熵指数与脑电双频指数对针刺镇静效能评价的比较

Comparison of Entropy Index and Bispectral Index in Evaluating the Efficacy of Acupuncture Sedation

摘要: 目的：观察针刺内关、合谷、足三里穴的镇静效能以及镇静过程中镇静指标的变化，比较熵指数和脑电双频指数在监测针刺镇静效果方面的差异。方法：选取60例健康志愿者入组，使用随机数字表法分为熵指数组(S组，n = 30)和脑电双频指数组(B组，n = 30)，两组采用相同的试验方案，均需经历静息态和镇静态两个阶段。从静息态至镇静态，每2.5分钟记录1次状态熵(SE)、反应熵(RE)、脑电双频指数(BIS)、和警觉/镇静观察评分法(OAA/S)评分，并记录留针至进入镇静态所需要的时间。结果：两组志愿者均可以进入镇静状态，且所用的时间无统计学差异。BIS、RE和SE均可反应针刺镇静的水平，与BIS和SE相比，当达到镇静态时，RE先降低，且差异有统计学意义(P < 0.05)。结论：针刺内关、合谷、足三里能较快达到镇静效果，并可用熵指数和BIS来评价镇静效果，其中RE对针刺镇静的预测更具时效性。

Abstract: Objective: To observe the sedative efficacy of acupuncture at Neiguan (PC6), Hegu (LI4), and Zusanli (ST36) acupoints, as well as the changes of sedative indices during sedation, and compare the differences between entropy index and bispectral index (BIS) in monitoring the sedative effect of acupuncture. Methods: Sixty healthy volunteers were enrolled and divided into an entropy index group (group S, n = 30) and a bispectral index group (group B, n = 30) using a random number table. Both groups adopted the same protocol, including a resting state and a sedative state. From the resting state to the sedative state, state entropy (SE), response entropy (RE), BIS, and Observer’s Assessment of Alertness/Sedation (OAA/S) score were recorded every 2.5 minutes, and the time from needle retention to the sedative state was documented. Results: Volunteers in both groups entered the sedative state, with no statistical difference in the time required. BIS, RE, and SE all reflected the level of acupuncture sedation. Compared with BIS and SE, RE decreased first when reaching the sedative state, and the difference was statistically significant (P < 0.05). Conclusion: Acupuncture at Neiguan, Hegu, and Zusanli can achieve sedation rapidly. Both entropy index and BIS can evaluate sedative efficacy, with RE demonstrating better timeliness in predicting acupuncture sedation.