电针调整慢性疲劳综合征昼夜节律的研究

【作者】 诸毅晖；

【导师】 梁繁荣；

【作者基本信息】 成都中医药大学 ， 针灸推拿学， 2008， 博士

【摘要】 目的:观察电针对CFS的治疗效应,探索电针治疗CFS的昼夜节律调整作用,为进一步研究电针治疗CFS的节律调整机制提供依据。方法:1、60例CFS患者随机分为电针穴位组和电针非穴位组,观察电针治疗对CFS临床症状和生活质量的影响。2、24小时动态检测电针穴位组20例CFS患者治疗前后以及20例健康对照者的体温、心率、血压、握力指数、事件相关电位、唾液皮质醇、唾液褪黑素,探索电针对CFS昼夜节律的调整作用。结果:1、电针肾俞、足三里可明显降低CFS患者的疲劳严重程度积分、潜在症状积分、疼痛程度积分,提高健康状况调查简表各维度积分,与电针非穴位组比较有极显著差异(P＜0.001)。2、CFS组右手握力指数、唾液褪黑素的24小时均值低于健康组(P＜0.05),电针治疗后唾液褪黑素24小时均值升高;CFS组舒张压、事件相关电位P3a和P3b潜伏期昼夜节律消失,电针治疗后舒张压和P3b潜伏期昼夜节律恢复;CFS组唾液褪黑素节律振幅明显减小,体温、心率、收缩压、握力指数、事件相关电位P3a和P3b潜伏期、唾液皮质醇振幅较健康组有减小趋势,电针治疗后上述指标的振幅均有所提高而接近健康者;CFS组体温、心率、血压、握力指数、唾液褪黑素的峰值相位较健康组有后移趋势,电针治疗使其前移而接近健康组,CFS组唾液皮质醇峰值相位较健康组有前移趋势,电针治疗使其后移接近健康组。结论:1、电针肾俞、足三里可减轻CFS患者临床症状、提高生活质量。2、CFS患者体温、心率、血压、握力指数、事件相关电位、唾液皮质醇、唾液褪黑素存在昼夜节律异常,表现为节律减弱甚至丧失、节律相位转移,存在节律内失同步趋势。3、电针治疗可良性调整CFS异常的昼夜节律,具有恢复丧失的昼夜节律、增强减弱的昼夜节律、调整异常的峰值相位的作用,从而恢复正常的昼夜节律性波动,使各指标节律趋于同步。更多还原

【Abstract】 Objects: To observe the therapeutic effects of electroacupuncture for chronic fatigue syndrome (CFS) and to explore the effects of electroacupuncture for adjustment circadian rhythm.Methods: 60 CFS patients were randomly divided into electroacupuncture acupoint group and electroacupuncture non-acupoint group. Evaluate the clinical symptoms and the quality of life in order to observe the clinical therapeutic effect by electroacupuncture. The body temperature, heart rate, blood pressure, grip strength index , event related potential, cortisol and melatonin of 20 health controls and 20 patients with CFS respectively before and after the electroacupuncture were examined by the chronobiologic research methods.Results: The electroacupuncture on the acupoints of Shenshu (BL23) and Zusanli (ST36) decreased the integral of FSS, SPHERE, VAS and enhance the integral of SF-36. Compared with control group, there was observably difference (P <0. 001).The right hand grip strength index and melatonin of CFS group decreased (P <0. 05). The circadian rhythm of the diastolic blood pressure, P3a and P3b latency of CFS group disappeared, after the electroacupuncture, the circadian rhythm of the diastolic blood pressure and the P3b latency had recovered. The amplitude of the melatonin of CFS group diminished, and the amplitudes of the body temperature, heart rate, systolic blood pressure, grip strength index and the cortisol had a tendency to diminish, after the electroacupuncture the amplitudes had a tendency to increase. The acrophase of the body temperature, heart rate, blood pressure, grip strength index and the melatonin of CFS group delayed, after the electroacupuncture the acrophase advanced. The acrophase of cortisol of CFS group advanced, after treatment, the acrophase delayed.Conclusions: The electroacupuncture on the acupoints of Shenshu (BL23) and Zusanli (ST36) ease the symptoms and improve the quality of life of CFS. The patients with CFS show a disorder of circadian rhythm, which mainly manifest the loss or diminishing of the circadian rhythm, the abnormality of acrophase and the circadian rhythm is desynchronization. Electroacupuncture can recover the circadian rhythm and synchronize the circadian rhythm.更多还原