针药结合治疗失眠症患者的事件相关电位及Quisi研究

Event-related potential and Quisi in patients with insomnia treated with acupuncture and medicine

目的探讨失眠症患者针药结合治疗前后睡眠脑电(Quisi)及事件相关电位变化。方法选择2021年9月至2022年12月就诊于上海市长宁区精神卫生中心中医科、心理咨询中心的失眠患者共150例作为失眠症组。经过临床最终筛选入组112例,其中男52例,女60例;年龄19~59岁,病程1.2~9年。2022年2月至2022年10月收集附近居民共52名作为对照组。所有研究对象进行Quisi及事件相关电位检测。比较两组Quisi睡眠指标,失匹性负波(MMN)和P300的波幅及潜伏期,并分析治疗前后失眠症组患者睡眠参数。结果与对照组相比,失眠症组的睡眠总时间减少,REM睡眠潜伏期、REM睡眠时间和REM周期数减少,同时睡眠潜伏期延长,醒觉时间和醒起时间均增加,睡眠效率下降,S1睡眠增加,S2和S3+S4睡眠减少,差异有统计学意义(P<0.05或0.01)。与对照组比较,失眠症组MMN和P300潜伏期延迟,波幅下降(P<0.01或0.05)。失眠症组治疗后睡眠连续性和睡眠总时间有显著改善。结论失眠症患者Quisi睡眠指标和事件相关电位指标异常,针药结合能改善患者的睡眠质量和事件相关脑电位等指标。

Objective To investigate the changes of sleep EEG(Quisi)and event-related potential before and after acupuncture and drug therapy in patients with insomnia.Methods A total of 150 patients with insomnia admitted to Shanghai Changning District Mental Health Center from September 2021 to December 2022 were selected as the insomnia group.After clinical screening,112 cases were enrolled,including 52 males and 60 females,aged 19-59 years,with a course of disease of 1.2-9 years.A total of 52 nearby residents were collected from February 2022 to October 2022 as the control group.Quisi and event-related potential were performed in all subjects.Quisi sleep indexes,mismatched negative potential(MMN)and P300 were compared between the two groups,and the sleep parameters of patients with insomnia before and after treatment were analyzed.Results Compared with the control group,the total sleep time,REM sleep latency,REM sleep time and REM cycle number decreased in the insomnia group,while the sleep latency was prolonged,the awake time and morning awaking time were increased,the sleep efficiency decreased,the S1 sleep increased,and the S2 and S3+S4 sleep decreased,with statistical significance(P<0.05 or 0.01).Compared with the control group,the latency of MMN and P300 in the insomnia group was delayed,and the amplitude of MMN and P300 was decreased(P<0.01 or 0.05).Sleep continuity and total sleep time were significantly improved in the insomnia group after treatment.Conclusion Quisi sleep index and event-related potential index are abnormal in patients with insomnia,and the combination of acupuncture and medicine can improve the sleep quality and event-related potential.