浅针疗法对原发性失眠自主神经功能的影响

The Influence of Shallow Insertion on Autonomic Nervous Function in Patients with Primary Insomnia

目的:观察浅针疗法对原发性失眠患者自主神经功能的影响。方法:将60例原发性失眠患者按照随机数字表法分为浅针组、艾灸组和经颅磁组,每组各20例。浅针组给予浅针镇静穴治疗,艾灸组给予艾灸镇静穴治疗,经颅磁组给予超低频重复经颅磁刺激治疗,各组治疗均持续15min,并在治疗前、治疗中、治疗后15min分别对使用穿戴式心电贴对患者心率变异性进行记录,包括心率(beats per minutes, BPM)、心率变异性的时域指标[全部正常RR间期的标准差(Standard deviation of NN intervals for period of interest, SDNN)、相邻RR间期差值的均方根(Root mean square of successive differences of NN intervals for period of interest, rMSSD)]及心率变异性的频域指标[低频功率(low frequency, LF)、高频功率(high frequency power, HF)、低频功率与高频功率之比(LF/HF)]。结果:与本组治疗前比较,浅针组、艾灸组、经颅磁组治疗中、治疗后BPM均降低,差异具有统计学意义(P<0.05);3组患者治疗中、治疗后BPM组间比较,差异无统计学意义(P>0.05)。与本组治疗前比较,浅针组、艾灸组、经颅磁组治疗中、治疗后SDNN、rMSSD均升高,差异具有统计学意义(P<0.05);浅针组治疗后SDNN、rMSSD高于治疗中,经颅磁组治疗后SDNN高于治疗中,治疗后浅针组SDNN、rMSSD高于艾灸组及经颅磁组,差异均有统计学意义(P<0.05)。与治疗前比较,浅针组、经颅磁组治疗中、治疗后LF、LF/HF均降低,HF均升高,差异具有统计学意义(P<0.05);治疗后艾灸组LF低于治疗中,差异具有统计学意义(P<0.05);治疗后浅针组HF高于经颅磁组,LF/HF低于艾灸组、经颅磁组,且艾灸组治疗后LF/HF经颅磁组,差异具有统计学意义(P<0.05)。结论:浅针疗法可改善原发性失眠患者交感神经系统和副交感神经系统之间的整体平衡,从而改善自主神经功能。

Objective: To observe the influence of shallow insertion on autonomic nervous function in patients with primary insomnia.Methods: A total of 60 patients with primary insomnia were randomly divided into the shallow insertion group, the moxibustion group and the transcranial magnetic stimulation group, with 20 cases in each group.The shallow insertion group was treated with shallow acupuncture at sedation point, the moxibustion group was treated with moxibustion at sedation point, and the transcranial magnetic stimulation group was treated with ultra-low frequency repeated transcranial magnetic stimulation.The treatment in each group lasted for 15 minutes, and the wearable ECG patch was used to record the heart rate variability of patients before, during, and 15 minutes after treatment, including beats per minute(BPM),time domain indexes of heart rate variability [including Standard deviation of NN intervals for period of interest(SDNN),Root mean square of successful differences of NN intervals for period of interest(rMSSD)] and frequency domain indexes of heart rate variability [including low frequency(LF),high frequency power(HF)],ratio of low frequency power to high frequency power(LF/HF) Results: Compared with that before treatment, BPM in the shallow insertion group, the moxibustion group and the transcranial magnetic stimulation group decreased during and after treatment, with a statistically significant difference(P<0.05);There was no significant difference between the three groups during and after treatment(P>0.05).Compared with that before treatment, SDNN and rMSSD in the shallow insertion group, the moxibustion group and the transcranial magnetic stimulation group increased during and after treatment, with a statistically significant difference(P<0.05).After treatment, SDNN and rMSSD in the shallow insertion group were higher than those during the treatment;SDNN after treatment in the transcranial magnetic stimulation group was higher than that during the treatment.After treatment, SDNN and rMSSD in the shallow insertion group were higher than those in the moxibustion group and the transcranial magnetic stimulation group, and all the differences were statistically significant(P<0.05).Compared with that before treatment, LF and LF/HF in the shallow insertion group, and the transcranial magnetic stimulation group decreased, while HF increased during and after treatment, and all the differences were statistically significant(P<0.05).LF in the moxibustion group after treatment was lower than that during treatment, and the difference was statistically significant(P<0.05).After treatment, HF in the shallow insertion group was higher than that in the transcranial magnetic stimulationgroup, while LF/HF was lower than that in the moxibustion group and the transcranial magnetic stimulation group, and LF/HF in the moxibustion group was lower than that intranscranial magnetic stimulation group, and all the differences were statistically significant(P<0.05).Conclusion: Shallow insertion therapy can improve the overall balance between sympathetic nervous system and parasympathetic nervous system in patients with primary insomnia, thereby improving autonomic nervous function.