發(fā)布時間：2018-07-25 13:48

【摘要】：目的:比較針刺與唑吡坦干預(yù)原發(fā)性失眠癥患者覺醒狀態(tài)的差異,并探討其相關(guān)神經(jīng)電生理學(xué)機(jī)制。方法:將61例原發(fā)性失眠癥患者隨機(jī)分為藥物組(30例)和針刺組(31例),連續(xù)治療4周。比較兩組治療前后匹茲堡睡眠質(zhì)量指數(shù)(Pittsburgh Sleep Quality Index,PSQI)評分、多導(dǎo)睡眠監(jiān)測儀(polysomnography,PSG)監(jiān)測睡眠結(jié)構(gòu)相關(guān)指標(biāo)及多次睡眠潛伏時間試驗(yàn)(multiple sleep latency test,MSLT)的平均睡眠潛伏時間(mean sleep latency,MSL)變化。結(jié)果:兩組治療后PSQI評分較本組治療前明顯降低(均P0.01)。針刺組治療后PSQI評分較藥物組降低(P0.05)。兩組治療后較本組治療前睡眠潛伏期(sleep onset latency,SOL)縮短、覺醒次數(shù)(number of awake1nings,NWAK)、入睡后清醒時間(wake after sleep onset,WASO)減少,總睡眠時間(total sleep time,TST)增多、睡眠效率(sleep efficiency,SE)明顯增高(均P0.01),藥物組治療后非快速眼動3期(non-rapid eye movement period 3,N3)較本組治療前增多,N1、N2和快速眼動睡眠期(rapid eye movement period,REM)比例較本組治療前比較無統(tǒng)計(jì)學(xué)意義(均P0.05),而針刺組治療后較本組治療前N1、N2比例減少,N3、REM比例增多(均P0.01)。兩組治療后SOL、NWAK、WASO、TST、SE比較差異無統(tǒng)計(jì)學(xué)意義(均P0.05),針刺組治療后較藥物組N1、N2比例減少,N3、REM比例增多(均P0.01)。兩組治療后MSLT的MSL較治療前明顯縮短(均P0.01)。針刺組治療后MSLT的MSL較藥物組縮短(P0.05)。結(jié)論:針刺較唑吡坦能夠更有效地改善原發(fā)性失眠癥患者的睡眠質(zhì)量,并更有利于調(diào)節(jié)其過度覺醒狀態(tài)。
[Abstract]:Aim: to compare the effects of acupuncture and zolpidem on the arousal state of patients with primary insomnia and to explore its neurophysiological mechanism. Methods: 61 patients with primary insomnia were randomly divided into drug group (30 cases) and acupuncture group (31 cases) for 4 weeks. The scores of Pittsburgh Sleep quality Index (Pittsburgh Sleep Quality), polysomnography monitor (PSG) and the mean sleep latency (mean sleep latencies) of the two groups before and after treatment were compared. Results: the PSQI score of the two groups after treatment was significantly lower than that before treatment (P0.01). The PSQI score in the acupuncture group was lower than that in the drug group (P0.05). The sleep latency (sleep onset latencies) of the two groups was shorter than that of the patients before treatment. The number of wakefulness was (number of awake1ningsnwak), the (wake after sleep onsette WASO) was decreased, and the total sleep time (total sleep time was increased. Sleep efficiency (SE) was significantly increased (P0.01). There was no significant difference in the proportion of non-rapid eye movement stage 3 (non-rapid eye movement period 3N 3) before treatment and (rapid eye movement periodontic sleep stage (P < 0.01) in the drug group compared with that before treatment. P 0.05), but the proportion of N _ 1 N _ 2 decreased after acupuncture treatment compared with that before treatment in this group (P < 0.05), and the REM ratio of N _ 3N _ 3 in acupuncture group was higher than that before treatment (all P 0.01). After treatment, there was no significant difference between the two groups (P0.05), but the proportion of N _ 1N _ 2 in the acupuncture group decreased than that in the drug group (P < 0.01), but the ratio of N _ 1N _ 2 in the acupuncture group was significantly lower than that in the drug group (P < 0.05), but the ratio of N _ 1N _ 2 in the acupuncture group was lower than that in the drug group. The MSL of MSLT in both groups was shorter than that before treatment (P 0.01). The MSL of MSLT in acupuncture group was shorter than that in drug group (P 0.05). Conclusion: acupuncture is more effective than zolpidem in improving sleep quality of patients with primary insomnia and regulating their overawakening.
【作者單位】： 杭州市第七人民醫(yī)院心理科;杭州市紅十字會醫(yī)院;
【基金】：浙江省中醫(yī)藥科技計(jì)劃項(xiàng)目(2013ZB107,2014ZB090) 杭州市衛(wèi)生科技計(jì)劃重點(diǎn)項(xiàng)目(2015Z08)
【分類號】：R246.6

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