腹针联合头针治疗围绝经期失眠疗效及其机制探讨

Investigate of effect in abdominal acupuncture combined with scalp acupuncture on perimenopausal insomnia and its mechanism

关键词:  围绝经期失眠  腹针  头针  多导睡眠图  雌激素  单胺类神经递质

Key words:  perimenopausal insomnia  abdominal acupuncture  scalp acupuncture  polysomnography  estrogen  monoamine neurotransmitter

摘要:

[目的] 探讨腹针联合头针治疗围绝经期失眠（PMI）疗效。[方法] 将90例PMI患者按照随机数字表法随机分为两组，每组45例，对照组应用艾司唑仑片、谷维素片口服治疗；治疗组应用腹针联合头针治疗，疗程均为8周。比较两组治疗前后匹兹堡睡眠质量指数（PSQI）评分、爱泼沃斯嗜睡量表（ESS）评分和改良Kupperman（KMI）评分；并比较两组多导睡眠图（PSG）检测指标和血清雌二醇（E2）、促卵泡激素（FSH）、黄体生成素（LH）；化学发光法测定血清5-羟色胺（5-HT）、去甲肾上腺素（NE）水平。[结果] 治疗后治疗组PSQI、ESS、KMI评分均低于对照组（P<0.01），睡眠总时间（TST）、睡眠维持率（SE）多于对照组（P<0.01）；觉醒时间（AWT）、觉醒次数（AT）、睡眠潜伏期（SL）均少于对照组（P<0.01）；慢波睡眠（NREM）的S1、S2低于对照组（P<0.05或P<0.01），S3+4、快波睡眠（REM）高于对照组（P<0.05或P<0.01）；血清E2、5-HT水平高于对照组（P<0.01）；FSH、LH、NE水平均低于对照组（P<0.01），差异均有统计学意义。[结论] 腹针联合头针治疗可改善PMI患者的睡眠进程，提高睡眠质量，其机制可能与调节雌激素的分泌，增加5-HT的合成和分泌，抑制了NE释放有关。

Abstract:

[Objective] To investigate the effect of abdominal acupuncture combined with scalp acupuncture on perimenopausal insomnia (PMI). [Methods] The 90 patients with PMI were divided into two groups according to the random number table method, with 45 cases in each group. The control group were treated with estazolam tablets and oryzanol tablets orally for 8 weeks. The treatment group were treated with abdominal acupuncture combined with scalp acupuncture for 8 weeks. Pittsburgh sleep quality index (PSQI), Epworth Sleepiness Scale (ESS) and modified Kupperman (KMI) scores were compared between two groups before and after treatment, and the polysomnography (PSG) test indexes and serum estradiol (E2), follicle stimulating hormone (FSH), luteinizing hormone (LH) were compared between two groups. Serum 5-hydroxytryptamine (5-HT) and noradrenaline (NE) were determinedby chemilumin escence method. [Results] PSQI, ESS and KMI scores of the treatment group were lower than those of the control group after treatment(P<0.01), and total sleep time (TST), sleep maintenance rate (SE) were higher than those of the control group (P<0.01).Wake time (AWT), wake times (AT), sleep latency (SL) were lower than those of the control group (P<0.01). S1 and S2 of slow wave sleep (NREM) were lower than those of the control group (P<0.05 or P<0.01), and S3 + 4, fast wave Sleep (REM) was higher than the control group (P<0.05 or P<0.01). Serum E2, 5-HT in the treatment group were higher than that in the control group (P<0.01), FSH, LH, NE in the treatment group were lower than that in the control group(P<0.01).The difference was statistically significant. [Conclusion] Abdominal acupuncture combined with scalp acupuncture can improve the sleep process and sleep quality of PMI patients. The mechanism may be related to the regulation of estrogen secretion, the increase of 5-HT synthesis and secretion, and the inhibition of NE release.