摘要
目的 观察头针联合浅针疗法对帕金森病合并睡眠障碍患者特异性紊乱睡眠结构及临床疗效的影响。方法 将105例帕金森病合并睡眠障碍患者随机分为头针组、浅针组和头针+加浅针组,每组35例。各组患者均给予西药常规治疗,在此基础上,头针组给予百会、四神聪、双侧舞蹈震颤控制区(头皮运动区往前额方向平行推移15 mm处)针刺,并连接电针治疗仪进行刺激;浅针组于山根穴(两目内眦连线之中点与鼻梁交集处)进行浅针治疗;头针+浅针组给予头针联合浅针干预,治疗方法同头针组和浅针组。各组均每2天治疗1次,每周治疗3次,共治疗8周。比较各组患者治疗前及治疗第8周时多导睡眠监测(PSG)中的睡眠有效率、入睡后清醒时间、快速眼动睡眠周期(REM期)睡眠有效率、周期性肢体运动指数(PLMI);于治疗前、治疗第4周及第8周时进行匹兹堡睡眠质量量表(PSQI)评分、统一帕金森评定量表第三部分(UPDRS-Ⅲ)评分;治疗8周后评价睡眠情况临床疗效及安全性。结果 与本组治疗前比较,治疗8周时各组睡眠有效率及REM期睡眠有效率均提高,入睡后清醒时间减少,PLMI降低(P<0.01)。治疗后组间比较,头针+浅针组睡眠效率、REM睡眠有效率均高于头针组、浅针组,入睡后清醒时间、PLMI低于头针组、浅针组(P<0.01)。与本组治疗前比较,各组治疗第4周及第8周时PSQI评分、UPDRS-Ⅲ评分明显降低,且各组治疗第8周时PSQI评分、UPDRS-Ⅲ评分均明显低于本组治疗第4周时(P<0.01)。治疗第8周时组间比较,头针+浅针组PSQI评分、UPDRS-Ⅲ评分均低于头针组、浅针组,浅针组PSQI评分低于头针组,头针组UPDRS-Ⅲ评分低于浅针组(P<0.05或P<0.01)。头针+浅针组睡眠情况临床总有效率为97.14%,高于头针组(75.76%)和浅针组(72.73%)(P<0.05)。各组治疗期间未见严重不良事件发生。结论 头针联合浅针疗法可通过提高帕金森病合并睡眠障碍患者睡眠效率、降低入睡后清醒时间纠正患者紊乱睡眠结构,同时可显著改善患者运动症状,疗效优于单纯头针和浅针治疗,且安全性好。
Objective To observe the therapeutic effect of scalp acupuncture combined with shallow acupuncture on specific disordered sleep structure in patients with Parkinson’s disease and sleep disorders.Methods A total of 105 Parkinson’s disease patients with sleep disorders were randomly divided into scalp acupuncture group,shallow acupuncture group,and combined group with 35 cases in each group.Routine western medicine was used as the basic treatment in all groups.The scalp acupuncture group was additionally treated with scalp acupuncture at Baihui(DU20),Sishengcong(EX-HN1) and bilateral dance tremor areas(the scalp motor area moves 15mm parallel to the forehead),and electro-stimulation was performed.The shallow acupuncture group was treated with shallow acupuncture at Shangen(the junction between the medial canthus and the bridge of nose).The combined group was treated with shallow acupuncture plus scalp acupuncture with the similar methods in other two groups.All groups were treated once every other day,3 times a week,for a total of 8 weeks.The sleep efficiency(SE),awake time after falling asleep,sleep efficiency in rapid eye movement(REM) period,and periodic limb movement index(PLMI) in all groups under polysomnography(PSG) before and after 8-week treatment were compared.Pittsburgh Sleep Quality Index(PSQI) and The third part of Unifie Parkinson’s Disease Rating Scale(UPDRS-Ⅲ)were evaluated before treatment and after 4-and 8-week treatment.The clinical effect and safety were evaluated after 8-week treatment.Results After 8-week treatment,the SE and REM sleep efficiency significantly inproved in all groups,the awake time after falling asleep and PLMI decreased(P<0.01).When compared between groups after treatment,the SE and REM sleep efficiency in the combined group were higher than those in the other two groups,while the awake time after falling asleep and PLMI index were lower(P<0.01).The scores of PSQI and UPDRS-Ⅲ in all groups after 4-and 8-week treatment were lower than those before treatment,and more changes were found after 8-week treatment than 4-week treatment(P<0.01).After 8-week treatment,the scores of PSQI and UPDRS-Ⅲin the combined group were lower than those in either scalp acupuncture group or shallow acupuncture group,as well as the PSQI score in the shallow acupuncture group than that in the scalp acupuncture group,and the UPDRS-III score in the scalp acupuncture group than that in the shallow acupuncture group(P<0.05 or P<0.01).The total effective rate of the combined group was 97.14%,which was higher than the scalp acupuncture group(75.76%) and the shallow acupuncture group(72.73%)(P<0.05).There was no serious adverse events in all groups.Conclusion Scalp acupuncture combined with shallow acupuncture could significantly improve the sleep structure and the motor symptoms of Parkinson’s disease with sleep disorder by improving the sleep efficiency and reducing the awake time after falling asleep,whose effect is superior to scalp acupuncture or shallow acupuncture alone and is safe.
作者
黄燕熙
江羚
林燕华
江沧州
HUANG Yanxi;JIANG Ling;LIN Yanhua;JIANG Cangzhou(Fuzhou Neuro-psychiatric Hospital,Fuzhou,350008)
出处
《中医杂志》
CSCD
北大核心
2023年第4期358-364,共7页
Journal of Traditional Chinese Medicine
基金
福州市科技计划项目(2021-S-206)。
关键词
帕金森病
睡眠障碍
头针
浅针
匹茨堡睡眠指数
多导睡眠监测
Parkinson’s disease
sleep disorders
scalp acupuncture
shallow acupuncture
Pittsburgh Sleep Quality Index
polysomnography
