疏肝调神针法联合耳穴揿针在腰椎间盘术前焦虑患者情绪与睡眠改善中的应用

Liver-smoothing and spirit-regulating acupuncture combined with auricular snap acupuncture in improving mood and sleep in patients with preoperative lumbar disc anxiety

关键词:  腰椎间盘突出症  疏肝调神针法  耳穴揿针  术前焦虑  睡眠状态  神经内分泌  神经递质

Key words:  lumbar disc herniation  liver-smoothing and spirit-regulating acupuncture method  ear point press acupuncture  preoperative anxiety  sleep state  neuroendocrine  neurotransmitter

摘要:

[目的] 探讨疏肝调神针法联合耳穴揿针对腰椎间盘突出症术前焦虑患者不良情绪以及睡眠状态的影响。[方法] 选择2022年1月—2024年1月广州中医药大学东莞医院收治的120例拟行择期手术治疗的腰椎间盘突出症患者，随机数字表法将患者分为两组。对照组(60例)术前采用疏肝调神针法治疗，观察组(60例)术前采用疏肝调神针法联合耳穴揿针治疗。观察两组焦虑状态、睡眠质量以及神经递质、神经内分泌指标。[结果] 两组治疗后焦虑自评量表(SAS)、汉密尔顿焦虑量表(HAMA)、术前焦虑量表(PAS-7)、匹兹堡睡眠质量指数量表(PSQI)评分，血清促肾上腺皮质激素(ACTH)、皮质醇(CORT)、去甲肾上腺素(NE)水平较治疗前降低(P＜0.05)，血清5-羟色胺(5-HT)、5-羟基吲哚乙酸(5-HIAA)、γ-氨基丁酸(GABA)水平较治疗前增高(P＜0.05)。观察组治疗后SAS、HAMA、PAS-7、PSQI评分，血清ACTH、CORT、NE水平低于对照组(P＜0.05)，血清5-HT、5-HIAA、GABA水平高于对照组(P＜0.05)。[结论] 疏肝调神针法联合耳穴揿针可有效调节神经内分泌功能和神经递质平衡，缓解腰椎间盘突出症患者焦虑程度，改善睡眠质量。

Abstract:

[Objective] To investigate the effect of liver-smoothing and spirit-regulating acupuncture combined with the auricular point on the adverse mood and sleep status of patients with anxiety before lumbar disc herniation. [Methods] From January 2022 to January 2024,the 120 patients with lumbar disc herniation who were expected to undergo elective surgery were selected from,Dongguan Hospital,Guangzhou University of Chinese Medicine,and divided into two groups by random number table method. The control group(60 cases) was treated with liver-smoothing and spirit-regulating acupuncture before surgery,and the observation group(60 cases) was treated with liver-smoothing and spirit-regulating acupuncture combined with ear acupuncture. The anxiety state,sleep quality,neurotransmitter,and neuroendocrine indexes of the two groups were observed. [Results] The self-rating anxiety scale(SAS),hamilton anxiety scale(HAMA),preoperative anxiety scale(PAS-7),pittsburgh sleep quality index(PSQI) scores of the two groups,the serum levels of adrenocorticotropin(ACTH),cortisol(CORT) and noadrenaline(NE) were decreased compared with those before treatment(P<0.05),and the serum levels of 5-hydroxytryptamine(5-HT),5-hydroxy indole acetic acid(5-HIAA) and gamma-aminobutyric acid(GABA) were increased compared with those before treatment(P<0.05). After treatment,SAS,HAMA,PAS-7,PSQI scores,serum ACTH,CORT,and NE levels in the observation group were lower than those in the control group(P<0.05),serum 5-HT,5-HIAA,GABA levels were higher than those in the control group(P<0.05). [Conclusion] Liver-smoothing and spirit-regulating acupuncture combined with auricular acupuncture can effectively regulate neuroendocrine function and neurotransmitter balance,relieve anxiety,and improve sleep quality in patients with lumbar disc herniation.