贺氏三通针法通过调节神经递质表达与脑血流治疗卒中后失眠的临床研究OA
Clinical Study on He's Three-Unblocking Acupuncture in Treatment of PSI by Regulating Neurotransmitter Expression and Cerebral Blood Flow
目的:基于神经递质表达与脑血流变化机制研究贺氏三通针法治疗卒中后失眠(PSI)的临床效果.方法:纳入2022 年1 月—2024 年12 月于上海市养志康复医院中医科就诊的PSI患者152 例,按照抽签法随机分为对照组与针刺组,每组76 例.对照组予以常规米氮平片治疗,针刺组予以米氮平+贺氏三通针法针刺治疗.比较不同治疗方法对两组患者睡眠质量[失眠严重指数量表(ISI)、匹兹堡睡眠质量指数(PSQI)]、脑血流动力学指标[平均血流速(Vm)、阻力指数(RI)和收缩期血流速度(Vs)]、神经递质表达[5-羟色胺(5-HT)、多巴胺(DA)、神经肽Y(NPY)和去甲肾上腺素(NE)]及生活质量的影响差异.结果:治疗后,两组患者ISI、PSQI、中医症状得分均下降,且针刺组低于对照组,生活质量评分均增高,针刺组高于对照组,且针刺组米氮平停药时间早于对照组,差异具有统计学意义(P<0.05).治疗后,两组患者睡眠潜伏期与觉醒时间明显缩短,针刺组短于对照组,睡眠总时间与睡眠效率明显提高,针刺组高于对照组,差异具有统计学意义(P<0.05).治疗后,两组Vm与Vs速度以及5-HT、DA与NPY指标表达水平均增高,针刺组高于对照组,RI与NE表达水平均下降,针刺组低于对照组,差异具有统计学意义(P<0.05).针刺组总有效率为93.42%(71/76),高于对照组的78.95%(60/76),差异具有统计学意义(P<0.05),不良反应率比较,差异无统计学意义(P>0.05).结论:贺氏三通针法针刺治疗能够改善PSI患者失眠症状,改善患者脑血流速度,调控神经递质表达,提高患者生活质量,安全可靠.
Objective:To investigate the clinical effects of HE's three-unblocking acupuncture in treatment of post-stroke insomnia(PSI)based on the mechanisms of neurotransmitter expression and cerebral blood flow changes.Methods:A total of 152 patients with PSI were randomly assigned into the control group and the acupuncture group by lottery,with 76 patients in each group.The control group was treated with Mirtazapine Tablet;on which basis,the acupuncture group was also treated with HE's three-unblocking acupuncture.Differences between the two groups were compared in terms of sleep quality(ISI,PSQI),cerebral hemodynamic parameters(Vm,RI,Vs),neurotransmitter expressions(5-HT,DA,NPY,NE),and quality of life.Results:The scores of ISI,PSQI,and TCM symptoms decreased in both groups after the treatment compared with baseline,with greater reductions observed in the acupuncture group(P<0.05).The scores of life quality increased in both groups,with the acupuncture group showing higher scores than the control group(P<0.05).Moreover,the acupuncture group discontinued Mirtazapine Tablet earlier than the control group(P<0.05).Both groups exhibited significantly shorter sleep latency and wake time,with the acupuncture group showing shorter durations than the control group(P<0.05).Total sleep time and sleep efficiency increased in both groups,with higher values observed in the acupuncture group(P<0.05).Cerebral hemodynamic parameters Vm and Vs,as well as neurotransmitter levels of 5-HT,DA,and NPY,were increased in both groups after the treatment,with higher values in the acupuncture group(P<0.05).The levels of RI and NE decreased in both groups,with lower values in the acupuncture group(P<0.05).The overall effective rate was 93.42%(71/76)in the acupuncture group,which was higher than 78.95%(60/76)in the control group(P<0.05).There was no statistical difference in adverse reaction rate between the two groups(P>0.05).Conclusion:HE's three-unblocking acupuncture can effectively improve insomnia symptoms in patients with PSI,enhance cerebral blood flow velocity,regulate neurotransmitter expression,and improve quality of life.The therapy is safe and reliable.
郁侃迪;陈昌乐;秦雯;孙婷婷
上海中医药大学,上海 201203上海中医药大学,上海 201203上海市养志康复医院 上海市阳光康复中心,上海 201613上海市养志康复医院 上海市阳光康复中心,上海 201613
医药卫生
脑卒中失眠睡眠质量贺氏三通针法针刺疗法神经功能脑血流动力学
StrokeInsomniaSleep qualityHE's three-unblocking acupunctureAcupuncture therapyNeurological functionCerebral hemodynamics
《针灸临床杂志》 2026 (4)
36-42,7
上海市养志康复医院(上海市阳光康复中心)同济大学附属养志康复医院阳光临床研究培育项目,编号:2024CRTS047.
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