“调卫健脑”法针刺治疗缺血性脑卒中后失眠：随机对照试验

张润; 陈新旺; 王孟雨; 褚文明; 武莉华; 高静; 刘培东; 史册; 刘力圆; 李炳臻; 姬苗苗; 和亚勇

doi:10.13703/j.0255-2930.20240417-k0006

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“调卫健脑”法针刺治疗缺血性脑卒中后失眠：随机对照试验

临床研究 | 更新时间：2025-10-11

- “调卫健脑”法针刺治疗缺血性脑卒中后失眠：随机对照试验
- Tiaowei Jiannao acupuncture for post-ischemic stroke insomnia: a randomized controlled trial
- 中国针灸 2025年45卷第10期页码：1405-1413
- 作者机构：
  
  河南中医药大学针灸推拿学院，郑州　450046
  河南中医药大学第一附属医院康复医学院，郑州　450046
  河南中医药大学第一附属医院康复科
- 作者简介：
  
  张润，河南中医药大学硕士研究生。E-mail：aurora19950901@163.com
  ✉陈新旺，副教授。E-mail：cxw23161@126.com
- 基金信息：
  
  国家自然基金青年基金项目(82305417);河南省特色骨干学科中医学学科建设项目(STG-ZYX02-202111);2023年河南省“双一流”创建学科中医学科学研究专项(HSRP-DFCTCM-T-10)
- DOI：10.13703/j.0255-2930.20240417-k0006
  中图分类号：
- 收稿：2024-04-17，
  
  修回：2025-08-16，
  
  网络首发：2025-08-19，
  
  纸质出版：2025-10-12
- 稿件说明：
移动端阅览
张润, 陈新旺, 王孟雨, 等. “调卫健脑”法针刺治疗缺血性脑卒中后失眠：随机对照试验[J]. 中国针灸, 2025,45(10):1405-1413.

ZHANG Run, CHEN Xinwang, WANG Mengyu, et al. Tiaowei Jiannao acupuncture for post-ischemic stroke insomnia: a randomized controlled trial[J]. Chinese Acupuncture & Moxibustion, 2025, 45(10): 1405-1413. DOI: 10.13703/j.0255-2930.20240417-k0006.
张润, 陈新旺, 王孟雨, 等. “调卫健脑”法针刺治疗缺血性脑卒中后失眠：随机对照试验[J]. 中国针灸, 2025,45(10):1405-1413. DOI： 10.13703/j.0255-2930.20240417-k0006.

ZHANG Run, CHEN Xinwang, WANG Mengyu, et al. Tiaowei Jiannao acupuncture for post-ischemic stroke insomnia: a randomized controlled trial[J]. Chinese Acupuncture & Moxibustion, 2025, 45(10): 1405-1413. DOI: 10.13703/j.0255-2930.20240417-k0006. DOI：

摘要

目的：

观察“调卫健脑”法针刺治疗缺血性脑卒中后失眠（PISI）的临床疗效和安全性。

方法：

将96例PISI患者随机分为针刺组（32例，剔除1例）、药物组（32例，脱落1例，剔除1例）和假针刺组（32例，脱落1例，剔除1例）。针刺组予“调卫健脑”法针刺，穴取双侧申脉、照海、合谷、太冲及百会、四神聪、印堂、神庭，每日1次，治疗6 d后休息1 d，共治疗3周；药物组予右佐匹克隆片口服，每次1~3 mg，每天1次，连续服用3周；假针刺组予非侵入式假针刺，取穴、治疗频次和疗程与针刺组相同。分别于治疗前及治疗2、3周后观察3组患者匹兹堡睡眠质量指数（PSQI）、睡眠状况自评量表（SRSS）、美国国立卫生研究院卒中量表（NIHSS）和汉密尔顿抑郁量表-17（HAMD-17）评分，于治疗前后采用多导睡眠监测图（PSG）记录患者睡眠参数，并在治疗后评价3组临床疗效和安全性。

结果：

治疗2、3周后，针刺组、药物组患者PSQI、HAMD-17、SRSS评分和假针刺组患者SRSS评分低于治疗前（

0.05）；治疗

2周后，针刺组患者NIHSS评分低于治疗前（

0.05）；治疗3周后，针刺组、药物组和假针刺组患者NIHSS评分低于治疗前（

0.05）。治疗3周后，针刺组、药物组患者PSQI、SRSS、HAMD-17、NIHSS评分和假针刺组患者NIHSS评分低于治疗2周后（

0.05）。治疗2、3周后，针刺组、药物组患者PSQI、SRSS、HAMD-17评分低于假针刺组（

0.05），针刺组患者NIHSS评分低于药物组和假针刺组（

0.05）；治疗3周后，针刺组患者HAMD-17评分低于药物组（

0.05），药物组患者NIHSS评分低于假针刺组（

0.05）。与治疗前比较，治疗后针刺组、药物组患者睡眠总时间延长（

0.05），入睡后清醒时间、睡眠潜伏期及非快速眼动睡眠潜伏期缩短（

0.05），睡眠效率提高（

0.05），觉醒次数减少（

0.05），快速眼动睡眠百分比（REM%）、非快速眼动睡眠第1期百分比（N1%）降低（

0.05），非快速眼动睡眠第2期百分比（N2%）、非快速眼动睡眠第3期百分比（N3%）升高（

0.05）；假针刺组患者睡眠潜伏期缩短（

0.05）。治疗后，针刺组、药物组患者PSG各项指标均优于假针刺组（

0.05）；针刺组患者觉醒次数少于药物组（

0.05），REM%、N1%低于药物组（

0.05），N2%、N3%高于药物组（

0.05）。针刺组总有效率为93.5%（29/31），药物组总有效率为90.0%（27/30），均高于假针刺组的10.0%（3/30，

0.05）；3组均未出现严重不良事件。

结论：

“调卫健脑”法针刺可改善缺血性脑卒中患者失眠症状，提高睡眠质量，增加深度睡眠，促进神经功能恢复，改善抑郁情绪，用于治疗PISI有效且安全。

Abstract

Objective

To observe the efficacy and safety of

Tiaowei Jiannao

acupuncture (acupuncture for regulating defensive

and nourishing brain) for post-ischemic stroke insomnia (PISI).

Methods

A total of 96 patients with PISI were randomized into an acupuncture group (32 cases

1 case was excluded)

a medication group (32 cases

1 case dropped out

1 case was excluded) and a sham-acupuncture group (32 cases

1 case dropped out

1 case was excluded). In the acupuncture group

Tiaowei Jiannao

acupuncture was applied at bilateral Shenmai (BL62)

Zhaohai (KI6)

Hegu (LI4)

Taichong (LR3)

and Baihui (GV20)

Sishencong (EX-HN1)

Yintang (GV24

)

Shenting (GV24)

once a day

1-day interv

al was taken after 6-day treatment

for 3 weeks totally. In the medication group

eszopiclone tablet was given orally

1-3 mg a time

once a day for 3 weeks. In the sham-acupuncture group

non-invasive sham acupuncture was applied

the acupoint selection

frequency and course of treatment were the same as the acupuncture group. Before treatment

after 2

3 weeks of treatment

the scores of Pittsburgh sleep quality index (PSQI)

self-rating sleep scale (SRSS)

National Institutes of Health Stroke scale (NIHSS)

Hamilton depression scale-17 (HAMD-17) were observed; before and after treatment

the sleep parameters were recorded using polysomnography (PSG); and the efficacy and safety were evaluated after treatment in the 3 groups.

Results

After 2

3 weeks of treatment

the scores of PSQI

HAMD-17 and SRSS in the acupuncture group and the medication group

as well as the SRSS scores in the sham-acupuncture group were decreased compared with those before treatment (

0.05); after 2 weeks of treatment

the NIHSS score in the acupuncture group was decreased compared with that before treatment (

0.05); after 3 weeks of treatment

the NIHSS scores in the acupuncture group

the medication group and the sham-acupuncture group were decreased compared with those before treatment (

0.05). After 3 weeks of treatment

the scores of PSQI

SRSS

HAMD-17 and NIHSS in the acupuncture group and the medication group

as well as the NIHSS score in the sham-acupuncture group were decreased compared with those after 2 weeks of treatment (

0.05). After 2

3 weeks of treatment

the scores of PSQI

SRSS and HAMD-17 in the acupuncture group and the medication group were lower than those in the sham-acupuncture group (

0.05)

the NIHSS scores in the acupuncture group were lower than those in the medication group and the sham-acupuncture group (

0.05); after 3 weeks of treatment

HAMD-17 score

in the acupuncture group was lower than that in the medication group (

0.05)

the NIHSS score in the medication group was lower than that in the sham-acupuncture group (

0.05). Compared before treatment

after treatment

the total sleep time was prolonged (

0.05)

the wake after sleep onset

sleep latency

and non-rapid eye movement (NREM) sleep latency were shortened (

0.05)

the sleep efficiency was improved (

0.05)

the number of awakenings was reduced (

0.05)

the percentage of rapid eye movement (REM%) and the percentage of NREM stage 1 (N1%) were decreased (

0.05)

the percentage of NREM stage 2 (N2%) and the percentage of NREM stage 3 (N3%) were increased (

0.05) in the acupuncture group and the medication group; the sleep latency was shortened in the sham-acupuncture group (

0.05). After treatment

the PSG indexes in the acupuncture group and the medication group were superior to those in the sham-acupuncture group (

0.05); in the acupuncture group

the number of awakenings was less than that in the medication group (

0.05)

the REM% and N1% were lower than those in the medication group (

0.05)

the N2% and N3% were higher than those in the medication group (

0.05). The total effective rate were 93.5% (29/31) and 90.0% (27/30) in the acupuncture group and the medication group respectively

which were higher than 10.0% (3/30) in the sham-acupuncture group (

0.05). There was no serious adverse events in any of the 3 groups.

Conclusion

Tiaowei Jiannao

acupuncture improves the insomnia symptoms in patients with ischemic stroke

improves the quality of sleep

increases the deep sleep

promotes the recovery of neurological function

and relieves the depression. It is effecti

ve and safe for the treatment of PISI.

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