“眠三针”配合重复经颅磁刺激改善脑卒中后失眠的临床研究

目的:观察"眠三针"配合重复经颅磁刺激(r TMS)改善缺血性脑卒中后失眠的临床疗效。方法:选取2019年1—12月在广东三九脑科医院康复训练中心就诊的缺血性脑卒中后失眠患者60例,随机分为治疗组与对照组,每组30例。对照组予重复经颅磁刺激治疗,治疗组在对照组基础上增加"眠三针"(四神针、三阴交、内关)针刺。每天治疗1次,治疗4周。治疗前后记录患者的血清5-羟色胺(5-HT)水平、匹兹堡睡眠质量指数评分、阿森斯失眠量表评分,并进行疗效评定。结果:治疗1个疗程后,两组患者血清5-HT水平均较治疗前上升,且治疗组上升更明显,两组患者匹兹堡睡眠质量指数评分、阿森斯失眠量表评分均较治疗前降低,且治疗组比对照组下降更明显,两组比较,差异均有统计学意义(P<0.05)。治疗组有效率为86.67%(26/30),对照组为73.33%(22/30),两组比较,差异有统计学意义(P<0.05)。结论:"眠三针"配合重复经颅磁刺激可有效提高脑卒中失眠患者的睡眠质量。

The Clinical Study of "Sleeping Three Needles" Combined with Repetitive Transcranial Magnetic Stimulation in Improving Insomnia after Stroke

Objective: To observe the clinical effect of "sleeping three needles" combined with repetitive transcranial magnetic stimulation(rTMS) in improving insomnia after ischemic stroke. Methods: Totally 60 patients with insomnia after ischemic stroke, treated in the rehabilitation training center of Guangdong Sanjiu Brain Hospital from January 2019 to December 2019, were randomly divided in to treatment and control groups, 30 cases in each group. The control group was treated with repeated transcranial magnetic stimulation, and the treatment group was treated with "three sleeping needles" Sishen needle, Sanyinjiao(SP6) and Neiguan(PC6)] on the basis of the control group. The patients were treated once a day for four weeks. The serum 5-HT level,Pittsburgh sleep quality index and Athens insomnia score were recorded before and after treatment, and the curative effect was evaluated. Results: After one course of treatment, the level of serum 5-HT increased in the two groups and the treatment group showed higher level of serum 5-HT than control group. The scores of Pittsburgh sleep quality index and Athens insomnia score decreased in the two groups and the treatment group showed lower scores than control group. There was significant difference between the two groups(P<0.05). The effective rate was 86.67%(26/30) in treatment group and 73.33%(22/30) in control group. There was significant difference in effective rate between the two groups(P<0.05). Conclusion: "Sleeping three needles" combined with repeated transcranial magnetic stimulation can effectively improve the sleep quality of patients with insomnia after stroke.