Effects of Electroacupuncture on Sleep Quality and Serum Transmitter Content in Patients with Chronic Insomnia and Emotional Disorders
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摘要:
目的 观察电针对慢性失眠症伴情绪障碍患者睡眠质量及血清多巴胺(DA)、γ-氨基丁酸(GABA)水平的影响。 方法 64例慢性失眠症伴情绪障碍患者随机分成治疗组和对照组各32例, 治疗期间治疗组脱落2例。2组均给予睡眠宣教, 治疗组加予电针治疗, 对照组予钝针不透皮浅刺, 2组疗程均为4周。治疗前后采用匹兹堡睡眠质量指数(PSQI)、失眠严重程度指数(ISI)、汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD-17)评估2组患者的睡眠质量、失眠程度、焦虑和抑郁状态, ELISA法检测血清中DA、GABA含量变化。 结果 治疗后, 治疗组PSQI总分及各项因子评分明显降低(P < 0.05, P < 0.01), ISI、HAMA、HAMD-17量表评分均显著下降(P < 0.01)，优于对照组(P < 0.05, P < 0.01)。治疗后, 治疗组血清DA、GABA含量显著增加(P < 0.01), 优于对照组(P < 0.01)。 结论 电针在改善慢性失眠症伴情绪障碍患者的睡眠质量方面疗效显著, 同时能够缓解其焦虑抑郁状态, 其作用机制可能与促进患者外周血清中DA、GABA等递质表达相关。 Abstract:OBJECTIVE To observe the effect of electroacupuncture (EA) on sleep quality and serum levels of dopamine (DA) and γ-aminobutyric acid (GABA) in patients with chronic insomnia and emotional disorders. METHODS 62 cases of chronic insomnia with emotional disorders were randomly divided into treatment group and control group, 32 cases in each group. Both groups were given sleep education, the treatment group was treated with electroacupuncture, and the control group was treated with blunt non-transdermal shallow needling. Both groups were treated for 4 weeks. The Pittsburgh sleep quality index (PSQI), insomnia severity index (ISI), Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD-17) were used to evaluate the sleep quality, insomnia, anxiety and depression of the two groups before and after treatment. Serum levels of dopamine and γ-aminobutyric acid were measured by ELISA. RESULTS After treatment, the PSQI total score and each factor score of the treatment group decreased (P < 0.01, P < 0.05), and the ISI, HAMA, HAMD-17 scale scores were significantly lower than those before treatment (P < 0.01). Compared with the control group, the scores of each scale in the treatment group were significantly lower (P < 0.01). After treatment, the serum levels of DA and GABA in the treatment group were higher than those before treatment and in the control group (P < 0.01). CONCLUSION Electroacupuncture is effective in improving the sleep quality of patients with chronic insomnia and emotional disorders, and can relieve their anxiety and depression. Its mechanism may be related to promoting the expression of DA, GABA and other transmitters in peripheral blood. -
Key words:
- insomnia /
- electroacupuncture /
- dopamine /
- γ-aminobutyric acid /
- anxiety /
- depression
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表 1 一般资料比较
Table 1. General information comparison
组别 例数 男 女 年龄/岁 病程/a ISI 不失眠 轻度失眠 中度失眠 重度失眠 对照组 32 20 12 45.84±12.67 2.78±3.14 0 14 14 4 治疗组 30 20 10 45.93±14.08 5.35±8.12 0 8 12 10 组别 例数 HAMA HAMD-17 无焦虑 轻度焦虑 中度焦虑 重度焦虑 极重度焦虑 无抑郁 轻度抑郁 中度抑郁 重度抑郁 对照组 32 0 12 12 8 0 0 13 19 0 治疗组 30` 0 18 7 5 0 0 14 16 0 
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表 2 2组患者治疗前后PSQI量表评分比较(x±s)
Table 2. Comparison of PSQI scale scores between two groups of patients before and after treatment (x±s)
组别 例数 治疗前 治疗后 对照组 32 14.91±2.53 14.16±3.32 治疗组 30 13.90±2.86 8.13±3.29**## 注: 组内比较, **P < 0.01;组间比较, ##P < 0.01。
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表 3 2组患者治疗前后ISI量表评分比较(x±s)
Table 3. Comparison of ISI scale scores between two groups of patients before and after treatment (x±s)
组别 例数 治疗前 治疗后 对照组 32 15.62±4.93 14.50±4.21 治疗组 30 18.40±5.12 9.60±5.11**## 注: 组内比较, **P < 0.01;组间比较, ##P < 0.01。
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表 4 2组患者治疗前后PSQI各项因子评分比较[M(P25, P75)]
Table 4. Comparison of PSQI factor scores between two groups of patients before and after treatment [M(P25, P75)]
组别 例数 时间 睡眠质量 入睡时间 睡眠时间 对照组 32 治疗前 3.00(2.00, 3.00) 3.00(2.00, 3.00) 3.00(2.00, 3.00) 32 治疗后 2.00(2.00, 3.00) 2.00(1.00, 3.00) 3.00(2.00, 3.00) 治疗组 30 治疗前 2.00(2.00, 3.00) 3.00(2.00, 3.00) 3.00(1.75, 3.00) 30 治疗后 1.00(1.00, 2.00)**## 1.00(1.00, 2.00)**## 2.00(1.00, 2.00)**## 对照组 32 治疗前 3.00(2.00, 3.00) 1.50(1.00, 2.00) 2.00(2.00, 3.00) 32 治疗后 3.00(2.00, 3.00) 1.00(1.00, 2.00) 2.00(1.00, 3.00) 治疗组 30 治疗前 2.50(1.00, 3.00) 1.50(1.00, 2.00) 3.00(2.00, 3.00) 30 治疗后 1.00(0.75, 2.00)**## 1.00(1.00, 1.00)* 1.00(1.00, 2.00)**# 注: 组内比较, *P < 0.05, **P < 0.01;组间比较, #P < 0.05, ##P < 0.01。
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表 5 2组患者治疗前后HAMA量表评分比较(x±s)
Table 5. Comparison of HAMA scale scores between two groups of patients before and after treatment (x±s)
组别 例数 治疗前 治疗后 对照组 32 17.06±6.21 16.09±5.39 治疗组 30 15.40±6.58 7.63±5.04**## 注: 组内比较, **P < 0.01;组间比较, ##P < 0.01。
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表 6 2组患者治疗前后HAMD-17量表评分比较(x±s)
Table 6. Comparison of HAMD-17 scale scores between two groups of patients before and after treatment (x±s)
组别 例数 治疗前 治疗后 对照组 32 17.16±4.73 14.69±5.76 治疗组 30 17.17±4.21 10.17±3.47**## 注: 组内比较, **P < 0.01;组间比较, ##P < 0.01。
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表 7 2组患者治疗前后血清DA、GABA含量比较(x±s, pg·mL-1)
Table 7. Comparison of serum DA and GABA levels between the two groups before and after treatment (x±s, pg·mL-1)
组别 时间 例数 DA GABA 对照组 治疗前 32 13.47±2.22 1.10±0.99 治疗后 32 14.25±2.11 1.16±0.12 治疗组 治疗前 30 14.13±1.64 1.06±0.27 治疗后 30 18.43±2.51**## 1.37±0.24**## 注: 组内比较, **P < 0.01;组间比较, ##P < 0.01。
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