Sleep disorders have a profound and well-documented impact on overall health and quality of life in the general population. In patients with chronic disease, sleep disorders are more prevalent, with an additional morb...Sleep disorders have a profound and well-documented impact on overall health and quality of life in the general population. In patients with chronic disease, sleep disorders are more prevalent, with an additional morbidity and mortality burden. The complex and dynamic relationship between sleep disorders and chronic kidney disease(CKD) remain relatively little investigated. This article presents an overview of sleep disorders in patients with CKD, with emphasis on relevant pathophysiologic underpinnings and clinical presentations. Evidence-based interventions will be discussed, in the context of individual sleep disorders, namely sleep apnea, insomnia, restless leg syndrome and excessive daytime sleepiness. Limitations of the current knowledge as well as future research directions will be highlighted, with a final discussion of different conceptual frameworks of the relationship between sleep disorders and CKD.展开更多
OBJECTIVE: To observe the clinical effect of pricking and penetrating moxibustion therapy on refractory insomnia.METHODS: Totally 60 subjects were randomly divided into treatment group and control group, 30 in each gr...OBJECTIVE: To observe the clinical effect of pricking and penetrating moxibustion therapy on refractory insomnia.METHODS: Totally 60 subjects were randomly divided into treatment group and control group, 30 in each group. The treatment group was treated with pricking and penetrating moxibustion therapy, the control group with penetrating moxibustion therapy, the treatment was given once every day, two groups of patients were treated 20 times,compared the efficacy, pinsburgh sleep quality index(PSQI) and Traditional Chinese Medicine symptom, safety evaluation between the two groups.RESULTS: Compared with 10, 20 times after the treatment, the effective rate of the treatment group(93.3%) higher than that of the control group(80.0%)(P < 0.05); Compared with beforetreatment, 20 times after treatment, the PSQI and TCM symptom pattern scores of the two groups were significantly decreased(P < 0.01); Compared with 10, 20 times after the treatment, the treatment group are better than the control group in improving the total score and the integral of PSQI(P <0.05 or P < 0.01); The treatment group are better than the control group in improving the TCM symptom pattern score, difficulty in going to sleep, palpitation, amnesia, fidget, sweating, impaired concentration(P < 0.01 or P < 0.05).CONCLUSION: The pricking and penetrating moxibustion therapy is safe and effective in the treatment of refractory insomnia and the treatment can improve the curative effect of the therapy that uses penetrating moxibustion only.展开更多
Objective： To observe the clinical efficacy of acupuncture plus bloodletting therapy in treating insomnia in people with blood stasis constitution. Methods： Seventy-two patients were randomized into a treatment grou...Objective： To observe the clinical efficacy of acupuncture plus bloodletting therapy in treating insomnia in people with blood stasis constitution. Methods： Seventy-two patients were randomized into a treatment group and a control group by using the random number table, 36 cases each. The treatment group received acupuncture plus bloodletting therapy, while the control group was intervened by oral administration of estazolam. One-week treatment was taken as a course, for 3 successive courses in total. A follow-up study was conducted 3 months later. The Pittsburgh sleep quality index （PSQI） was evaluated before and after the intervention, as well as in the follow-up. The clinical efficacies were also compared. Results： The total effective rate was 88.9% in the treatment group versus 83.3% in the control group, and the between-group difference was statistically significant （P〈0.O5）. After the intervention, the PSO.I scores dropped significantly in both groups （both P〈0.05）; the between-group difference in PSQI score was statistically significant （P〈O.05）. The follow-up study showed that the between-group difference in the global score of PSO, I was statistically significant （P〈0.05）. Conclusion： Acupuncture plus bloodletting therapy can produce a more significant efficacy than oral administration of estazolam in treating insomnia in people with blood stasis constitution.展开更多
Clinical DataThe 120 cases in this series were outpatients suffering from insomnia due to interior-stirring by phlegm-heat, ranging in age from 28 to 67 years. They were randomly divided into a treatment group and a c...Clinical DataThe 120 cases in this series were outpatients suffering from insomnia due to interior-stirring by phlegm-heat, ranging in age from 28 to 67 years. They were randomly divided into a treatment group and a control group.展开更多
42 middle-aged and old people at the age between 55-70 years were selected and given the warm needling at Zusanli (ST 36), and their IL-2 and NO contents of peripheral blood before and after acupuncture were determine...42 middle-aged and old people at the age between 55-70 years were selected and given the warm needling at Zusanli (ST 36), and their IL-2 and NO contents of peripheral blood before and after acupuncture were determined. The results showed that IL-2 and NO contents increased significantly after the warm needling (P<0.01).展开更多
目的观察针刺联合耳穴贴压治疗骨髓瘤伴失眠的临床疗效及对认知功能、睡眠质量的影响。方法将160例骨髓瘤中重度疼痛合并失眠患者随机分为观察组(89例)与对照组(71例)。对照组采用常规药物治疗,观察组在对照组基础上采用针刺联合耳穴贴...目的观察针刺联合耳穴贴压治疗骨髓瘤伴失眠的临床疗效及对认知功能、睡眠质量的影响。方法将160例骨髓瘤中重度疼痛合并失眠患者随机分为观察组(89例)与对照组(71例)。对照组采用常规药物治疗,观察组在对照组基础上采用针刺联合耳穴贴压治疗。观察两组治疗前后匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)评分、简易智力状态检查量表(mini-mental state examination,MMSE)、日常生活活动能力(activity of daily living,ADL)量表、视觉模拟量表(visual analog scale,VAS)、汉密尔顿抑郁量表(Hamilton depression scale,HAMD)及汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)评分变化,并比较两组临床疗效及骨髓瘤患者认知功能与睡眠质量的关系。结果观察组总有效率为94.4%,显著高于对照组的80.3%,差异有统计学意义(P<0.05)。治疗后,两组PSQI和VAS评分均下降,且观察组低于对照组,差异均有统计学意义(P<0.05);两组MMSE和ADL评分均上升,且观察组高于对照组,差异均有统计学意义(P<0.05)。治疗后,两组HAMD和HAMA评分均下降,且观察组低于对照组,差异有统计学意义(P<0.05)。骨髓瘤患者认知功能与睡眠质量呈现显著正相关(P<0.05)。结论在常规药物基础上,针刺联合耳穴贴压治疗骨髓瘤伴失眠效果显著,能够有效提升患者睡眠质量及认知水平,改善疼痛及负性情绪。展开更多
目的评价不同治疗方案对睡眠障碍的疗效及不良反应,为睡眠障碍提供有循证证据的最佳治疗方案。方法以sleep disorde(r睡眠障碍)、insomnia(失眠)、restless legss yndrome or RLS(不宁腿综合征)、obstructive sleep apnea or OSA(阻塞...目的评价不同治疗方案对睡眠障碍的疗效及不良反应,为睡眠障碍提供有循证证据的最佳治疗方案。方法以sleep disorde(r睡眠障碍)、insomnia(失眠)、restless legss yndrome or RLS(不宁腿综合征)、obstructive sleep apnea or OSA(阻塞性睡眠呼吸暂停)、narcolepsy(发作性睡病)、REM behaviour disorder or RBD(快速眼动睡眠期行为障碍)、treatment or therapy(治疗)等英文词汇作为检索词,分别检索2006-2013年Cochrane图书馆、美国国家图书馆医学在线(MEDLINE)、Science Direct等数据库,获得临床指南、系统评价、随机对照临床试验、回顾性病例分析研究、病例观察研究及综述等文献,采用Jadad量表进行质量评价。结果经筛选共计纳入与睡眠障碍治疗有关的临床指南6篇、系统评价12篇、随机对照临床试验5篇、回顾性病例分析2篇、病例观察1篇、综述14篇;其中33篇为高质量文献、7篇为低质量文献。经对各项临床试验治疗原则及不同治疗方法疗效和安全性评价显示:(1)失眠为最常见的睡眠障碍,以药物治疗和改善认知行为为主要治疗方法,两种治疗方法各有优缺点,联合治疗为最佳方案。(2)原发性不宁腿综合征的一线治疗药物为多巴胺受体激动药和抗惊厥药,继发性患者主要为病因治疗。(3)阻塞性睡眠呼吸暂停综合征治疗包括经鼻持续气道正压通气、口腔矫正器、手术治疗,其中经鼻持续气道正压通气为一线治疗方法。(4)发作性睡病的药物治疗包括莫达非尼、羟丁酸钠及抗抑郁药,应根据临床分型选择不同药物。(5)快速眼动睡眠期行为障碍的治疗包括一般治疗如避免诱因、保证睡眠环境安全等,药物治疗主要有苯二氮类及褪黑素。结论借助循证医学评价方法可为不同类型睡眠障碍的治疗提供最佳临床证据。展开更多
基金Supported by a NIH grant to Dr.Cukor(MD006875)(in part)
文摘Sleep disorders have a profound and well-documented impact on overall health and quality of life in the general population. In patients with chronic disease, sleep disorders are more prevalent, with an additional morbidity and mortality burden. The complex and dynamic relationship between sleep disorders and chronic kidney disease(CKD) remain relatively little investigated. This article presents an overview of sleep disorders in patients with CKD, with emphasis on relevant pathophysiologic underpinnings and clinical presentations. Evidence-based interventions will be discussed, in the context of individual sleep disorders, namely sleep apnea, insomnia, restless leg syndrome and excessive daytime sleepiness. Limitations of the current knowledge as well as future research directions will be highlighted, with a final discussion of different conceptual frameworks of the relationship between sleep disorders and CKD.
基金Supported by Project funded by China Postdoctoral Science Foundation:The mechanism of moxibustion improves rheumatoid arthritis by promoting lymphatic drainage function(No.2016M590681)
文摘OBJECTIVE: To observe the clinical effect of pricking and penetrating moxibustion therapy on refractory insomnia.METHODS: Totally 60 subjects were randomly divided into treatment group and control group, 30 in each group. The treatment group was treated with pricking and penetrating moxibustion therapy, the control group with penetrating moxibustion therapy, the treatment was given once every day, two groups of patients were treated 20 times,compared the efficacy, pinsburgh sleep quality index(PSQI) and Traditional Chinese Medicine symptom, safety evaluation between the two groups.RESULTS: Compared with 10, 20 times after the treatment, the effective rate of the treatment group(93.3%) higher than that of the control group(80.0%)(P < 0.05); Compared with beforetreatment, 20 times after treatment, the PSQI and TCM symptom pattern scores of the two groups were significantly decreased(P < 0.01); Compared with 10, 20 times after the treatment, the treatment group are better than the control group in improving the total score and the integral of PSQI(P <0.05 or P < 0.01); The treatment group are better than the control group in improving the TCM symptom pattern score, difficulty in going to sleep, palpitation, amnesia, fidget, sweating, impaired concentration(P < 0.01 or P < 0.05).CONCLUSION: The pricking and penetrating moxibustion therapy is safe and effective in the treatment of refractory insomnia and the treatment can improve the curative effect of the therapy that uses penetrating moxibustion only.
文摘Objective： To observe the clinical efficacy of acupuncture plus bloodletting therapy in treating insomnia in people with blood stasis constitution. Methods： Seventy-two patients were randomized into a treatment group and a control group by using the random number table, 36 cases each. The treatment group received acupuncture plus bloodletting therapy, while the control group was intervened by oral administration of estazolam. One-week treatment was taken as a course, for 3 successive courses in total. A follow-up study was conducted 3 months later. The Pittsburgh sleep quality index （PSQI） was evaluated before and after the intervention, as well as in the follow-up. The clinical efficacies were also compared. Results： The total effective rate was 88.9% in the treatment group versus 83.3% in the control group, and the between-group difference was statistically significant （P〈0.O5）. After the intervention, the PSO.I scores dropped significantly in both groups （both P〈0.05）; the between-group difference in PSQI score was statistically significant （P〈O.05）. The follow-up study showed that the between-group difference in the global score of PSO, I was statistically significant （P〈0.05）. Conclusion： Acupuncture plus bloodletting therapy can produce a more significant efficacy than oral administration of estazolam in treating insomnia in people with blood stasis constitution.
文摘Clinical DataThe 120 cases in this series were outpatients suffering from insomnia due to interior-stirring by phlegm-heat, ranging in age from 28 to 67 years. They were randomly divided into a treatment group and a control group.
文摘42 middle-aged and old people at the age between 55-70 years were selected and given the warm needling at Zusanli (ST 36), and their IL-2 and NO contents of peripheral blood before and after acupuncture were determined. The results showed that IL-2 and NO contents increased significantly after the warm needling (P<0.01).
文摘目的观察针刺联合耳穴贴压治疗骨髓瘤伴失眠的临床疗效及对认知功能、睡眠质量的影响。方法将160例骨髓瘤中重度疼痛合并失眠患者随机分为观察组(89例)与对照组(71例)。对照组采用常规药物治疗,观察组在对照组基础上采用针刺联合耳穴贴压治疗。观察两组治疗前后匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)评分、简易智力状态检查量表(mini-mental state examination,MMSE)、日常生活活动能力(activity of daily living,ADL)量表、视觉模拟量表(visual analog scale,VAS)、汉密尔顿抑郁量表(Hamilton depression scale,HAMD)及汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)评分变化,并比较两组临床疗效及骨髓瘤患者认知功能与睡眠质量的关系。结果观察组总有效率为94.4%,显著高于对照组的80.3%,差异有统计学意义(P<0.05)。治疗后,两组PSQI和VAS评分均下降,且观察组低于对照组,差异均有统计学意义(P<0.05);两组MMSE和ADL评分均上升,且观察组高于对照组,差异均有统计学意义(P<0.05)。治疗后,两组HAMD和HAMA评分均下降,且观察组低于对照组,差异有统计学意义(P<0.05)。骨髓瘤患者认知功能与睡眠质量呈现显著正相关(P<0.05)。结论在常规药物基础上,针刺联合耳穴贴压治疗骨髓瘤伴失眠效果显著,能够有效提升患者睡眠质量及认知水平,改善疼痛及负性情绪。
文摘目的评价不同治疗方案对睡眠障碍的疗效及不良反应,为睡眠障碍提供有循证证据的最佳治疗方案。方法以sleep disorde(r睡眠障碍)、insomnia(失眠)、restless legss yndrome or RLS(不宁腿综合征)、obstructive sleep apnea or OSA(阻塞性睡眠呼吸暂停)、narcolepsy(发作性睡病)、REM behaviour disorder or RBD(快速眼动睡眠期行为障碍)、treatment or therapy(治疗)等英文词汇作为检索词,分别检索2006-2013年Cochrane图书馆、美国国家图书馆医学在线(MEDLINE)、Science Direct等数据库,获得临床指南、系统评价、随机对照临床试验、回顾性病例分析研究、病例观察研究及综述等文献,采用Jadad量表进行质量评价。结果经筛选共计纳入与睡眠障碍治疗有关的临床指南6篇、系统评价12篇、随机对照临床试验5篇、回顾性病例分析2篇、病例观察1篇、综述14篇;其中33篇为高质量文献、7篇为低质量文献。经对各项临床试验治疗原则及不同治疗方法疗效和安全性评价显示:(1)失眠为最常见的睡眠障碍,以药物治疗和改善认知行为为主要治疗方法,两种治疗方法各有优缺点,联合治疗为最佳方案。(2)原发性不宁腿综合征的一线治疗药物为多巴胺受体激动药和抗惊厥药,继发性患者主要为病因治疗。(3)阻塞性睡眠呼吸暂停综合征治疗包括经鼻持续气道正压通气、口腔矫正器、手术治疗,其中经鼻持续气道正压通气为一线治疗方法。(4)发作性睡病的药物治疗包括莫达非尼、羟丁酸钠及抗抑郁药,应根据临床分型选择不同药物。(5)快速眼动睡眠期行为障碍的治疗包括一般治疗如避免诱因、保证睡眠环境安全等,药物治疗主要有苯二氮类及褪黑素。结论借助循证医学评价方法可为不同类型睡眠障碍的治疗提供最佳临床证据。
