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督脉灸、耳针与阿普唑仑联合治疗对冠心病伴失眠患者心功能及神经递质水平的影响:一项观察性研究。

Effects of integrative therapy with Du Meridian moxibustion, ear acupuncture, and alprazolam on cardiac function and neurotransmitter levels in patients with coronary heart disease and insomnia: An observational study.

机构信息

Shanghai Pudong New Area Hospital of Chinese Traditional Medicine/Non Drug Therapy Center, Shanghai, China.

Rehabilitation Department, Shanghai Pudong New Area Dongming Community Health Service Center, Shanghai, China.

出版信息

Medicine (Baltimore). 2024 Aug 23;103(34):e39318. doi: 10.1097/MD.0000000000039318.

Abstract

To explore the effects of Du Meridian moxibustion combined with ear acupuncture on clinical symptoms and serum neurotransmitters in patients with coronary heart disease and insomnia. This study is a retrospective study. From June 2021 to May 2023, 116 patients with coronary heart disease and insomnia treated at our hospital were selected as subjects. They were divided into 2 groups according to the treatment. The control group received treatment with alprazolam, while the experimental group received Du Meridian moxibustion combined with ear acupuncture in addition to alprazolam treatment. The efficacy of the 2 groups was compared, and the levels of cardiac function indicators, serum melatonin, leptin, and neurotransmitters were measured. The total effectiveness rate in the experimental group was 93.10% (with a cure rate of 36.21%, a significant improvement rate of 41.38%, and an effective rate of 15.52%), which was significantly higher than the 79.31% in the control group (with a cure rate of 24.14%, a significant improvement rate of 32.76%, and an effective rate of 22.41%) (P < .05). Both groups exhibited an increase in left ventricular ejection fraction, stroke volume, and cardiac output after treatment compared to before treatment. Additionally, left ventricular end-systolic diameter decreased after treatment compared to before treatment, but the cardiac function was compared between the 2 groups after treatment (P > .05). In both groups, serum melatonin and serotonin (5-HT) levels increased after treatment compared to before treatment, while serum leptin, dopamine, and glutamate levels decreased after treatment compared to before treatment. Furthermore, the experimental group had higher serum melatonin, 5-HT, and gamma-aminobutyric acid levels compared to the control group, and lower serum leptin, dopamine, and glutamate levels compared to the control group (P < .05). The serum traditional Chinese medicine syndrome score and Pittsburgh sleep quality index score of the 2 groups decreased after treatment, and the experimental group was lower than the conventional group (P < .05). The combination of Du Meridian acupuncture with ear acupuncture in the treatment of insomnia in coronary heart disease can regulate the expression of serum melatonin, leptin, and neurotransmitters, alleviate symptoms, and improve therapeutic efficacy.

摘要

探讨督脉灸联合耳针治疗冠心病伴失眠患者的临床疗效及对血清神经递质的影响。本研究为回顾性研究,选取 2021 年 6 月至 2023 年 5 月在我院就诊的冠心病伴失眠患者 116 例为研究对象,按照治疗方法分为 2 组,对照组采用阿普唑仑治疗,观察组在阿普唑仑治疗基础上加用督脉灸联合耳针治疗,比较 2 组的疗效,检测心脏功能指标、血清褪黑素、瘦素、神经递质水平。观察组总有效率为 93.10%(治愈率 36.21%,显效率 41.38%,有效率 15.52%),明显高于对照组的 79.31%(治愈率 24.14%,显效率 32.76%,有效率 22.41%)(P < .05)。2 组治疗后左心室射血分数、每搏输出量、心输出量均高于治疗前,左心室收缩末期内径低于治疗前,治疗后组间比较差异无统计学意义(P > .05)。2 组治疗后血清褪黑素、5-羟色胺(5-HT)水平较治疗前升高,血清瘦素、多巴胺、谷氨酸水平较治疗前降低,且观察组治疗后血清褪黑素、5-HT、γ-氨基丁酸水平高于对照组,血清瘦素、多巴胺、谷氨酸水平低于对照组(P < .05)。2 组治疗后中医证候积分、匹兹堡睡眠质量指数评分较治疗前降低,且观察组低于对照组(P < .05)。结论:督脉灸联合耳针治疗冠心病伴失眠能调节血清褪黑素、瘦素、神经递质的表达,改善症状,提高疗效。

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