壮医药线点灸联合针刺对失眠患者血浆Orexin及HPA轴的影响

目的观察失眠患者血浆Orexin、促肾上腺皮质激素释放激素(CRH)、促肾上腺皮质激素(ACTH)含量的变化,讨论壮医药线点灸联合针刺治疗失眠的机制。方法 50例失眠患者为针灸组,54例作为健康对照组,针灸组予以壮医药线点灸足三里联合针刺百会、神门治疗,健康对照组予以指压按摩百会、神门、足三里。记录疗效,ELISA法检测血浆Orexin、CRH、ACTH的含量。结果①治疗前针灸组和对照组比较,针灸组Orexin(112.02±8.95)pg/ml升高(P<0.05),CRH(0.88±0.13)ng/L、ACTH(15.32±4.56)ng/L均显著升高(P<0.01)。②与本组治疗前比较,针灸组治疗后血浆Orexin含量(62.01±6.22)pg/ml降低(P<0.05),CRH(0.41±0.09)ng/L、ACTH(8.01±4.02)ng/L均显著降低(P<0.01)。结论壮医药线点灸联合针刺治疗失眠的起效环节在于抑制Orexin、CRH、ACTH合成和分泌,恢复下丘脑-垂体-肾上腺轴(HPA轴)的正常功能。

The effects of Zhuang-medical-thread moxibustion in combination with acupuncture on Orexin and HPA axis in patients with insomnia

Objective To assay serum Orexin,CRH and ACTH in patients with insomnia after treatment with Zhuang-medical-thread moxibustion in combination with acupuncture and to study its therapeutic mechanism.Methods 50 patients with insomnia were enrolled in acupuncture group,54 healthy subjects participated in this study were admitted to control group.Using ignited Zhuang-medical-thread to Zusanli(ST36) acupoint on the skin in combination with pricking Baihui(GV20) and Shenmen(HT7) acupoints with acupuncture needle for cases in acupuncture group.Pressing Baihui(GV20),Shenmen(HT7),Zusanli(ST36) acupoints with fingers for healthy controls.Recorded therapeutic results,ELISA was used to measure the levels of Orexin,CRH and ACTH.Results ①Compared to control group before treatment,acupuncture group in elevated serum Orexin(112.02±8.95)pg/ml was statistically significant(P<0.05),both elevated CRH(0.88±0.13)mg/L,ACTH(15.32±4.56) mg/L were highly statistically significant(P<0.01).②Compared to the same group pre-treatment,acupuncture group in serum Orexin(62.01±6.22)pg/ml lowered statistically significant(P<0.05),both CRH(0.41±0.09)mg/L,ACTH(8.01±4.02) mg/L lowered highly statistically significant(P<0.01).Conclusion Zhuang-medical-thread moxibustion in combination with acupuncture can inhibit the synthesis and secretion of Orexin,CRH and ACTH so that normal function of HPA axis recovered.