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针刺“滋阴潜阳”法对心肾不交型慢性失眠患者执行功能及睡眠结构的影响。

Acupuncture for reducing the south to reinforce the north on executive function and sleep structure in patients with chronic insomnia disorder of heart-kidney disharmony.

机构信息

Psychosomatic Department, Affiliated Mental Health Center, School of Medicine, Zhejiang University, Hangzhou Seventh People's Hospital, Hangzhou 310013, China.

Digestive Department, Hangzhou Red Cross Hospital.

出版信息

Zhongguo Zhen Jiu. 2024 Apr 12;44(4):384-388. doi: 10.13703/j.0255-2930.20230501-k0004.

Abstract

OBJECTIVES

To observe the efficacy of acupuncture for reducing the south to reinforce the north on executive function, sleep structure and sleep quality in patients with chronic insomnia disorder of heart-kidney disharmony.

METHODS

A total of 100 patients with chronic insomnia disorder of heart-kidney disharmony were randomized into an acupuncture group (50 cases, 1 case dropped out) and a western medication group (50 cases, 2 cases dropped out). Acupuncture for reducing the south to reinforce the north was applied at Baihui (GV 20) and bilateral Shenmen (HT 7), Sanyinjiao (SP 6), Shenmai (BL 62), Zhaohai (KI 6), Xinshu (BL 15), Shenshu (BL 23) in the acupuncture group, once a day, 5 days a week. Lorazepam tablet was given orally in the western medication group, 0.5-1 mg a time, once a day. Both groups were treated for 4 weeks. The Stroop color-word test (SCWT) indexes (the time consuming and the correct number of card A, B, C and the Stroop interference effect [SIE]), sleep structure indexes (total sleep time [TST], sleep latency [SL], wake after sleep onset [WASO], sleep efficiency [SE], non-rapid eye movement period 1 [N1], non-rapid eye movement period 2 [N2], non-rapid eye movement period 3 [N3], rapid eye movement period [REM]) and Pittsburgh sleep quality index (PSQI) score were observed before and after treatment in the two groups.

RESULTS

After treatment, the time consuming of card B and C, the time consuming and the correct number of SIE, SL, WASO, N1, N2, as well as the sub-item scores and total score of PSQI were decreased (<0.05, <0.01), the correct number of card A, B and C, TST, SE, N3 and REM were increased (<0.01) compared with those before treatment in the acupuncture group; the time consuming of card C and SIE, the correct number of card A and SIE, TST, SE, REM were increased (<0.05, <0.01), SL, WASO, N1, as well as the sub-item scores of sleep quality, sleep latency, sleep duration, sleep efficiency, daytime function and total score of PSQI were decreased (<0.01) compared with those before treatment in the western medication group. After treatment, in the acupuncture group, the time consuming of card C, the time consuming and the correct number of SIE, N1, N2, as well as the sub-item scores of sleep quality, sleep dysfunction, daytime function and total score of PSQI were lower than those in the western medication group (<0.01), the correct number of card B and C, N3, REM were higher than those in the western medication group (<0.01).

CONCLUSIONS

Acupuncture for reducing the south to reinforce the north can improve the executive function of patients with chronic insomnia disorder of heart-kidney disharmony, adjust the sleep structure, and improve the night sleep quality and daytime body function.

摘要

目的

观察针刺“滋阴潜阳”法对心肾不交型慢性失眠患者执行功能、睡眠结构及睡眠质量的影响。

方法

将 100 例心肾不交型慢性失眠患者采用随机数字表法分为针刺组(50 例,脱落 1 例)和西药组(50 例,脱落 2 例)。针刺组取百会(GV 20)、双侧神门(HT 7)、三阴交(SP 6)、神门(BL 62)、照海(KI 6)、心俞(BL 15)、肾俞(BL 23),针刺得气后接电针仪,选用疏密波,频率 2/150 Hz,强度以患者耐受为度,每日治疗 1 次,每周治疗 5 次。西药组口服劳拉西泮片,0.5~1 mg/次,每日 1 次。两组均连续治疗 4 周。观察两组患者治疗前后的斯特鲁普色词测验(SCWT)指标[反应时(card A、B、C)、正确数及色词干扰效应(Stroop interference effect,SIE)]、睡眠结构指标[总睡眠时间(total sleep time,TST)、睡眠潜伏期(sleep latency,SL)、觉醒后入睡时间(wake after sleep onset,WASO)、睡眠效率(sleep efficiency,SE)、非快速眼动睡眠 1 期(non-rapid eye movement period 1,N1)、非快速眼动睡眠 2 期(non-rapid eye movement period 2,N2)、非快速眼动睡眠 3 期(non-rapid eye movement period 3,N3)、快速眼动睡眠期(rapid eye movement period,REM)]和匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)评分。

结果

与治疗前比较,两组治疗后卡 B、C 反应时、SIE 反应时和正确数,SL、WASO、N1、N2 时间及 PSQI 各维度评分和总分均降低(P<0.05,P<0.01),卡 A、B、C 正确数,TST、SE、N3 时间和 REM 时间均增加(P<0.01);与治疗前比较,西药组治疗后卡 C 反应时和 SIE 正确数,卡 A 反应时和 SIE 正确数,TST、SE、REM 时间均增加(P<0.05,P<0.01),SL、WASO、N1、N2 时间和 PSQI 各维度评分和总分均降低(P<0.01)。治疗后,针刺组卡 C 反应时、SIE 反应时和正确数,N1、N2 时间,PSQI 各维度评分和总分均低于西药组(P<0.01),卡 B、C 正确数,N3、REM 时间均高于西药组(P<0.01)。

结论

针刺“滋阴潜阳”法可改善心肾不交型慢性失眠患者的执行功能,调整睡眠结构,提高夜间睡眠质量和日间躯体功能。

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