Li Jia-Huan, Wu Wen-Zhong, Liu Cheng-Yong, Wang Xiao-Qiu, Qin Shan, Zhao Ya-Nan, Xi Han-Qing, Zheng Shi-Yu, Xu Liang
Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, China.
Zhen Ci Yan Jiu. 2021 Aug 25;46(8):690-4. doi: 10.13702/j.1000-0607.201009.
To observe the clinical efficacy of Tiaoshen needling (dredging Governor Vessel and regulating mind)in the treatment of chronic insomnia (CI) and its effect on plasma melatonin (MT) and cortisol (CORT) levels, so as to explore its underlying mechanism.
Sixty patients with CI were randomly divided into the treatment group and the control group, with 30 cases in each group. Both groups were given sleep hygiene education before treatment. Patients in the treatment group received acupuncture or electroacupuncture at Baihui (GV20), Shenting (GV24), Yintang (GV29), bilateral Shenmen (HT7) and Sanyinjiao (SP6). Patients in the control group received acupuncture or electroacupuncture at bilateral Shousanli (LI10), Futu (ST32) and Feiyang(BL58). Both groups were treated every other day, 3 times a week, for a total of 4 weeks. Before and after treatment, Pittsburgh sleep quality index (PSQI) and fatigue severity scale (FSS) were used to evaluate sleep qua-lity and daytime fatigue, the plasma MT and CORT levels were measured by enzyme-linked immunosorbent assay.
Compared with before treatment, the PSQI scores and total FSS score of the treatment group decreased significantly (<0.01,<0.05), and the plasma MT content increased and CORT decreased significantly in the treatment group (<0.01),while the sleep-onset time score, sleep disturbance score and the PSQI total score of the control group decreased significantly (<0.05). Compared with the control group, the PSQI sleep disorder score and total score, and the total FSS score as well as plasma CORT level were significantly down-regulated (<0.01,<0.05), while the plasma MT content was up-regulated (<0.05) in the treatment group.
Tiaoshen acupuncture can significantly improve the sleep quality of patients with CI and relieve daytime fatigue, which may be related to the increase of plasma MT content in patients with CI, thereby inhibiting the excessive activation of the hypothalamic-pituitary-adrenal axis.
观察调神针法(疏通督脉、调畅心神)治疗慢性失眠的临床疗效及其对血浆褪黑素(MT)和皮质醇(CORT)水平的影响,以探讨其作用机制。
将60例慢性失眠患者随机分为治疗组和对照组,每组30例。两组在治疗前均给予睡眠卫生教育。治疗组患者取百会(GV20)、神庭(GV24)、印堂(GV29)、双侧神门(HT7)和三阴交(SP6)进行针刺或电针治疗。对照组患者取双侧手三里(LI10)、伏兔(ST32)和飞扬(BL58)进行针刺或电针治疗。两组均隔日治疗1次,每周3次,共治疗4周。治疗前后采用匹兹堡睡眠质量指数(PSQI)和疲劳严重程度量表(FSS)评估睡眠质量和日间疲劳程度,采用酶联免疫吸附测定法检测血浆MT和CORT水平。
与治疗前比较,治疗组PSQI评分及FSS总分显著降低(<0.01,<0.05),血浆MT含量升高、CORT降低(<0.01);对照组入睡时间评分、睡眠障碍评分及PSQI总分显著降低(<0.05)。与对照组比较,治疗组PSQI睡眠障碍评分、总分及FSS总分、血浆CORT水平显著下调(<0.01,<0.05),血浆MT含量上调(<0.05)。
调神针法可显著改善慢性失眠患者的睡眠质量,缓解日间疲劳,其机制可能与提高慢性失眠患者血浆MT含量、抑制下丘脑-垂体-肾上腺轴过度激活有关。