标题：时空针刺飞腾八法治疗中风后睡眠障碍疗效观察

      作者：赵娟 1，2，黄霄汉 3    1.河南推拿职业学院针灸推拿系，河南 洛阳 471023；2.河南推拿职业学院附属医院针灸科，河南 洛阳 471003；3.河南省洛阳正骨医院(河南省骨科医院)膝关节科，河南 洛阳 471003

      卷次： 2024年35卷10期

      【摘要】 目的 探究时空针刺飞腾八法对中风后睡眠障碍患者睡眠质量及神经递质的影响。方法 选取2018年3月至2021年3月河南推拿职业学院附属医院和河南省洛阳正骨医院(河南省骨科医院)收治的86例中风后睡眠障碍患者作为研究对象，根据治疗方案的不同分为对照组和观察组，每组43例。对照组患者进行常规针刺，观察组患者采用时空针刺飞腾八法治疗，每日1次，连续针刺5 d后休息2 d，共治疗3周。比较两组患者的治疗效果，以及治疗前后的睡眠状况自评量表(SRSS)、匹茨堡睡眠质量指数量表(PSQI)、焦虑自评量表(SAS)及抑郁自评量表(SDS)的评分和脑神经递质水平，同时比较两组患者治疗期间的不良反应发生情况。结果 经过3周治疗，观察组患者的治疗总有效率为93.02%，明显高于对照组的76.74%，差异有统计学意义(P<0.05)；治疗前，两组患者的PSQI评分、SRSS评分和SAS评分比较差异均无统计学意义(P>0.05)；治疗后，两组患者的PSQI评分、SRSS评分和SAS评分较治疗前明显降低，且观察组患者治疗后的 PSQI、SRSS和 SAS评分分别为(4.16±1.03)分、(5.69±1.16)分和(42.03±12.02)分，明显低于对照组的(9.76±2.07)分、(16.79±2.41)分和(47.71±13.45)分，差异均有统计学意义(P<0.05)；治疗前，两组患者的γ-氨基丁酸(GABA)、5-羟色胺(5-HT)、乙酰胆碱(Ach)和谷氨酸(Glu)水平比较差异均无统计学意义(P>0.05)；治疗后，两组患者的GABA和 5-HT水平较治疗前明显升高，且观察组患者治疗后的GABA和5-HT水平分别为(5.54±1.26) mHz和(12.06±2.14) mHz，明显高于对照组的(4.86±1.12) mHz和(10.43±2.03) mHz，差异均有统计学意义(P<0.05)，而观察组患者治疗后的Ach和Glu水平分别为(13.83±3.15) mHz和(6.93±2.16) mHz，与对照组的(13.63±1.53) mHz和(6.31±1.72) mHz比较差异均无统计学意义(P>0.05)；观察组患者治疗期间出现针刺后出血2例，对照组1例，经局部按摩及按压针孔等处理后好转，两组患者治疗期间均未发生感染、晕针、过敏等严重不良反应。结论 时空针刺飞腾八法可通过改善GABA、5-HT神经递质水平进而改善中风后睡眠障碍患者的睡眠质量，提高患者生存质量。
      【关键词】 中风后睡眠障碍；时空针刺飞腾八法；神经递质；睡眠质量
      【中图分类号】 R743.3 【文献标识码】 A 【文章编号】 1003—6350（2024）10—1406—05

Efficacy of spatiotemporal acupuncture with Feiteng eight methods in the treatment of post-stroke sleepdisorders.
ZHAO Juan 1, 2, HUANG Xiao-han 3. 1. Department of Acupuncture and Moxibustion Massage, Henan Vocational Collegeof Tuina, Luoyang 471023, Henan, CHINA; 2. Department of Acupuncture and Moxibustion, the Affiliated Hospital of HenanVocational College of Tuina, Luoyang 471003, Henan, CHINA; 3. Department of Knee Joint, Luoyang Orthopedic-TraumatologicalHospital of Henan Province (Henan Provincial Orthopedic Hospital), Luoyang 471003, Henan, CHINA
【Abstract】 Objective To explore the effect of spatiotemporal acupuncture with Feiteng eight methods on sleepquality and neurotransmitters in patients with post-stroke sleep disorders. Methods Eighty-six patients with post-strokesleep disorders admitted to the Affiliated Hospital of Henan Vocational College of Tuina and Orthopedic-Traumatologi-cal Hospital of Henan Province from March 2018 to March 2021 were selected as the study subjects. They were dividedinto a control group and an observation group based on different treatment plans, with 43 cases in each group. Patients inthe control group were treated with routine acupuncture, while those in the observation group were treated with spatio-temporal acupuncture with Feiteng eight methods, once a day, for 3 weeks (continuous acupuncture for 5 days, with a in-terval of 2 days). The treatment outcomes were compared between the two groups of patients, as well as the scores of theSelf Rating Sleep Scale (SRSS), Pittsburgh Sleep Quality Index (PSQI), Self-rating Anxiety Scale (SAS), Self-rating De-pression Scale (SDS) before and after treatment, and the levels of brain neurotransmitters and adverse reactions duringtreatment. Results After 3 weeks of treatment, the total effective rate of the observation group was 93.02%, significant-ly higher than the control group's 76.74% (P<0.05). Before treatment, there was no statistically significant difference inPSQI, SRSS, and SAS scores between the two groups (P>0.05). After treatment, the PSQI, SRSS, and SAS scores of thetwo groups of patients were significantly reduced compared to those before treatment, and the scores of the observationgroup after treatment were (4.16±1.03) points, (5.69±1.16) points, and (42.03±12.02) points, respectively, significantlylower than the control group's (9.76±2.07) points, (16.79±2.41) points, and (47.71±13.45) points, with statistically signif-icant differences (P<0.05). Before treatment, the two groups of patients showed no statistically significant difference inthe levels of γ-aminobutyric acid (GABA), 5-hydroxytryptamine (5-HT), acetylcholine (Ach), and glutamate (Glu), P>0.05. After treatment, the levels of γ-GABA and 5-HT of the two groups increased significantly compared with thosebefore treatment, and the levels in the observation group were (5.54±1.26) mHz and (12.06±2.14) mHz, respectively, sig-nificantly higher than the control group's (4.86±1.12) mHz and (10.43±2.03) mHz, with statistically significant differences(P<0.05); the levels of Ach and Glu in the observation group after treatment were (13.83±3.15) mHz and (6.93±2.16) mHz,respectively, and there was no statistically significant difference compared to the control group's (13.63±1.53) mHz and(6.31±1.72) mHz, with statistically significant differences (P>0.05). During the treatment period, 2 patients in the obser-vation group and 1 patient in the control group experienced bleeding after acupuncture, who were improved after localmassage and needle hole pressing. Both groups of patients did not experience serious adverse reactions such as infection,dizziness, or allergies. Conclusion The spatiotemporal acupuncture with Feiteng eight methods can improve the sleepquality of patients with post-stroke sleep disorders and enhance their quality of life by improving the levels of GABAand 5-HT neurotransmitters.
      【Key words】 Post-stroke sleep disorders; Spatiotemporal acupuncture with Feiteng eight methods; Neurotrans-mitter; Sleep quality