摘要
目的分析星状神经节阻滞联合阿普唑仑治疗脑卒中后睡眠障碍(PSSD)的临床效果。方法抽取2016年2月至2021年2月河南医学高等专科学校附属医院收治的PSSD患者76例,按随机数字表法分为联合组与单一组,每组38例。单一组采用阿普唑仑治疗,联合组采用星状神经节阻滞联合阿普唑仑治疗。比较两组疗效和治疗前后睡眠质量[睡眠状况自评量表(SRSS)、阿森斯失眠量表(AIS)评分]、睡眠多导图参数(睡眠潜伏期、睡眠总时间)、下丘脑-垂体-肾上腺素水平[促肾上腺皮质激素(ACTH)、皮质醇(Cor)]及单胺类神经递质因子水平[5-羟色胺(5-HT)、脑源性神经营养因子(BDNF)]。结果联合组总有效率(94.74%,36/38)高于对照组(76.32%,29/38),差异有统计学意义(P<0.05)。治疗后,两组SRSS、AIS评分均较治疗前降低,且联合组低于单一组,差异有统计学意义(P<0.05)。治疗后,两组睡眠潜伏期、睡眠总时间均较治疗前改善,且联合组睡眠潜伏期较单一组短,睡眠总时间较单一组长,差异有统计学意义(P<0.05)。治疗后,两组血清ACTH、Cor水平均较治疗前降低,且联合组低于单一组,差异有统计学意义(P<0.05)。治疗后,两组血清5-HT、BDNF水平均较治疗前增高,且联合组高于单一组,差异有统计学意义(P<0.05)。结论星状神经节阻滞联合阿普唑仑治疗PSSD效果显著,可调节下丘脑-垂体-肾上腺素水平和单胺类神经递质因子水平,改善睡眠多导图参数,提高睡眠质量,减轻睡眠障碍。
Objective To analyze the effect of stellate ganglion block combined with alprazolam in the treatment of post-stroke sleep disorders(PSSD).Methods A total of 76 patients with PSSD treated in the Affiliated Hospital of Henan Medical College from February 2016 to February 2021 were selected and divided into combined group(n=38)and single group(n=38)according to the random number table method.The single group was treated with alprazolam,and the combined group was treated with stellate ganglion block combined with alprazolam.The curative effect,sleep quality scores,including self-rating scale of sleep(SRSS),Athens insomnia scale(AIS),polysomnography parameters(sleep latency,total sleep time),hypothalamus pituitary adrenaline levels,including adrenocor ticotropic hormore(ACTH),cortisol(Cor),and monoamine neurotransmitter factor levels,including 5-hydroxytryptamine(5-HT),brain-derived neurotrophic factor(BDNF),before and after treatment were compared between the two groups.Results The total effective rate of the combined group(94.74%,36/38)was higher than that of the single group(76.32%,29/38),and the difference was statistically significant(P<0.05).After treatment,the SRSS score and AIS score of the two groups were lower than those before treatment,and those of the combined group were lower than those of the single group,and the difference was statistically significant(P<0.05).After treatment,the sleep latency and total sleep time of the two groups were improved,and the sleep latency of the combined group was shorter than that of the single group,while the total sleep time was longer than that of the single group,and the difference was statistically significant(P<0.05).After treatment,the serum levels of ACTH and Cor of the two groups were lower than those before treatment,and those of the combined group were lower than those of the single group(P<0.05).After treatment,the serum levels of 5-HT and BDNF of the two groups were higher than those before treatment,and those of the combined group were higher than those of the single group(P<0.05).Conclusions Stellate ganglion block combined with alprazolam is significant in the treatment of PSSD,which can regulate the levels of hypothalamus-pituitary-adrenaline and monoamine neurotransmitter factors,improve the parameters of polysomnography,improve sleep quality,and alleviate sleep disorders.
作者
唐泉淼
唐硕
王玉玲
Tang Quanmiao;Tang Shuo;Wang Yuling(Internal Medicine-Neurology,the Affiliated Hospital of Henan Medical College,Xinzheng 451100,China;College of Clinical Medicine,Henan University of Science and Technology,Luoyang 471000,China)
出处
《中国实用医刊》
2021年第17期78-81,共4页
Chinese Journal of Practical Medicine
