醒脑开窍针刺法配合灵龟八法治疗脑卒中后昼间嗜睡的随机对照及随访研究
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摘要
目的:观察醒脑开窍针刺法配合灵龟八法治疗脑卒中后昼间嗜睡的远期临床疗效。方法:将60例脑卒中后昼间嗜睡患者随机分为观察组和对照组,每组各30例,观察组采用醒脑开窍针刺法结合灵龟八法治疗,对照组单纯醒脑开窍针刺法治疗。共治疗28天,对治疗前、治疗后28天及治疗结束后6个月患者的Epworth嗜睡量表(ESS)评分、匹兹堡睡眠量表质量指数(PSQI)及综合疗效进行评定。结果:最终完成观察54例。治疗第28天、治疗后6个月随访时两组ESS量表评分与治疗前比较均有改善(P<0.01),且观察组改善均优于对照组(P<0.05);治疗第28天、治疗后6个月随访时两组PSQI评分与治疗前比较均有改善(P<0.01),治疗第28天时观察组PSQI评分改善均优于对照组(P<0.01),治疗后6个月随访时两组PSQI评分比较差异无统计学意义(P>0.05);全分析集总体有效率比较,观察组为80%,对照组为53.3%,观察组优于对照组(P<0.05);符合方案集总体有效率比较,观察组为82.1%,对照组为53.8%,观察组优于对照组(P<0.05)。结论:醒脑开窍针刺法配合灵龟八法治疗脑卒中后昼间嗜睡的远期疗效较好。
Objective:To investigate the long-term clinical efficacy of "XNKQ" acupuncture therapy with "LGBF" acupuncture on post-stroke excessive daytime sleepiness(EDS).Methods:Sixty patients diagnosed definitely with post-stroke EDS were randomly allocated to observation and control groups and each group had 30 cases.The treatment group received "XNKQ" acupuncture therapy with "LGBF" acupuncture and the control group received "XNKQ" acupuncture therapy only.The influence on the ESS,PSQI and combined efficacy were evaluated before treatment,28 days and 6 months after treatment.Results:28 days and 6 months after treatment.Both groups ESS and PSQI were better than those before treatment(P<0.01) and the ESS's improvement of observation group was better than that of the control(P<0.05).28 days after treatment,the PSQI's improvement of observation group was better than that of the control(P<0.01),but 6 months after treatment there was no difference between two groups(P>0.05).The overall efficiencies of the observation and control groups in full analysis set(FAS) were 80% and 53.3% respectively.The overall efficiencies of the observation and control groups in per protocol set(PPS) were 82.1% and 53.8% respectively.The observation group's was better than that of the control(P<0.05).Conclusion:"XNKQ" acupuncture therapy with "LGBF" acupuncture has a good long-term effect on post-stroke EDS.
Objective:To investigate the long-term clinical efficacy of "XNKQ" acupuncture therapy with "LGBF" acupuncture on post-stroke excessive daytime sleepiness(EDS).Methods:Sixty patients diagnosed definitely with post-stroke EDS were randomly allocated to observation and control groups and each group had 30 cases.The treatment group received "XNKQ" acupuncture therapy with "LGBF" acupuncture and the control group received "XNKQ" acupuncture therapy only.The influence on the ESS,PSQI and combined efficacy were evaluated before treatment,28 days and 6 months after treatment.Results:28 days and 6 months after treatment.Both groups ESS and PSQI were better than those before treatment(P<0.01) and the ESS's improvement of observation group was better than that of the control(P<0.05).28 days after treatment,the PSQI's improvement of observation group was better than that of the control(P<0.01),but 6 months after treatment there was no difference between two groups(P>0.05).The overall efficiencies of the observation and control groups in full analysis set(FAS) were 80% and 53.3% respectively.The overall efficiencies of the observation and control groups in per protocol set(PPS) were 82.1% and 53.8% respectively.The observation group's was better than that of the control(P<0.05).Conclusion:"XNKQ" acupuncture therapy with "LGBF" acupuncture has a good long-term effect on post-stroke EDS.
引文
[1] Lee CH,Ng WY,Hau W,et al.Excessive daytime sleepiness is associated with longer culprit lesion and adverse outcomes in patients with coronary artery disease[J].J Clin Sleep Med,2013,9(12):1267-1272.
[2] Worthington AD,Melia Y.Rehabilitation is compromised by arousal and sleep disorders:results of a survey of rehabilitation centres[J].Brain Inj,2006,20(3):327-332.
[3] 张晓燕,王升旭.子午流注纳甲法治疗脑卒中后睡眠倒错的临床观察[J].针灸临床杂志,2012,28(1):7-9.
[4] 王文熠,王锋.醒脑开窍针刺法结合灵龟八法治疗脑卒中后昼间嗜睡[J].吉林中医药,2015,35(11):1176-1179.
[5] 史玉泉.实用神经病学[M].2版.上海:上海科学技术出版社,1994:1126-1127.
[6] 石学敏.针灸学(新世纪第二版)[M].北京:中国中医药出版社,2003:347.
[7] Autret A,Lucas B,Mondon K,et al.Sleep and brain lesions:a critical review of the literature and additional new cases[J].Neurophysiol Clin,2001,31(6):356-375.
[8] Hermann DM,Bassetti CL.Sleep-related breathing and sleep-wake disturbances in ischemic stroke[J].Neurology,2009,73(16):1313-1322.
[9] Marquez-Romero JM,Morales-Ramírez M,Arauz A.Non-breathing-related sleep disorders following stroke[J].Neurologia,2014,29 (9):511-516.
[10] 石学敏.脑卒中与醒脑开窍[M].北京:科学出版社,2007:275-280.
[2] Worthington AD,Melia Y.Rehabilitation is compromised by arousal and sleep disorders:results of a survey of rehabilitation centres[J].Brain Inj,2006,20(3):327-332.
[3] 张晓燕,王升旭.子午流注纳甲法治疗脑卒中后睡眠倒错的临床观察[J].针灸临床杂志,2012,28(1):7-9.
[4] 王文熠,王锋.醒脑开窍针刺法结合灵龟八法治疗脑卒中后昼间嗜睡[J].吉林中医药,2015,35(11):1176-1179.
[5] 史玉泉.实用神经病学[M].2版.上海:上海科学技术出版社,1994:1126-1127.
[6] 石学敏.针灸学(新世纪第二版)[M].北京:中国中医药出版社,2003:347.
[7] Autret A,Lucas B,Mondon K,et al.Sleep and brain lesions:a critical review of the literature and additional new cases[J].Neurophysiol Clin,2001,31(6):356-375.
[8] Hermann DM,Bassetti CL.Sleep-related breathing and sleep-wake disturbances in ischemic stroke[J].Neurology,2009,73(16):1313-1322.
[9] Marquez-Romero JM,Morales-Ramírez M,Arauz A.Non-breathing-related sleep disorders following stroke[J].Neurologia,2014,29 (9):511-516.
[10] 石学敏.脑卒中与醒脑开窍[M].北京:科学出版社,2007:275-280.