温针灸脐周四边穴对心脾两虚型慢性失眠患者睡眠结构的影响

Influence of Needle-Warming Moxibustion on Periumbilical Four Sided Acupoints to Sleep Structure of Chronic Insomnia due to Deficiency of Heart and Spleen

目的:观察温针灸脐周四穴对心脾两虚型慢性失眠(CID)患者睡眠结构的影响。方法:121例心脾两虚型慢性失眠患者随机分为普通针刺组61例和温针灸组60例。所有患者均给予加味归脾汤进行常规治疗,普通针刺组取百会、神门、安眠、内关及三阴交等穴位进行常规针刺干预,温针灸组取百会、神门、安眠与脐周四边穴等进行温针灸干预,3次/周,连续治疗4周。比较两组治疗前后匹兹堡睡眠质量指数(PSQI)、失眠严重指数量表(ISI)及睡眠结构相关指标[总睡眠时间(TST)、睡眠潜伏期(SOL)、睡眠效率(SE)、入睡后的觉醒(WASO)以及N1、N2、N3和REM百分比],采用酶联免疫吸附法(ELISA)检测两组患者治疗前后血清中5-羟色胺(5-HT)、多巴胺(DA)及褪黑素(MT)含量水平。结果:经治疗后两组患者PSQI评分、ISI评分均较本组治疗前明显降低(P<0.05),且温针灸组PSQI评分、ISI评分明显低于普通针刺组(P<0.05);经治疗后两组患者TST、SE、N3%和REM%值明显升高,SOL、WASO、N1%和N2%值明显降低(P<0.05),且温针灸组患者睡眠结构相关指标均优于普通针刺组(P<0.05);经治疗后两组患者血清中5-HT及MT水平明显升高,DA水平明显降低(P<0.05),且温针灸组患者血清中5-HT、DA及MT水平明显优于普通针刺组(P<0.05)。结论:温针灸脐四边穴治疗心脾两虚型慢性失眠疗效显著,可有效改善患者睡眠结构,提高睡眠质量,调节血清中5-HT、DA及MT水平。

Objective:To observe the influence of needle-warming moxibustion on periumbilical four sided acupoints to sleep structure of the patients with chronic insomnia disorder(CID) due to deficiency of Heart and Spleen.Methods:121 patients with CID due to deficiency of Heart and Spleen were randomly divided into the control group(n=61) and the study group(n=60).Both groups were treated with Jiawei Guipi Decoction;on which basis,the control group was also treated with needling Baihui(DU20),Shenmen(HT7),Anmian(HN-54),Neiguan(PC6) and Sanyinjiao(SP6),whereas the study group was also treated with needling DU20,HT7 and HN-54,as well as needling-warming moxibustion on periumbilical four sided acupoints.The treatment was performed 3 times a week for 4 weeks.The scores of PSQI and ISI,as well as the values of TST,SOL,SE,WASO,N1,N2,N3 and REM were compared between before and after the treatment in the two groups.The serum levels of 5-HT,DA and MT were detected by ELISA before and after the treatment in the two groups.Results:The scores of PSQI and ISI were decreased after the treatment in both groups(P<0.05),and the decreases were more significant in the study group than those in the control group(P<0.05).The values of TST,SE,N3% and REM% were significantly increased,whereas the values of SOL,WASO,N1% and N2% were significantly decreased in both groups after the treatment(P<0.05).All the sleep structure parameters were better in the study group than those in the control group(P<0.05).The serum levels of 5-HT and MT were increased(P<0.05),and the serum level of DA was decreased after the treatment in the two groups(P<0.05),and the improvements were more significant in the study group than those in the control group(P<0.05).Conclusion:Needle-warming moxibustion on periumbilical four sided acupoints has a significant effect on chronic insomnia due to deficiency of Heart and Spleen,which can effectively improve the sleep structure and sleep quality,and regulate the serum levels of 5-HT,DA and MT.