通督调神针法联合艾司唑仑片对缺血性脑卒中后失眠患者脑血流、多导睡眠图指标以及神经递质的影响

Effect of Tongdu Tiaoshen Acupuncture Combined with Estazolam Tablets on Cerebral Blood Flow,Polysomnography Index and Neurotransmitter in Patients with Insomnia after Ischemic Stroke

目的:探讨通督调神针法联合艾司唑仑片对缺血性脑卒中(CIS)后失眠患者脑血流、多导睡眠图指标以及神经递质的影响。方法:选择我院2021年1月-2023年7月期间我院治疗的气虚血瘀型CIS后失眠患者95例,根据随机数字表法将患者分为对照组(艾司唑仑片治疗)47例和研究组(通督调神针法联合艾司唑仑片治疗)48例。对比两组中医证候积分、匹兹堡睡眠质量指数(PSQI)、阿森斯失眠量表(AIS)、多导睡眠图相关指标[觉醒时长(WASO)、睡眠潜伏时长(SOL)和睡眠总时长(TST)]、血清神经递质[去甲肾上腺素(NE)、5-羟色胺(5-HT)、5-羟吲哚乙酸(5-HIAA)]、大脑前动脉、大脑中动脉和大脑后动脉的脑血流速度。结果:治疗后,两组主症、次症、总分、PSQI、AIS评分下降,且研究组低于对照组同时间点(P<0.05)。治疗后,两组WASO、SOL、NE降低,且研究组低于对照组同时间点;TST、5-HIAA、5-HT升高,且研究组高于对照组同时间点(P<0.05)。治疗后,两组大脑前动脉、大脑中动脉、大脑后动脉的脑血流速度升高,且研究组高于对照组同时间点(P<0.05)。结论:CIS后失眠患者采用通督调神针法和艾司唑仑片联合治疗,可改善患者的失眠症状,提高睡眠质量,改善脑血流和神经递质水平分泌。

Objective:To investigate the effects of tongdu tiaoshen acupuncture combined with estazolam tablets on cerebral blood flow,polysomnography index and neurotransmitter in patients with insomnia after ischemic stroke(CIS).Methods:95 patients with insomnia after CIS of qi deficiency and blood stasis type were treated in our hospital from January 2021 to July 2023 were selected,patients were divided into control group(estazolam tablets treatment)47 cases and study group(tongdu tiaoshen acupuncture combined with estazolam tablets treatment)48 cases according to the random number table method.The chinese medicine syndrome scores,Pittsburgh Sleep Quality Index(PSQI),Athens Insomnia Scale(AIS),polysomnography related indicators[awakening time(WASO),sleep latency(SOL)and total sleep time(TST)],serum neurotransmitters[norepinephrine(NE),5-hydroxytryptamine(5-HT),5-hydroxyindoleacetic acid(5-HIAA)],cerebral blood flow velocity of anterior cerebral artery,middle cerebral artery and posterior cerebral artery were compared between two groups.Results:After treatment,the main symptoms,secondary symptoms,total scores,PSQI and AIS scores in two groups decreased,and those in study group were lower than those in control group at the same time point(P<0.05).After treatment,WASO,SOL and NE in two groups decreased,and those in study group were lower than those in control group at the same time point.TST,5-HIAA and 5-HT increased,and those in study group were higher than those in control group at the same time point(P<0.05).After treatment,the cerebral blood flow velocity of anterior cerebral artery,middle cerebral artery and posterior cerebral artery in two groups increased,and those in study group were higher than those in control group at the same time point(P<0.05).Conclusion:Estazolam tablets and tongdu tiaoshen acupuncture of the combined treatment for insomnia patients after CIS,which can improve insomnia symptoms,improve sleep quality,and improve cerebral blood flow and neurotransmitter secretion.