针刺治疗睡眠觉醒时相延迟障碍的疗效观察及对睡眠、情绪及血浆褪黑素水平的影响

Efficacy observation of acupuncture for delayed sleep-wake phase disorder and its effect on sleep,mood,and plasma melatonin level

目的观察针刺治疗睡眠觉醒时相延迟障碍的临床疗效及对睡眠、情绪及血浆褪黑素水平的影响。方法将60例睡眠觉醒时相延迟障碍患者随机分为对照组和治疗组,每组30例。两组在睡眠卫生教育的基础上,治疗组采用常规针刺治疗,对照组采用安慰平头针治疗。观察两组治疗前后匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)、早-晚问卷(morningness-eveningness questionnaire,MEQ)、汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)和17项汉密尔顿抑郁量表(17-item Hamilton depression rating scale,HAMD-17)评分变化,检测治疗前后血浆褪黑素(melatonin,MT)含量;并比较两组临床疗效及不良反应。结果治疗组临床疗效优于对照组(P<0.01)。治疗后,治疗组PSQI总分及5项因子(睡眠质量、入睡时间、睡眠时间、睡眠效率和日间功能障碍)、HAMA和HAMD-17评分较治疗前降低(P<0.01,P<0.05),且治疗组低于对照组(P<0.01,P<0.05);MEQ评分较治疗前显著升高(P<0.01),且治疗组高于对照组(P<0.01);治疗组血浆MT含量较治疗前升高(P<0.05),且治疗组高于对照组(P<0.01);对照组PSQI中2项因子(睡眠时间和睡眠效率)及HAMA评分较治疗前降低(P<0.01,P<0.05)。两组治疗过程中均未出现不良反应。结论在睡眠卫生教育的基础上,针刺可有效改善睡眠觉醒时相延迟障碍患者的睡眠质量,调整患者睡眠觉醒时相,改善患者的焦虑、抑郁状况,并可提升患者血浆MT含量。

Objective To observe the clinical efficacy of acupuncture in treating delayed sleep-wake phase disorder(DSWPD)and its effect on sleep,mood,and plasma melatonin(MT)level.Method Sixty DSWPD patients were randomly divided into a control group and a treatment group,with 30 cases in each group.Both groups received sleep health education;in addition,the treatment group was given ordinary acupuncture treatment,and the control group was treated with placebo blunt needles.Before and after the treatment,the Pittsburgh sleep quality index(PSQI),morningness-eveningness questionnaire(MEQ),Hamilton anxiety scale(HAMA),and 17-item Hamilton depression rating scale(HAMD-17)scores were observed,and the plasma MT content was determined.The clinical efficacy and adverse reactions were compared between the two groups.Result The treatment group was superior to the control group in comparing the clinical efficacy(P<0.01).In the treatment group,the PSQI total score and five component scores(sleep quality,sleep latency,sleep duration,sleep efficiency,and daytime dysfunction),HAMA score,and HAMD-17 score decreased after the intervention(P<0.01,P<0.05)and were lower than those in the control group(P<0.01,P<0.05);the MEQ score increased significantly(P<0.01)and was higher than that in the control group(P<0.01);the plasma MT content rose in the treatment group after the intervention(P<0.05)and was higher than that in the control group(P<0.01).In the control group,two PSQI component scores(sleep duration and sleep efficiency)and HAMA score dropped after the treatment(P<0.01,P<0.05).During the intervention,neither group showed adverse reactions.Conclusion For DSWPD patients,on the basis of sleep health education,acupuncture can effectively improve sleep quality,adjust the sleep-wake phase,mitigate anxiety and depression,and elevate the plasma MT content.