腹针治疗脑卒中后睡眠障碍的临床观察

Clinical Observation of Abdominal Acupuncture on Post-stroke Sleep Disorders:A Randomized Controlled Trial

目的:探讨腹针疗法干预脑卒中后睡眠障碍患者的临床疗效。方法:选取2020年7月至2021年12月福建中医药大学附属康复医院/福建省康复技术重点实验室收治的脑卒中后睡眠障碍患者60例作为研究对象,按照随机数字表法分为对照组和观察组,每组30例。对照组采用常规治疗结合常规针刺疗法,观察组在对照组的基础上结合腹针,共持续治疗2个疗程(2周为1个疗程)。在治疗4周后,通过观察干预前后2组患者匹兹堡睡眠质量指数(PSQI)评分、睡眠时间、觉醒次数和时间、促肾上腺皮质激素释放激素(CRH)、皮质酮(CORT)、皮质醇(COR)、促肾上腺皮质激素(ACTH)水平,进行比较评价。结果:干预前后2组患者的一般资料比较,差异无统计学意义(P>0.05),具有可比性。干预后,观察组PSQI评分降低、睡眠时间延长、觉醒次数和觉醒时间减少,CRH、CORT、COR、ACTH水平均降低,且与对照组比较,差异有统计学意义(P<0.05)。结论:腹针疗法可有效改善脑卒中后睡眠障碍患者睡眠质量,临床疗效确切,其作用机制可能与调节下丘脑-垂体-肾上腺轴激素分泌,从而介导脑-肠轴功能稳态有关。

Objective:To explore the clinical effect of abdominal acupuncture in the treatment of post-stroke sleep disorders.Methods:A total of 60 patients with post-stroke sleep disorders admitted to the Rehabilitation Hospital affiliated to Fujian University of Traditional Chinese Medicine/Fujian Key Laboratory of Rehabilitation Technology from July 2020 to December 2021 were selected as the research subjects.They were divided into a control group and an observation group according to random number table method,with 30 patients in each group.The control group was treated with conventional therapy combined with conventional acupuncture therapy,while the observation group was treated with abdominal acupuncture on the basis of the control group for a total of 2 consecutive courses of treatment(2 weeks as 1 course).After 4 weeks of treatment,the Pittsburgh Sleep Quality Index(PSQI)score,sleep time,arousal frequency and time,levels of corticotropin releasing hormone(CRH),corticosterone(CORT),cortisol(COR),and corticotropin(ACTH)were compared and evaluated between the two groups of patients before and after the intervention.Results:The general data comparison between the two groups of patients before and after intervention showed no statistically significant difference(P>0.05),indicating comparability.After intervention,the PSQI score of the observation group decreased,sleep time prolonged,awakening frequency and time decreased,and the levels of CRH,CORT,COR,and ACTH all decreased,with statistically significant differences compared to the control group(P<0.05).Conclusion:Abdominal acupuncture therapy can effectively improve the sleep quality of patients with post-stroke sleep disorders,and the clinical effect is definite,and its mechanism of action may be to regulate the secretion of hormones in the hypothalamic-pituitary-adrenal axis,thereby mediating the functional homeostasis of the brain-gut axis.