低频rTMS联合耳穴埋豆治疗脑卒中后睡眠障碍患者血清IL-1β、NSE及5-HT的影响

The effects of low-frequency rTMS combined with auricular acupoint burying on serum levels of interleukin-1β,neuron-specific enolase and 5-hydroxytryptamine in patients with sleep disorders after stroke

目的探讨低频rTMS联合耳穴埋豆治疗对脑卒中后睡眠障碍患者血清白细胞介素-1β(IL-1β)、神经元特异性烯醇化酶(NSE)及5-羟色胺(5-HT)的影响。方法选取2018年8月至2021年2月本院治疗的脑卒中后伴睡眠障碍患者93例为研究对象,根据随机数表法随机分为3组,每组31例。对照组予以阿普唑仑片口服,观察组予以低频rTMS治疗,联合组予以低频rTMS+耳穴埋豆治疗。1个月后,比较三组患者治疗前后匹兹堡睡眠质量指数量表(PSQI)、神经功能缺损评分(NIHSS)、不良反应发生率以及血清IL-1β、NSE和5-HT的差异。结果三组患者治疗前PSQI和NIHSS评分以及血清IL-1β、NSE和5-HT水平比较,差异无统计学意义(P>0.05);治疗1个月后,三组患者PSQI和NIHSS评分均有改善,且联合组改善最明显(P<0.05)。治疗后,三组患者血清IL-1β、NSE均有降低,且联合组降低最明显(P<0.05)。治疗后,三组患者血清5-HT发生升高,且联合组升高最明显(P<0.05)。观察组和联合组不良反应发生率低于对照组(P<0.05)。结论低频rTMS联合耳穴埋豆可以通过降低血清IL-1β和NSE水平,提高5-HT水平改善脑卒中后睡眠障碍患者的睡眠质量,并促进患者神经功能的恢复。

Objective To investigate the effects of low-frequency rTMS combined with auricular acupoint burying on serum levels of interleukin-1β(IL-1β),neuron-specific enolase(NSE)and 5-hydroxytryptamine(5-HT)in patients with sleep disorders after stroke.Methods A total of 93 patients with post-stroke sleep disorders treated in Zhejiang Xin'an International Hospital from August 2018 to February 2021 were selected as the research subjects and randomly divided into 3 groups according to the random number table method,with 31 patients in each group.The control group was given Alprazolam tablet orally,the experimental group was given low-frequency rTMS,and the combined group was treated with low frequency rTMS+ear acupoint embedding bean.After 1 month,the Pittsburgh Sleep Quality Index(PSQI),neurological deficit score(NIHSS),incidence of adverse reactions,serum IL-1β,NSE and 5-HT were compared among the three groups before and after the treatment.Results Before the treatment,there were no significant differences in PSQI,NIHSS scores,serum IL-1β,NSE and 5-HT levels among the three groups(all P>0.05).After 1 month of treatment,PSQI and NIHSS scores were improved in all three groups,and the improvement was the most significant in the combination group,with statistical significance(all P<0.05).After the treatment,serum IL-1βand NSE were decreased in the three groups,and the decrease was the most significant in the combined group(all P<0.05).After the treatment,the serum 5-HT in the three groups was decreased,and the increase was the most significant in the combined group,with statistical significance(all P<0.05).The incidence of adverse reactions in the experimental group and the combined group was lower than that in the control group,with statistical significance(P<0.05).Conclusion Low frequency rTMS combined with auricular acupoint burial-dandu can improve the sleep quality of patients with sleep disorders after stroke by reducing serum IL-1βand NSE levels,increasing 5-HT levels,and promoting the recovery of neurological function.