自拟疏肝解郁酸枣汤联合调和针灸对脑卒中后睡眠障碍的机制分析

Mechanism Analysis of Self-Prepared Shugan Jieyu Suanzao Decoction Combined with Harmonizing Acupuncture for Sleep Disorders after Stroke

摘要: 目的：分析自拟疏肝解郁酸枣汤联合调和针灸对脑卒中后睡眠障碍的机制分析。方法：选取2023年9月~2024年9月80例脑卒中后睡眠障碍患者，利用随机数字表进行样本分组，分为针灸组及针药联合组，各40例。所有患者均睡前口服艾司唑仑片，针灸组同时实施调和针灸治疗，针药联合组在针灸组基础上增加自拟疏肝解郁酸枣汤治疗。治疗2周后，对比其临床疗效，治疗前后中医证候积分、神经功能、睡眠质量及血液相关指标。结果：针药联合组总有效率90.00%高于针灸组72.50% (P < 0.05)；治疗后两组中医证候积分均降低，针药联合组主症(10.56 ± 1.41)分、次症(8.76 ± 1.75)分低于针灸组(P < 0.05)；治疗后两组相关神经功能指标均升高，针药联合组神经生长因子(NGF) (246.34 ± 38.54) ng/L、脑源性神经营养因子(BDNF) (17.21 ± 2.98) ng/L高于针灸组(P < 0.05)；治疗后两组睡眠质量相关指标均有所改善，针药联合组睡眠总时间(7.53 ± 1.57) h高于针灸组，觉醒时间(31.56 ± 2.16) min、睡眠潜伏期(24.57 ± 3.63) min、匹兹堡睡眠质量指数评分(PSQI)评分(5.63 ± 1.53)分低于针灸组(P < 0.05)；治疗后针药联合组5-羟色胺(5-HT) (14.21 ± 1.93) ng/mL高于针灸组，针药联合组去甲肾上腺素(NE) (420.60 ± 61.16) pg/mL、神经肽Y (NPY) (161.68 ± 10.12) pg/mL低于针灸组(P < 0.05)。结论：自拟疏肝解郁酸枣汤联合调和针灸治疗脑卒中后睡眠障碍疗效显著，改善睡眠障碍症状，提升神经功能。

Abstract: Objective: Analysis of the mechanism of self-prepared Shugan Jieyu Suanzao Decoction combined with harmonizing acupuncture for sleep disorders after stroke. Methods: 80 patients with post-stroke sleep disorder from September 2023 to September 2024 were selected, and the samples were grouped according to the random number table. They were divided into an acupuncture and moxibustion group and a combined acupuncture and medicine group, with 40 patients in each group. All patients took estazolam tablets before going to bed. The acupuncture and moxibustion group was treated with concordant acupuncture and moxibustion at the same time, and the acupuncture drug combination group was treated with self-prepared Shugan Jieyu Suanzao Decoction on the basis of the acupuncture and moxibustion group. After 2 weeks of treatment, compare the clinical efficacy, TCM syndrome scores, neurological function, sleep quality, and blood-related indicators before and after treatment. Results: The total effective rate of the combined acupuncture and medicine group was 90.00% higher than that of the acupuncture and moxibustion group (72.50%, P < 0.05); After treatment, the scores of TCM syndromes in both groups decreased. The scores of main symptoms (10.56 ± 1.41) and secondary symptoms (8.76 ± 1.75) in the combined acupuncture and medicine group were lower than those in the acupuncture and moxibustion group (P < 0.05); After treatment, the related neurological function indexes in both groups increased. The nerve growth factor (NGF) (246.34 ± 38.54) ng/L and brain-derived neurotrophic factor (BDNF) (17.21 ± 2.98) ng/L in the acupuncture and drug combination group were higher than those in the acupuncture and moxibustion group (P < 0.05); After treatment, the indexes related to sleep quality in both groups improved. The total sleep time (7.53 ± 1.57) h in the acupuncture and drug combination group was higher than that in the acupuncture and moxibustion group, and the awakening time (31.56 ± 2.16) min, sleep latency (24.57 ± 3.63) min, and Pittsburgh sleep quality index (PSQI) score (5.63 ± 1.53) were lower than those in the acupuncture and moxibustion group (P < 0.05); After treatment, 5-hydroxytryptamine (5-HT) (14.21 ± 1.93) ng/mL in the acupuncture drug combination group was higher than that in the acupuncture and moxibustion group, norepinephrine (NE) (420.60 ± 61.16) pg/mL and neuropeptide Y (NPY) (161.68 ± 10.12) pg/mL in the acupuncture drug combination group were lower than those in the acupuncture and moxibustion group (P < 0.05). Conclusion: The self-prepared Shugan Jieyu Suanzao Decoction combined with acupuncture and moxibustion has a significant effect on sleep disorder after stroke, improving the symptoms of sleep disorder and improving the neurological function.