电针对老年慢性肌肉骨骼疼痛相关睡眠及认知损害的影响

Electroacupuncture improves sleep and cognitive impairment associated with chronic musculoskeletal pain of the elderly

目的 观察电针对老年慢性肌肉骨骼疼痛相关睡眠及认知损害的影响。方法 选择2020年8月—2022年3月在连云港市中医院治疗的147例老年慢性肌肉骨骼疼痛患者,随机分为针刺组和假针刺组,最终79例纳入统计,其中针刺组38例、假针刺组41例。针刺组穴取四神聪,针刺入穴接电针仪,2 Hz连续波,每次30 min,每日1次,每周治疗5 d;假针刺组采用安慰针具模拟电针操作。2组患者均治疗4周。比较2组患者治疗前后匹兹堡睡眠质量指数(PSQI)评分、蒙特利尔认知评估基础量表(MoCA-B)评分、短时记忆编码实验结果、修订版面部表情疼痛量表(FPS-R)评分及疼痛发展过程变化问卷(PSOCQ)评分。结果 与治疗前比较,治疗4周后针刺组患者PSQI评分降低,短时记忆编码实验反应时间缩短,MoCA-B评分、短时记忆编码实验正确率升高,FPS-R评分下降,PSOCQ中思考前期和思考期评分明显降低,PSOCQ中行动期/维持期评分明显升高,差异均有统计学意义(P均<0.05);治疗4周后假针刺组PSQI评分、FPS-R评分降低,MoCA-B评分、短时记忆编码实验正确率升高,差异均有统计学意义(P均<0.05),其余指标与治疗前比较差异均无统计学意义(P均>0.05);针刺组PSQI、MoCA-B、FPS-R评分及短时记忆编码实验正确率和反应时间改善程度均优于假针刺组(P均<0.05)。结论 电针治疗对老年慢性肌肉骨骼疼痛患者的睡眠及认知功能均有正向调节作用,可有效缓解患者的疼痛严重程度,协同改善患者的负性情绪。

Objective It is to observe the effect of electroacupuncture on sleep and cognitive impairment associated with chronic musculoskeletal pain of the elderly.Methods A total of 147 patients with chronic musculoskeletal pain of the elderly treated in Lianyungang Hospital of Traditional Chinese Medicine from August 2020 to March 2022 were selected and randomly divided into acupuncture group and sham acupuncture group,79 cases were finally included in the statistics,including 38 cases in the acupuncture group and 41 cases in the sham acupuncture group.In the acupuncture group,EX-HN1 was selected as the acupuncture point,and the acupuncture point was connected to the electroacupuncture instrument with 2 Hz continuous wave,30min each time,once a day,5 days a week.The sham acupuncture group was treated with placebo acupuncture to simulate electroacupuncture,and both groups were treated for 4 weeks.The scores of Pittsburgh sleep quality index(PSQI),Montreal cognitive assessment basic scale(MoCA-B),the results of short-term memory coding experiment(STM),the scores of faces pain scale-revised(FPS-R)and the scores of pain stages of change questionnaire(PSOCQ)before and after treatment were compared between the two groups.Results Compared with before treatment,the PSQI score was decreased,the reaction time in the short-term memory coding experiment was shortened,the MoCA-B score and correct rate in the short-term memory coding experiment were increased,the FPS-R score was decreased,the scores of prethinking and thinking stages in PSOCQ were decreased,and the scores of action/maintenance stages in PSOCQ were increased in the patients of acupuncture group after 4 weeks of treatment,the differences were all significant(all P<0.05).Compared with before treatment,the scores of PSQI and FPS-R were decreased,the MoCA-B score and correct rate in the short-term memory coding experiment were increased in the patients of sham acupuncture group after 4 weeks of treatment,the differences were significant(all P<0.05),and the other indexes were not significantly different from those before treatment(P>0.05).The improvements of PSQI score,MoCA-B score,FPS-R score,and correct rate,reaction time in the short-term memory coding experiment in the acupuncture group were better than those in the sham acupuncture group(all P<0.05).Conclusion Electroacupuncture can positively regulate the sleep and cognitive function of patients with chronic musculoskeletal pain of the elderly and can synergistically improve their negative emotions and effectively alleviate the severity of pain.