| Objective:To observe the clinical effect of acupuncture at different time (Youshi,Chenshi) to treat post-stroke sleep reversal (PSSR), and discuss the issue of chronergy of acupuncture for the treatment of PSSR.Method:60 hospitalized patients diagnosed as PSSR were randomly divided into Youshi acupuncture group and Chenshi acupuncture group, each group of 30 patients.On the basis of routine treatment of stroke, the patients in Youshi acupuncture group were treated with "XNKQ needle therapy" at Youshi (17:00-19:00), the patients in Chenshi acupuncture group were treated with "XNKQ needle therapy" at Chenshi (7:00-9:00). All the patients were treated once a day,6 days for 1 course, rest one day between the two courses,3 courses in total. Before the treatment and after finishing the period of treatment for 3 courses, respectively evaluated the sleep quality of each patient with the Athens insomnia scale(AIS) and the Pittsburgh sleep quality index (PSQI), evaluated the degree of neurological deficit of each patient with the Modified Edinburgh-Scandinavia stroke scale (MESSS), and evaluated the degree of depression of each patient with the Hamilton depression scale(HAMD). The score of each scale was compared in each group and between two groups, to observe the difference of effect between the two groups and do relative analysis. All the data was analyzed by the statistical software of SPSS17.0.Results:1.Comparison of the score of MESSS within each group and between the two groups before and after treatment:After treatment, the score of MESSS of two groups all was lower than pre-treatment, and the difference has statistical significance(P<0.01), suggesting that the two groups of patients after treatment all were improved neurological deficit. After treatment, there is no statistical significance in the score of MESSS of two groups(P>0.05), suggesting that acupuncture at Youshi and acupuncture at Chenshi have similar curative effect in the neurological deficit.2. Comparison of the curative effect of neurological deficit in two groups after treatment:In the Youshi acupuncture group,0 cases were cured,8 cases markedly effective,21 cases effective,1 cases ineffective, markedly effective rate was 26.67%, the total effective rate was 96.7%; in the Chenshi acupuncture group,0 cases were cured,6 cases markedly effective,22 cases effective,2 cases ineffective,markedly effective rate was 20.00%, the total efficiency was 93.33%.There is no statistical difference in the markedly effective rate and the total effective rate of neurological deficit between the two groups(P>0.05), indicating that acupuncture at Youshi and acupuncture at Chenshi have quite curative effect in the neurological deficit.3.Comparison of the score of AIS within each group and between the two groups before and after treatment:After treatment, the score of AIS of the two groups all was decreased compared with that before treatment, and the difference has statistical significance(P＜0.01), suggesting that acupuncture at Youshi and acupuncture at Chenshi all can improve the sleep conditions of PSSR. After treatment, the score of AIS of the Youshi acupuncture group was lower than that of the Chenshi acupuncture group, and the difference was statistical significant (P<0.01), showing that acupuncture at Youshi to treat PSSR can more significantly improve sleep conditions than acupuncture at Chenshi to treat it.4.Comparison of the score of PSQI within each group and between the two groups before and after treatment:After treatment, the score of PSQI of two groups all was decreased compared with that before treatment, and the difference was statistical significant(P<0.01), suggesting that the sleep conditions of patients of two groups was improved after treatment. After treatment, the PSQI score of the Youshi acupuncture group was lower than that of the Chenshi acupuncture group, and the difference was statistical significant (P＜0.01), it suggests that acupuncture at Youshi to treat PSSR can more significantly improve sleep conditions than acupuncture at Chenshi to treat it.5.Comparison of the score of 6 factors of PSQI within each group and between the two groups before and after treatment:After treatment, the score of 6 factors of PSQI of two groups was lower than pre-treatment,and the difference was statistical significant(P<0.01), illustrating that acupuncture at Youshi or Chenshi to treat PSSR all can reduce the score of 6 factors of PSQI. After treatment, there is no statistical significance in the score of Subjective sleep quality, Sleep disorder and Daytime function of two groups(P>0.05), suggesting that acupuncture at Youshi and acupuncture at Chenshi have similar curative effect in the Subjective sleep quality, Sleep disorder and Daytime function. After treatment, the score of Time to fall asleep, Sleepy time and Sleep efficiency of the Youshi acupuncture group was lower than that of the Chenshi acupuncture group, and the difference was statistical significant(P<0.05), suggesting that acupuncture at Youshi to treat PSSR can more significantly improve the Time to fall asleep, Sleepy time and Sleep efficiency than acupuncture at Chenshi to treat it.6.Comparison of the curative effect of post-stroke sleep reversal in two groups after treatment: In the Youshi acupuncture group,4 cases were cured,19 cases markedly effective,6 cases effective,1 cases ineffective, markedly effective rate was 76.67%, the total effective rate was 96.7%; in the Youshi acupuncture group,2 cases were cured,12 cases markedly effective,14 cases effective,2 cases ineffective,markedly effective rate was 46.67%, the total efficiency was 93.33%. There is no statistical difference in the total effective rate of PSSR between the two groups(P>0.05), but there is statistical difference in the markedly effective rate of PSSR between the two groups(P<0.05), showing that acupuncture at Youshi to treat PSSR has a better therapeutic effect than Chenshi to treat it.7.Comparison of the score of HAMD within each group and between the two groups before and after treatment:After treatment, the score of HAMD of two groups was lower than pre-treatment, and the difference was statistical significant(P<0.01),suggesting that acupuncture at Youshi and acupuncture at Chenshi all can significantly improve the depressive symptom of patients of PSSR. After treatment, there is no statistical difference in the score of HAMD(P>0.05), suggesting that acupuncture at Youshi and acupuncture at Chenshi have similar effect in the improvement of the depressive symptom.8.Comparison of the curative effect of depressive symptom in two groups after treatment:In the Youshi acupuncture group,2 cases were cured,9 cases markedly effective,18cases effective, leases ineffective, markedly effective rate was 36.67%, the total effective rate was 96.67%; in the Youshi acupuncture group,2 cases were cured,6cases markedly effective,19 cases effective, 3cases ineffective, markedly effective rate was 26.67%, the total efficiency was 90.00%. There is no statistical difference in the markedly effective rate and the total effective rate of depressive symptom between the two groups(P>0.05), indicating that acupuncture at Youshi and acupuncture at Chenshi have quite effect in the improvement of the depressive symptom.Conclusion:1.Acupuncture at Youshi to treat PSSR can more significantly improve sleep conditions than acupuncture at Chenshi to treat it, and acupuncture at Youshi to treat PSSR can more effectively improve the Time to fall asleep, Sleepy time and Sleep efficiency than acupuncture at Chenshi to treat it.2. Acupuncture at Youshi or Chenshi in the improvement of the neurological function and depressive symptom was quite. |
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