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1.首都医科大学附属北京中医医院针灸中心,北京100010
2.清华大学第一附属医院中医科,北京100016
郭静,主任医师。E-mail:guojing_2002@163.com
收稿:2022-11-20,
网络首发:2023-06-15,
纸质出版:2023-09-12
移动端阅览
霍一珊,陈昭伊,尹雪娇等.调神法针刺治疗原发性失眠:随机对照预试验[J].中国针灸,2023,43(09):1008-1013.
HUO Yi-shan,CHEN Zhao-yi,YIN Xue-jiao,et al.Tiaoshen acupuncture for primary insomnia: a pilot randomized controlled trial[J].Chinese Acupuncture & Moxibustion,2023,43(09):1008-1013.
霍一珊,陈昭伊,尹雪娇等.调神法针刺治疗原发性失眠:随机对照预试验[J].中国针灸,2023,43(09):1008-1013. DOI: 10.13703/j.0255-2930.20221120-0001.
HUO Yi-shan,CHEN Zhao-yi,YIN Xue-jiao,et al.Tiaoshen acupuncture for primary insomnia: a pilot randomized controlled trial[J].Chinese Acupuncture & Moxibustion,2023,43(09):1008-1013. DOI: 10.13703/j.0255-2930.20221120-0001.
目的
2
观察调神法针刺对原发性失眠(PI)患者认知功能及睡眠质量的影响。
方法
2
将60例PI患者随机分为观察组(30例,脱落2例)和对照组(30例,脱落2例,剔除1例)。观察组于百会、神庭、四神聪,双侧本神、神门、内关、三阴交行针刺治疗;对照组于非效穴行浅刺治疗。均每次30 min,隔日1次,每周治疗3次,连续治疗4周。于治疗前后及随访期(治疗结束后4周)采用蒙特利尔认知评估量表(MoCA)、数字广度测验(DST)、连线测验(TMT)-A、匹兹堡睡眠质量指数(PSQI)、疲劳量表-14(FS-14)评定两组患者认知功能及睡眠质量。对观察组PSQI评分和MoCA总分治疗前后差值进行相关性分析。
结果
2
治疗后及随访期,观察组MoCA总分、视空间与执行功能评分、延迟回忆评分及DST-倒背评分较治疗前升高(
P
<
0.0
1),TMT-A时间较治疗前缩短(
P
<
0.01),PSQI、FS-14评分较治疗前降低(
P
<
0.01);对照组PSQI评分较治疗前降低(
P
<
0.01,
P
<
0.05)。治疗后及随访期,观察组MoCA总分、视空间与执行功能评分、延迟回忆评分及DST-倒背评分高于对照组(
P
<
0.05,
P
<
0.01),TMT-A时间短于对照组(
P
<
0.05,
P
<
0.01),PSQI、FS-14评分低于对照组(
P
<
0.01)。观察组PSQI评分差值(治疗后–治疗前)与MoCA总分差值(治疗后–治疗前)呈负相关(
r
=–0.481,
P
<
0.01); PSQI评分差值(随访–治疗前)与MoCA总分差值(随访–治疗前)呈负相关(
r
=–0.282,
P
<
0.05)。
结论
2
调神法针刺可提高PI患者认知功能,改善睡眠质量,缓解日间疲劳,PI患者认知功能提高与睡眠质量改善相关。
Objective
2
To observe the effects of
Tiaoshen
(regulating the spirit) acupuncture on cognitive function and sleep quality in patients with primary insomnia (PI).
Methods
2
Sixty patients with PI were randomly divided into an observation group (30 cases
2 cases dropped off) and a control group (30 cases
2 cases dropped off
1 case was excluded). The patients in the observation group were treated with acupuncture at Baihui (GV 20)
Shenting (GV 24)
Sishencong (EX-HN 1)
and bilateral Benshen (GB 13)
Shenmen (HT 7)
Neiguan (PC 6)
Sanyinjiao (SP 6). The patients in the control group were treated with shallow needling at non-effective points. Each treatment was provided for 30 min
once every other day
3 treatments per week for 4 weeks. The Montreal cognitive assessment (MoCA)
digit span test (DST)
trail making test (TMT)-A
Pittsburgh sleep quality index (PSQI)
and fatigue scale-14 (FS-14) were used to assess cognitive function and sleep quality before and after treatment
as well as in follow-up of 4-week after treatment completion. Correlation analysis was conducted between the differences in PSQI scores and differences in MoCA scores before and after treatment in the observation group.
Results
2
Compared with before treatment
the total score
visuospatial and executive function score and delayed memory score of MoCA as well as DST backward score were increased (
P
<
0.01)
while TMT-A time
PSQI and FS-14 scores were significantly reduced (
P
<
0.01) after treatment and in follow-up in the observation group. Compared with before treatment
the PSQI score in the control group was reduced (
P
<
0.01
P
<
0.05). After treatment and in follow-up
the observation group had significantly higher total score
visuospatial and executive function score
delayed memory score of MoCA
and DST backward score compared to the control group (
P
<
0.05
P
<
0.01). In the observation group
the TMT-A time was significantly shorter than that in the control group (
P
<
0.05
P
<
0.01)
and the PSQI and FS-14 scores were significantly lower than those in the control group (
P
<
0.01). In the observation group
there was a negative correlation between the difference in PSQI scores (post-treatment minus pre-treatment) and the difference in MoCA scores (post-treatment minus pre-treatment) (
r
=–0.481
P
<
0.01). A similar negative correlation was found between the difference in PSQI scores (follow-up minus pre-treatment) and the difference in MoCA scores (follow-up minus pre-treatment) (
r
=–0.282
P
<
0.05).
Conclusion
2
Tiaoshen
acupuncture could improve cognitive function
enhance sleep quality
and alleviate daytime fatigue in patients with PI. The improvement in cognitive function in patients with PI is correlated with the improvement in sleep quality.
中华医学会神经病学分会 , 中华医学会神经病学分会睡眠障碍学组 . 中国成人失眠诊断与治疗指南(2017版) [J ] . 中华神经科杂志 , 2018 , 51 ( 5 ): 324 - 335 .
American Psychiatric Association . Diagnostic and Statistical Manual of Mental Disorders [M ] . 4th Edition . Washington DC : American Psychiatric Press , 1999 : 240 - 241 .
Wardle-Pinkston S , Slavish DC , Taylor DJ . Insomnia and cognitive performance: a systematic review and meta-analysis [J ] . Sleep Med Rev , 2019 , 48 : 101205 .
Léger D , Bayon V , Ohayon MM , et al . Insomnia and accidents: cross-sectional study (EQUINOX) on sleep-related home, work and car accidents in 5293 subjects with insomnia from 10 countries [J ] . J Sleep Res , 2014 , 23 ( 2 ): 143 - 152 .
李焕芹 , 邹忆怀 , 郭静 , 等 . “周氏调神针刺法”治疗原发性失眠30例 [J ] . 环球中医药 , 2017 , 10 ( 7 ): 882 - 885 .
宣雅波 , 郭静 , 王麟鹏 , 等 . 针刺对原发性失眠患者睡眠质量的影响:随机对照研究 [J ] . 中国针灸 , 2007 , 27 ( 12 ): 886 - 888 .
Nasreddine ZS , Phillips NA , Bédirian V , et al . The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment [J ] . J Am Geriatr Soc , 2005 , 53 ( 4 ): 695 - 699 .
Lezak MD . Neuropsychological Assessment [M ] . 3rd Edition . New York : Oxford University Press , 1995 : 357 .
Partington JE , Leiter RG . Partington's pathways test [EB/OL ] . [ 2022-10-11 ] . https://doi.org/10.1037/t66320-000 https://doi.org/10.1037/t66320-000 .
Backhaus J , Junghanns K , Broocks A , et al . Test-retest reliability and validity of the Pittsburgh sleep quality index in primary insomnia [J ] . J Psychosom Res , 2002 , 53 ( 3 ): 737 - 740 .
Chalder T , Berelowitz G , Pawlikowska T , et al . Development of a fatigue scale [J ] . J Psychosom Res , 1993 , 37 ( 2 ): 147 - 153 .
Brinkhaus B , Hummelsberger J , Kohnen R , et al . Acupuncture and Chinese herbal medicine in the treatment of patients with seasonal allergic rhinitis: a randomized-controlled clinical trial [J ] . Allergy , 2004 , 59 ( 9 ): 953 - 960 .
Assefi NP , Sherman KJ , Jacobsen C , et al . A randomized clinical trial of acupuncture compared with sham acupuncture in fibromyalgia [J ] . Ann Intern Med , 2005 , 143 ( 1 ): 10 - 19 .
Chang CH , Huang JL , Ting CT , et al . Atropine-induced HRV alteration is not amended by electroacupuncture on Zusanli [J ] . Am J Chin Med , 2005 , 33 ( 2 ): 307 - 314 .
范清雨 , 杨新利 , 张桂莲 , 等 . 慢性失眠患者认知功能与睡眠质量、血清鸢尾素和脑源性神经营养因子水平的相关性研究 [J ] . 中国临床神经科学 , 2021 , 29 ( 4 ): 399 - 405 .
张轩 , 刘艳艳 , 郭丹 , 等 . 基于心肺耦合技术的慢性失眠患者客观睡眠评价及其与认知功能的相关性研究 [J ] . 中华神经医学杂志 , 2019 , 18 ( 7 ): 656 - 661 .
Guo H , Wei MJ , Ding WT . Changes in cognitive function in patients with primary insomnia [J ] . Shanghai Arch Psychiatry , 2017 , 29 ( 3 ): 137 - 145 .
Scullin MK , Bliwise DL . Sleep, cognition, and normal aging: integrating a half century of multidisciplinary research [J ] . Perspect Psychol Sci , 2015 , 10 ( 1 ): 97 - 137 .
刘慧林 , 夏淑文 , 周德安 . 周德安“针灸六治”理论及“周氏针灸要方”学术观点述要 [J ] . 北京中医药 , 2011 , 30 ( 9 ): 666 - 668 .
Pan Y , Luo J , Zhang HL . Study on the effect of acupuncture at Sishencong and Baihui on the serum amino acids neurotransmitters of insomnia patients [J ] . World J Acupunct-Moxibust , 2017 , 27 ( 1 ): 23 - 27 .
王盛春 , 姜一鸣 , 来丹丹 , 等 . 针刺神门及四神聪对150例原发性失眠患者多导睡眠图影响的临床观察 [J ] . 中华中医药杂志 , 2018 , 33 ( 7 ): 3203 - 3205 .
李佳 , 刘娇萍 . 针刺“神门”穴对睡眠剥夺大鼠脑电波及其认知能力的影响 [J ] . 针刺研究 , 2017 , 42 ( 6 ): 502 - 506 .
史玉泉 . 实用神经病学 [M ] . 2版 . 上海 : 上海科学技术出版社 , 1995 .
董兴辉 . 针刺内关穴对健康青年人脑电图变化的研究 [D ] . 哈尔滨 : 黑龙江中医药大学 , 2014 .
刘丽莎 , 董宝强 , 刘旭来 , 等 . 针刺三阴交、神门、内关对失眠大鼠下丘脑5-HT含量及Glu/GABA比值影响机制的探究 [J ] . 中华中医药学刊 , 2022 , 40 ( 3 ): 65 - 68 .
Thompson MD , Scott JG , Dickson SW , et al . Clinical utility of the Trail Making Test practice time [J ] . Clin Neuropsychol , 1999 , 13 ( 4 ): 450 - 455 .
陆骏超 , 郭起浩 , 洪震 , 等 . 连线测验(中文修订版)在早期识别阿尔茨海默病中的作用 [J ] . 中国临床心理学杂志 , 2006 , 14 ( 2 ): 118 - 120 .
Fang QQ , Wang XQ , Liu CY , et al . The efficacy of acupuncture on the sleep structure of patients with insomnia: a systematic review and meta-analysis [J ] . Anat Rec (Hoboken) , 2021 , 304 ( 11 ): 2412 - 2425 .
王晓秋 , 秦珊 , 吴文忠 , 等 . 电针治疗老年失眠症及对血清褪黑素和多巴胺的影响 [J ] . 中国针灸 , 2021 , 41 ( 5 ): 501 - 504 .
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