[神门（HT7）与三阴交（SP6）改善失眠患者日间疲劳及嗜睡的腧穴配伍效应及机制]

[Acupoint compatibility effect and mechanism of Shenmen (HT7) and Sanyinjiao (SP6) in improving daytime fatigue and sleepiness of insomnia].

作者信息

Song Xiao-Jun, Zhu Yi-Hui, Wu Pei, Du Li, Li Zhong-Wen

机构信息

School of Acupuncture-moxibustion and Tuina, Chengdu University of Traditinal Chinese Medicine, Chengdu 610075, China.

出版信息

Zhen Ci Yan Jiu. 2022 Jul 25;47(7):630-5. doi: 10.13702/j.1000-0607.20210590.

DOI:10.13702/j.1000-0607.20210590

PMID:35880281

Abstract

OBJECTIVE

To observe the acupoint compatibility effect of Shenmen (HT7) and Sanyinjiao (SP6) in improving daytime fatigue and sleepiness of insomnia, and its mechanism in regulating hypothalamic-pituitary-adrenal (HPA) axis and suprachiasmatic nucleus-pineal gland-melatonin (SCN-PG-MT) system.

METHODS

Ninety patients with insomnia were randomly divided into HT7, SP6 and HT7-SP6 (HT7 plus SP6) groups, with 30 cases in each group. Electroacupuncture (EA,5 Hz/25 Hz) was applied to HT7, SP6 or HT7-SP6 in each group for 30 min. The EA treatment was conducted once daily, 5 days a week for 2 weeks. Before and after treatment, the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) were observed, separately. The contents of serum adrenocorticotrophic hormone (ACTH), cortisol (CS) and melatonin (MT) were detected by ELISA.

RESULTS

Compared with before treatment, the sleep quality, sleep time, sleep efficiency, sleep disturbance, daytime dysfunction scores and total score of PSQI in the three groups after treatment were decreased (<0.05), the time to fall asleep score of PSQI and total score of ESS were decreased in the SP6 and HT7-SP6 groups (<0.05). After treatment, the sleep quality, time to fall asleep, sleep efficiency, daytime dysfunction scores, total score of PSQI and total score of ESS in the HT7-SP6 group were lower than those in the HT7 group (<0.05), the sleep quality, sleep efficiency and total score of PSQI in the SP6 group were lower than those in the HT7 group (<0.05). Compared with before treatment, the serum ACTH and CS levels in the three groups were decreased (<0.05), and the serum MT levels in the SP6 and HT7-SP6 groups were increased (<0.05). After treatment, the ACTH and CS levels in the HT7-SP6 group were lower than those in the HT7 group (<0.05), and the serum MT levels in the SP6 and HT7-SP6 groups were higher than that in the HT7 group (<0.05).

CONCLUSION

The compatibility of HT7 and SP6 has a synergism effect on the improvement of night sleep quality and daytime fatigue and sleepiness of insomnia patients, the mechanism may be related with its function in down-regulating the serum ACTH and CS levels and increasing the serum MT content. SP6 has a better effect than HT7, and plays a major role in acupoint compatibility.

摘要

目的

观察神门（HT7）与三阴交（SP6）穴位配伍对改善失眠患者日间疲劳及嗜睡的作用，以及其调节下丘脑 - 垂体 - 肾上腺（HPA）轴和视交叉上核 - 松果体 - 褪黑素（SCN - PG - MT）系统的机制。

方法

将90例失眠患者随机分为HT7组、SP6组和HT7 - SP6（HT7加SP6）组，每组30例。分别对每组的HT7、SP6或HT7 - SP6进行电针（EA，5Hz/25Hz）治疗30分钟。EA治疗每日1次，每周5天，共2周。治疗前后分别观察匹兹堡睡眠质量指数（PSQI）和爱泼沃斯嗜睡量表（ESS）。采用酶联免疫吸附测定法检测血清促肾上腺皮质激素（ACTH）、皮质醇（CS）和褪黑素（MT）的含量。

结果

与治疗前比较，三组治疗后PSQI的睡眠质量、睡眠时间、睡眠效率、睡眠障碍、日间功能障碍评分及总分均降低（<0.05），SP6组和HT7 - SP6组PSQI的入睡时间评分及ESS总分降低（<0.05）。治疗后，HT7 - SP6组的睡眠质量、入睡时间、睡眠效率、日间功能障碍评分、PSQI总分及ESS总分均低于HT7组（<0.05），SP6组的睡眠质量、睡眠效率及PSQI总分低于HT7组（<0.05）。与治疗前比较，三组血清ACTH和CS水平均降低（<0.05），SP6组和HT7 - SP6组血清MT水平升高（<0.05）。治疗后，HT7 - SP6组的ACTH和CS水平低于HT7组（<0.05），SP6组和HT7 - SP6组血清MT水平高于HT7组（<0.05）。