不同时辰针刺对原发性失眠患者睡眠质量及血清5-羟色胺、脑源性神经营养因子的影响*

作者：杨兴春1，徐亚琳1，童禄缘1，潘小燕2，张德绸2，徐厚平2，吴 晓2

单位：1.西南医科大学中西医结合学院，四川 泸州 646000； 2.西南医科大学附属中医医院，四川 泸州 646000

引用：引用：杨兴春，徐亚琳，童禄缘，潘小燕，张德绸，徐厚平，吴晓.不同时辰针刺对原发性失眠患者睡眠质量及血清5-羟色胺、脑源性神经营养因子的影响[J].中医药导报,2025,31(11):68-73.

DOI：10.13862/j.cn43-1446/r.2025.11.012

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摘要：目的：评估辰时针刺和酉时针刺治疗原发性失眠的疗效差异及对血清5-羟色胺（5-HT）、脑源性神经营养因子（BDNF）水平的影响。方法：将70例原发性失眠患者随机分为辰时组（35例）和酉时组（35例），两组分别在辰时（07:00:00—09:00:00）、酉时（17:00:00—19:00:00）予以针刺治疗，每周治疗5次，连续3周。治疗前后采用匹兹堡睡眠质量指数（PSQI）、阿森斯失眠量表（AIS）、汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表（HAMD）评分及AI睡眠筛查数据评估患者睡眠情况，检测患者血清5-HT、BDNF水平，并评价两组患者疗效。结果：酉时组总有效率为86.67%（26/30），辰时组为66.67%（20/30），两组比较，差异无统计学意义（P＞0.05）。治疗后，两组患者PSQI、AIS评分均降低（P<0.01或P<0.05），且酉时组均低于辰时组（P<0.01）；治疗后，两组患者HAMD评分均降低（P<0.01），睡眠总时长及夜间客观睡眠质量总得分均增加（P<0.01或P<0.05）；治疗后，酉时组患者入睡潜伏期短于治疗前（P<0.05），REM期、浅睡眠时长、深睡眠时长均长于治疗前（P<0.01或P≤0.05），且酉时组患者REM期长于辰时组（P<0.05）；治疗后，两组患者血清5-HT、BDNF水平均升高（P<0.01或P<0.05），且酉时组患者血清BDNF水平高于辰时组（P<0.01）。结论：辰时针刺、酉时针刺均可改善原发性失眠患者睡眠质量及血清5-HT、BDNF水平；酉时针刺在改善睡眠质量及血清BDNF水平方面优于辰时针刺。

关键词：原发性失眠；针刺；辰时；酉时；睡眠质量；5-羟色胺；脑源性神经营养因子

Abstract：

Objective: To evaluate the efficacy differences of acupuncture at Chenshi (辰时) and Youshi (酉时) in treating primary insomnia and their effects on serum 5-hydroxytryptamine (5-HT) and brain-derived neurotrophic factor (BDNF). Methods: A total of 70 patients with primary insomnia were randomly divided into the Chenshi group (n=35) and Youshi (n=35). Both groups received acupuncture at Chenshi (07:00:00-09:00:00) and Youshi (17:00:00-19:00:00) respectively, with 5 sessions per week for 3 consecutive weeks. Before and after treatment, the Pittsburgh sleep quality index (PSQI), Athens insomnia scale (AIS), Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD), and AI sleep monitoring results were used to assess the patients' sleep conditions, and the levels of serum 5-HT and BDNF were measured. The efficacy was evaluated. Results: The total effective rate was 86.67% (26/30) in Youshi group and 66.67% (20/30) in Chenshi group. There was no statistically significant difference in the total effective rate between the two groups (P>0.05). After treatment, the PSQI and AIS scores decreased in two groups (P<0.01 or P<0.05), and the Youshi group showed lower PSQI and AIS scores than Chenshi group (P<0.01). After treatment, the HAMD scores decreased in two groups (P<0.01), and the total sleep duration and total score of objective sleep quality at night increased in two groups (P<0.01 or P<0.05). After treatment, the sleep latency of the Youshi group was shorter than that before treatment (P<0.05), and the duration of the REM sleep, light sleep, and deep sleep were longer than those before treatment in Youshi group (P<0.01 or P≤0.05). The Youshi group showed longer duration of REM sleep than Chenshi group after treatmen (P<0.05). After treatment, the levels of serum 5-HT and BDNF increased in two groups (P<0.01 or P<0.05), and the Youshi group showed higher level of serum BDNF than Chenshi group (P<0.01). Conclusion: Acupuncture at Chenshi and Youshi can both improve the sleep quality of patients with primary insomnia and increase serum 5-HT and BDNF levels. Acupuncture at Youshi is superior to that at Chenshi in improving sleep quality and serum BDNF levels.

Key words：primary insomnia; acupuncture; Chenshi; Youshi; sleep quality; 5-hydroxytryptamine; brain-derived neurotrophic factor

发布时间：2025-11-30

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