泻南补北法针刺对心肾不交型慢性失眠障碍患者执行功能及睡眠结构的影响

刘义; 冯慧; 余正和; 周传龙; 陈广烈; 韦又丹

doi:10.13703/j.0255-2930.20230501-k0004

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泻南补北法针刺对心肾不交型慢性失眠障碍患者执行功能及睡眠结构的影响

临床研究 | 更新时间：2024-06-03

- 泻南补北法针刺对心肾不交型慢性失眠障碍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
- 中国针灸 2024年44卷第4期页码：384-388
- 作者机构：
  
  1.浙江大学医学院附属精神卫生中心/杭州市第七人民医院心身科，杭州310013
  2.杭州市红十字会医院消化科
  3.浙江中医药大学附属第三医院针灸科/浙江中医药大学第三临床医学院针灸教研室
- 作者简介：
  
  刘义，副主任中医师。E-mail：passexamliuyi@163.com
- 基金信息：
  
  浙江省中医药科技计划项目(2022ZB291);2017ZA115
- DOI：10.13703/j.0255-2930.20230501-k0004
  中图分类号：
- 收稿：2023-05-01，
  
  纸质出版：2024-04-12
- 稿件说明：
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刘义,冯慧,余正和,等.泻南补北法针刺对心肾不交型慢性失眠障碍患者执行功能及睡眠结构的影响[J].中国针灸,2024,44(4):384-388.

LIU Yi,FENG Hui,YU Zhenghe,et al.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[J].Chinese Acupuncture & Moxibustion,2024,44(04):384-388.
刘义,冯慧,余正和,等.泻南补北法针刺对心肾不交型慢性失眠障碍患者执行功能及睡眠结构的影响[J].中国针灸,2024,44(4):384-388. DOI： 10.13703/j.0255-2930.20230501-k0004.

LIU Yi,FENG Hui,YU Zhenghe,et al.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[J].Chinese Acupuncture & Moxibustion,2024,44(04):384-388. DOI： 10.13703/j.0255-2930.20230501-k0004.

摘要

目的

观察泻南补北法针刺对心肾不交型慢性失眠障碍患者执行功能、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障碍患者随机分为针刺组（50例，脱落1例）和西药组（50例，脱落2例）。针刺组施泻南补北法针刺（穴取百会及双侧神门、三阴交、申脉、照海、心俞、肾俞，每日1次，每周5 d），西药组予口服劳拉西泮片（每次0.5~1 mg，每日1次），两组均治疗4周。分别于治疗前后观察两组患者Stroop色词测验（SCWT）指标［卡片A、B、C耗时数和正确数，Stroop干扰量（SIE）耗时数和正确数］、睡眠结构指标［总睡眠时间（TST）、睡眠潜伏期（SL）、入睡后清醒时间（WASO）、睡眠效率（SE）、非快速眼球运动1期（N1）、非快速眼球运动2期（N2）、非快速眼球运动3期（N3）、快速眼球运动期（REM）］及匹兹堡睡眠质量指数（PSQI）评分。

结果

治疗后，针刺组卡片B耗时数、卡片C耗时数、SIE耗时数、SIE正确数、SL、WASO、N1、N2、PSQI各项评分及总分较治疗前减少（

0.05，

0.01），卡片A正确数、卡片B正确数、卡片C正确数、TST、SE、N3、REM较治疗前增加（

0.01）；西药组卡片C耗时数、SIE耗时数、卡片A正确数、SIE正确数、TST、SE、REM较治疗前增加（

0.05，

0.01），SL、WASO、N1较治疗前减少（

0.01），PSQI睡眠质量、入睡时间、睡眠时间、睡眠效率、日间功能评分及总分较治疗前减少（

0.01）。治疗后，针刺组卡片C耗时数、SIE耗时数、SIE正确数、N1、N2低于西药组（

0.01），PSQI睡眠质量、睡眠障碍、日间功能评分及总分低于西药组（

0.01），卡片B正确数、卡片C正确数、N3、REM高于西药组（

0.01）。

结论

泻南补北法针刺可改善心肾不交型慢性失眠障碍患者的执行功能，调节其睡眠结构，并提高其夜间睡眠质量、日间机体功能。

Abstract

Objective

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

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

WASO

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

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

REM were increased (

0.05，

0.01)

WASO

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

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

REM were higher than those in the western medication group (

0.01).

Conclusion

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.

关键词

Keywords

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