndrome scores in the two groups were decreased when compared with those before treatment,and the score in the observation group was lower than that in the control group,differences being significant(P<0.05). After treatment,the levels of 5-HT and BDNF in the two groups were increased when compared with those before treatment,and the levels in the observation group were higher than those in the control group(P<0.05);the levels of OrexinA in the two groups were decreased when compared with those before treatment,and the level in the observation group was lower than that in the control group(P<0.05). The incidence of adverse reactions was 5.00% in the observation group,lower than that of 20.00% in the control group,the difference being significant(P<0.05). Conclusion:The application of thunderfire moxibustion at Shenque point for insomnia after cerebral infarction has significant effect,and can significantly improve the insomnia of patients,increase the levels of 5-HT and BDNF,and reduce the levels of orexin-A.