耳针配合舌下神经针刺及中药治疗阻塞性睡眠呼吸暂停低通气综合征的疗效观察

Therapeutic efficacy of auricular acupuncture combined with sublingual nerve acupuncture and Chinese herbal medicines in the treatment of obstructive sleep apnea hypoventilation syndrome

目的观察耳针配合舌下神经针刺及中药治疗阻塞性睡眠呼吸暂停低通气综合征的临床疗效。方法将60例阻塞性睡眠呼吸暂停低通气综合征患者随机分为观察组和对照组,每组30例。观察组采用耳针配合舌下神经针刺及口服理气消鼾方治疗,对照组采用单纯口服理气消鼾方治疗。观察两组治疗前后呼吸暂停低通气指数(apnea-hypopnea index,AHI)、夜间最低氧饱和度(lowest oxygen saturation,LSpO2)、Epworth嗜睡量表(Epworth sleepiness scale,ESS)评分、睡眠过程中呼吸暂停与低通气反复发作次数、各项中医证候积分及血清低氧诱导因子-1(hypoxia inducible factor-1,HIF-1)、促红细胞生成素(erythropoietin,EPO)、神经生长因子(nerve growth factor,NGF)及脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)水平的变化情况,并比较两组临床疗效。结果观察组总有效率为96.7%,明显高于对照组的83.3%(P<0.05)。两组治疗后LSpO2及血清NGF、BDNF水平均较同组治疗前显著上升,AHI、ESS评分、睡眠过程中呼吸暂停与低通气反复发作次数、各项中医证候积分及HIF-1、EPO水平均显著下降,差异均具有统计学意义(P<0.05)。观察组治疗后LSpO2及血清NGF、BDNF水平明显高于对照组,AHI、ESS评分、睡眠过程中呼吸暂停与低通气反复发作次数、各项中医证候积分及HIF-1、EPO水平均明显低于对照组,差异均具有统计学意义(P<0.05)。结论耳针配合舌下神经针刺及口服理气消鼾方治疗阻塞性睡眠呼吸暂停低通气综合征疗效确切,不仅能有效改善患者AHI及LSpO2,快速缓解其打鼾、睡眠中发生呼吸暂停、日间嗜睡等症状,还能保护神经,减轻缺血缺氧损伤。

Objective To observe the clinical efficacy of auricular acupuncture with sublingual nerve acupuncture and Chinese herbal medicines in the treatment of obstructive sleep apnea hypoventilation syndrome.Method A total of 60 patients with obstructive sleep apnea hypoventilation syndrome were randomly divided into the observation group and the control group,30 cases in each group.The observation group was treated with auricular acupuncture combined with sublingual nerve acupuncture and oral administration of the Liqi Xiaohan formula,while the control group was treated with the Liqi Xiaohan formula alone.The changes in apnea-hypopnea index(AHI),lowest oxygen saturation(LSpO2),Epworth sleepiness scale(ESS)score,the number of repeated episodes of apnea and hypoventilation during sleep,the Chinese medicine syndrome score,and serum hypoxia inducible factor-1(HIF-1),erythropoietin(EPO),nerve growth factor(NGF),and brain-derived neurotrophic factor(BDNF)before and after treatment were observed in the two groups.The clinical efficacy of the two groups was compared.Result The total effective rate of the observation group was 96.7%,which was significantly higher than that of the control group(83.3%).The LSpO2 and serum NGF and BDNF levels of the two groups increased significantly after treatment compared with those of the same group before treatment,and the AHI and ESS scores,the number of recurrent episodes of apnea and hypoventilation during sleep,the Chinese medicine syndrome scores,and the levels of HIF-1 and EPO decreased significantly,and the differences were statistically significant(P<0.05).The LSpO2 and serum NGF and BDNF levels of the observation group were significantly higher than those of the control group after treatment,and the AHI and ESS scores,the number of recurrent episodes of apnea and hypoventilation during sleep,the Chinese medicine syndrome scores,and the levels of HIF-1 and EPO were significantly lower than those of the control group,with the differences being statistically significant(P<0.05).Conclusion Auricular acupuncture,together with sublingual nerve acupuncture and oral administration of Liqi Xiaohan formula,is effective in treating obstructive sleep apnea and hypoventilation syndrome,which not only can effectively improve the AHI and LSpO2 of patients and quickly relieve their symptoms of snoring,apnea in sleep and daytime somnolence,but also protect the nerves and reduce the ischemic-hypoxic injury.