电针治疗高血压合并失眠症的随机对照临床研究

Randomized Controlled Clinical Study on Electroacupuncture Treatment of Hypertension Combined with Insomnia

  • 摘要:
    目的 观察电针对高血压合并失眠症患者失眠症状和血压水平的影响。
    方法 采用随机对照临床试验, 选取2021年12月至2022年12月江苏省中医院60例高血压合并伴失眠症患者, 以1∶1的比例随机分为治疗组和对照组各30例。治疗期间, 对照组脱落2例, 治疗组脱落1例。2组患者均予睡眠、高血压健康宣教以及常规高血压药物治疗, 治疗组加予电针干预, 对照组加予假电针干预。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)量表以及便携式多导睡眠仪(PPSG)评估2组患者睡眠质量变化; 采用家庭自测血压(HBPM)评估2组患者血压水平变化。Spearman相关性分析及线性回归分析研究患者血压水平与PPSG参数之间关系。
    结果 治疗后, 对照组仅入睡潜伏期(SOL)和睡眠效率(SE)明显改善(P < 0.05);治疗组PSQI、ISI评分以及清晨及夜间收缩压(SBP)、舒张压(DBP)均显著降低(P < 0.01), 优于对照组(P < 0.05,P < 0.01), PPSG各项睡眠参数明显改善(P < 0.01), 优于对照组(P < 0.05,P < 0.01)。Spearman相关性分析结果显示, 治疗前患者清晨SBP水平与入睡后清醒时间(WASO)以及微觉醒(MAS)次数相关, 治疗后患者清晨SBP的降低与MAS减少以及SOL的缩短相关。
    结论 电针能够有效改善高血压患者的失眠症状及血压水平, 其疗效机制可能与减少患者MAS次数、改善睡眠碎片化程度有关。

     

    Abstract:
    OBJECTIVE To observe the effect of electroacupuncture on insomnia symptoms and blood pressure levels in patients with hypertension and insomnia.
    METHODS A randomized controlled clinical trial was conducted. A total of 60 patients with hypertension and insomnia were enrolled in Jiangsu Province Hospital of Chinese Medicine from December 2021 to December 2022 and randomly divided into a treatment group and a control group at a ratio of 1:1, with 30 cases in each group. During the treatment period, 2 cases dropped out of the control group and 1 case dropped out of the treatment group. Both groups of patients received sleep and hypertension health education and conventional hypertension drug treatment. The treatment group was given electroacupuncture intervention, and the control group was given sham electroacupuncture intervention. The treatment course of both groups was 4 weeks. Before and after treatment, the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI) scale and portable polysomnography (PPSG) were used to evaluate the changes in sleep quality of the two groups of patients; home blood pressure measurement (HBPM) was adopted to evaluate the changes in blood pressure levels of the two groups of patients. Spearman correlation analysis and linear regression analysis were used to study the relationship between blood pressure levels and PPSG parameters.
    RESULTS After treatment, only the sleep onset latency (SOL) and sleep efficiency (SE) of the control group were significantly improved (P < 0.05); the PSQI, ISI scores, morning and night systolic blood pressure (SBP), and diastolic blood pressure (DBP) of the treatment group were significantly reduced (P < 0.01), which was better than that of the control group (P < 0.05, P < 0.01); the sleep parameters of PPSG were significantly improved (P < 0.01), which was better than that of the control group (P < 0.05, P < 0.01). The results of Spearman correlation analysis showed that the morning SBP level of patients before treatment was related to the wake time after sleep onset (WASO) and the number of micro-arousals (MAS). After treatment, the decrease in the morning SBP of patients was related to the reduction of MAS and the shortening of SOL.
    CONCLUSION Electroacupuncture can effectively improve the insomnia symptoms and blood pressure levels of patients with hypertension. Its therapeutic mechanism may be related to reducing the number of MAS and improving the degree of sleep fragmentation.

     

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