通督调神联合补阴泻阳法针刺治疗卒中后失眠的疗效观察OA

Objective To observe the efficacy difference between the combined use of Tong Du Tiao Shen and Bu Yin Xie Yang needling methods and the use of Tong Du Tiao Shen needling method alone in treating poststroke insomnia(PSI).Method Sixty PSI patients were allocated to two groups(an observation group and a control group)using the random number table method,with 30 cases in each group.Both groups received basic treatment.In addition,the control group received Tong Du Tiao Shen acupuncture treatment,and the observation group received Bu Yin Xie Yang acupuncture treatment based on the control group's intervention.The two groups were observed before and after intervention for changes in the Pittsburgh sleep quality index(PSQI),Athens insomnia scale(AIS)score,insomnia severity index(ISI),patient health questionnaire-9(PHQ-9)score,Hamilton anxiety scale(HAMA)score,polysomnography(PSG)variables(total sleep time,sleep latency,number of awakenings,and sleep efficiency),and serum levels of orexin-A(OXA),adenosine,and neuropeptide Y(NPY).The clinical efficacy and adverse reactions were also compared between the two groups.Result After treatment,the PSQI,AIS,PHQ-9,and HAMA scores all decreased in the two groups(P＜0.05)and were lower in the observation group than in the control group(P＜0.05);the total sleep time and sleep efficiency increased in both groups(P＜0.05)and were higher in the observation group than in the control group(P＜0.05);the sleep latency and number of awakenings were reduced in the two groups(P＜0.05)and were shorter or smaller in the observation group than in the control group(P＜0.05);both groups demonstrated a decreased OXA level after treatment(P＜0.05),and the observation group was lower than the control group(P＜0.05);the levels of adenosine and NPY increased after treatment in both groups(P＜0.05)and were higher in the observation group than in the control group(P＜0.05).There were no significant differences in the total effective rate and adverse reaction rate between the two groups(P＞0.05).Conclusion Based on the basic treatment,either the combined use of Tong Du Tiao Shen and Bu Yin Xie Yang needling or the use of Tong Du Tiao Shen needling alone can improve sleep quality and alleviate anxiety and depression in patients with PSI;the combined acupuncture method produced more pronounced efficacy,which may be associated with downregulating the level of OXA and upregulating the levels of adenosine and NPY in the serum.