五音调神法对缺血性脑卒中后抑郁患者心理和睡眠的影响

Effects of "Wu Yin Tiao Shen" technique on mood and sleep quality of patients with post-ischemic stroke depression

目的 探讨五音调神法对缺血性脑卒中后轻、中度抑郁患者心理和睡眠的影响。方法 将缺血性脑卒中后抑郁患者随机分为认知治疗组(n=35)和五音调神组(n=36),在基础治疗基础上,认知治疗组采取认知行为疗法治疗,五音调神组采取针刺督脉要穴(百会、印堂、神庭)联合角调式五行音乐治疗。干预前后观察两组匹兹堡睡眠质量指数、汉密尔顿抑郁量表24项临床疗效和多导睡眠图检查参数变化。结果 干预后两组抑郁评分较干预前显著下降(均P<0.01)。两组抑郁、睡眠治疗有效率比较,差异无统计学意义(均P>0.05)。多导睡眠图检查结果显示,干预后两组睡眠总时间、REM潜伏期和睡眠效率显著增加,睡眠潜伏期时间、觉醒时间显著缩短,觉醒次数显著减少,且五音调神组睡眠进程变化较认知治疗组更显著(P<0.05,P<0.01);干预后两组N1、N2、N3、REM期睡眠时间延长,N1、N2期睡眠比例降低,N3、REM期睡眠比例增加,且五音调神组显著优于认知治疗组(均P<0.01)。结论 五音调神法能显著改善缺血性脑卒中后抑郁患者抑郁情绪和失眠症状。

Objective To observe the effects of "Wu Yin Tiao Shen" technique on mood and sleep quality in patients with mild to moderate post-ischemic stroke depression(PISD). Methods PISD patients were randomly divided into two groups. The cognitive therapy group(n=35) received cognitive treatment, while the WuYinTiaoShen group(n=36) received acupuncture at Baihui, Yintang and Shenting combined with five-element music treatment in Angle mode. Before and after intervention, the Pittsburgh Sleep Quality Index(PSQI), the Hamilton-24 Depression Scale(HAMD-24), and polysomnography were used to measure and compare the efficacy of the two groups. Results The post-intervention depression scores in both groups saw significant drops from before(P<0.01 for both). There was no statistical significance in the improvement rates of depression and sleep between the two groups(P>0.05 for both). The results of polysomnography showed that the total sleep time, REM latency and sleep efficiency increased significantly, the sleep latency time and wake-up time were shortened significantly, and the number of wake-ups decreased significantly in both groups after treatment, and the changes in sleep process in the WuYinTiaoShen group were more significant than those in the cognitive treatment group(P<0.05,P<0.01);the sleep time of N1, N2, N3 and REM stage was prolonged, the proportion of N1 and N2 stage sleep was decreased, and the proportion of N3 and REM stage sleep increased in both groups after treatment, with the WuYinTiaoShen group significantly better than the cognitive treatment group(all P<0.01). Conclusion "Wu Yin Tiao Shen" technique can significantly improve depressive mood and insomnia symptoms in patients with depression after ischemic stroke.