基于EEG功率谱探究电针改善卒中相关失眠患者日间嗜睡的即刻及累积效应

Immediate and Cumulative Effects of EA on Daytime Somnolence in Patients with Stroke-Related Insomnia Based on EEG Power Spectrum

目的:采用EEG功率谱观察评价电针治疗卒中相关失眠患者日间嗜睡的即刻效应及累积效应。方法:将24例符合纳入标准的脑卒中相关失眠患者采用随机单盲的方法分为电针组和假电针组,每组12例。电针组取四神聪穴针刺入穴后接通电针仪,频率选择连续波2 Hz,1次/d,每次20 min,治疗21 d。假电针组选4处四神聪穴远端非经非穴点,用安慰针及电针仪模拟电针治疗过程,1次/d,每次20 min,治疗21 d。观察两组治疗前后采集的EEG数据变化,并对统计结果进行分析。结果:Karolinska嗜睡量表:电针组患者KSS评分疗程后较疗程前,差异有统计学意义(P<0.01),电针组KSS评分改善程度较假电针组差异有统计学意义(P<0.01)。电针改善日间嗜睡的即刻效应在首次治疗时不明显,治疗21 d后,即刻效应显现,脑电快波活动比治疗前增加,差异具有统计学意义(P<0.05)。电针改善日间嗜睡的累积效应:患者Beta频段标准化功率值增加,差异具有统计学意义(P<0.05),脑电觉醒活动增强,日间嗜睡减轻。结论:电针治疗日间嗜睡在单次治疗中存在即刻效应,但在疗程早期的单次治疗中并不明显,连续多次治疗后,即刻效应显现,能够增加患者的脑电觉醒活动。

Objective:To observe and evaluate immediate and cumulative effects of electro-acupuncture(EA)on daytime somnolence in patients with stroke-related insomnia based on EEG power spectrum.Methods:24 stroke-related insomnia patients who met the inclusion criteria were randomly divided into the EA group(n=12)and the sham EA group(n=12).The EA group was treated with electro-needling Sishencong(EX-HN1),2 Hz,20 min once a day for 21 days.The sham EA group was treated with sham electro-needling non-meridian and non-acupoint at the distal end of EX-HN1,once a day,20 min each time for 21 days.The changes of EEG data before and after treatment were observed,and the statistical results were analyzed in the two groups.Results:Karolinska sleepiness scale(KSS)results showed that the KSS score of the EA group after the treatment was significantly different from that before the treatment(P<0.01),and the improvement of the KSS score of the EA group was more significant than that of the sham EA group(P<0.01).The immediate effect of EA on daytime somnolence was not obvious at the first treatment,but the immediate effect appeared and the fast wave activity of EEG increased after 21 days of treatment compared with those before the treatment(P<0.05).In terms of EA improving cumulative effect of daytime somnolence,the standardized power value of Beta band was increased(P<0.05);the activity of EEG awakening was enhanced,and daytime somnolence was alleviated.Conclusion:EA treatment of daytime somnolence has an immediate effect in a single treatment,but it is not obvious in the early stage of the course of treatment.After several consecutive treatments,the immediate effect appears,which can increase the EEG awakening activity of the patients.