醒神健脑方联合子午流注低频电针疗法治疗血管性认知障碍伴睡眠倒错临床研究

Clinical Study on Xingshen Jiannao Prescription Combined with Midnight-Midday Low-Frequency Electroacupuncture Therapy for Vascular Cognitive Impairment Complicated with Sleep Inversion

目的:观察醒神健脑方联合子午流注低频电针疗法治疗血管性认知障碍伴睡眠倒错的临床疗效。方法:选择90例血管性认知障碍伴睡眠倒错患者,按随机数字表法分为针刺组和联合组各45例。针刺组给予子午流注电针治疗,联合组给予子午流注低频电针疗法联合醒神健脑方治疗。评价2组临床疗效,比较2组治疗前后阿森斯失眠量表(AIS)、失眠症临床观察调查表(SPIEGEL)、匹兹堡睡眠质量指数(PSQI)、简易精神状态量表(MMSE)、老年性痴呆评定量表-认知分量表(ADAS-cog)评分,检测入睡期(S1)、浅睡期(S2)、熟睡期(S3)+深睡期(S4)、快速动眼睡眠(REM)百分比,检测肿瘤坏死因子-α (TNF-α)、白细胞介素-6 (IL-6)、补体C3水平及血脑屏障通透性指标Ki/c。结果:联合组总有效率为97.78%,高于针刺组82.22%(P<0.05)。治疗后,2组AIS评分、PSQI评分、ADAS-cog评分较治疗前降低(P<0.05),联合组AIS评分、PSQI评分、ADAS-cog评分低于针刺组(P<0.05);2组SPIEGEL评分、MMSE评分较治疗前升高(P<0.05),联合组SPIEGEL评分、MMSE评分高于针刺组(P<0.05)。治疗后,2组S2、S3+S4、REM百分比较治疗前升高(P<0.05),联合组S2、S3+S4、REM百分比高于针刺组(P<0.05);2组S1百分比较治疗前降低(P<0.05),联合组S1百分比低于针刺组(P<0.05)。治疗后,2组TNF-α、IL-6、补体C3、Ki/c水平较治疗前降低(P<0.05),联合组TNF-α、IL-6、补体C3、Ki/c水平低于针刺组(P<0.05)。结论:醒神健脑方联合子午流注低频电针疗法治疗血管性认知障碍伴睡眠倒错患者,可抑制机体炎症反应,降低补体C3水平,改善血脑屏障,调节睡眠结构,改善睡眠质量及认知功能,提升临床疗效。

Objective:To observe the clinical effect of Xingshen Jiannao Prescription combined with midnight-midday low-frequency electroacupuncture therapy on vascular cognitive impairment complicated with sleep inversion.Methods:A total of 90 cases of patients with vascular cognitive impairment complicated with sleep inversion were selected and divided into the acupuncture group and the combination group according to the random number table method,with 45 cases in each group.The acupuncture group was treated with midnight-midday low-frequency electroacupuncture therapy,and the combination group was treated with midnight-midday low-frequency electroacupuncture therapy combined with Xingshen Jiannao Prescription.The clinical effects were evaluated in the two groups.The scores of Athens Insomnia Scale(AIS),Spiegel sleep questionnaire(SPIEGEL),Pittsburgh Sleep Quality Index(PSQI),Mini Mental State Scale(MMSE),and Alzheimer's Disease Assessment Scale-Cognitive Subscale(ADAS-Cog) were compared before and after treatment.The percentages of falling asleep period(S1),light sleep period(S2),sound sleep period(S3) + deep sleep period(S4),and rapid eye movement(REM) sleep were detected.The levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),and complement C3,and blood-brain barrier permeability index Ki/c were detected.Results:The total effective rate was 97.78% in the combination group,higher than that of 82.22% in the acupuncture group(P<0.05).After treatment,the scores of AIS,PSQI,and ADAS-cog in the two groups were decreased when compared with those before treatment(P<0.05),and the scores of AIS,PSQI,and ADAS-cog in the combination group were lower than those in the acupuncture group(P<0.05);the scores of SPIEGEL and MMSE in the two groups were increased when compared with those before treatment(P<0.05),and the scores of SPIEGEL and MMSE in the combination group were higher than those in the acupuncture group(P<0.05).After treatment,the percentages of S2,S3+S4,and REM in the two groups were increased when compared with those before treatment(P<0.05),and the percentages of S2,S3+S4,and REM in the combination group were higher than those in the acupuncture group(P<0.05).The percentage of S1 in the two groups was decreased when compared with that before treatment(P<0.05),and the percentage of S1 in the combination group was lower than that in the acupuncture group(P<0.05).After treatment,the levels of TNF-α,IL-6,complement C3,and Ki/c were decreased when compared with those before treatment(P<0.05),and the levels of TNF-α,IL-6,complement C3,and Ki/c in the combination group were lower than those in the acupuncture group(P<0.05).Conclusion:Xingshen Jiannao Prescription combined with midnight-midday low-frequency electroacupuncture therapy for patients with vascular cognitive impairment complicated with sleep inversion can inhibit the inflammatory responses in the body,reduce complement C3 levels,improve the blood-brain barrier,regulate sleep structure,improve sleep quality and cognitive function,and enhance clinical effects.