目的:观察针刺治疗睡眠觉醒时相延迟障碍(DSWPD)的临床疗效。方法:将84例DSWPD患者随机分为观察组(42例,脱落2例)和对照组(42例,脱落3例)。两组均予睡眠卫生健康宣教,在此基础上,观察组针刺申脉、照海、合谷、太冲、足三里、三阴交,对...目的:观察针刺治疗睡眠觉醒时相延迟障碍(DSWPD)的临床疗效。方法:将84例DSWPD患者随机分为观察组(42例,脱落2例)和对照组(42例,脱落3例)。两组均予睡眠卫生健康宣教,在此基础上,观察组针刺申脉、照海、合谷、太冲、足三里、三阴交,对照组于相同穴位予安慰针刺,均治疗8周,第1~4周隔日1次,每周3次;第5~8周隔2 d 1次,每周2次。治疗前后,观察两组患者睡眠体动记录仪(ACT)客观睡眠指标(总卧床时间、总睡眠时间、睡眠效率、觉醒次数、入睡后觉醒时间)及血浆皮质醇(CORT)含量;治疗前后及治疗结束后1、3个月随访时,观察两组患者早-晚问卷(MEQ)、失眠严重程度指数(ISI)、疲劳严重程度量表(FSS)、Epworth嗜睡量表(ESS)评分。结果:与治疗前比较,治疗后观察组总睡眠时间延长、睡眠效率提高、觉醒次数减少、入睡后觉醒时间缩短(P<0.01,P<0.05),且治疗后观察组上述指标均优于对照组(P<0.01,P<0.05)。与治疗前比较,两组治疗后及观察组随访1、3个月MEQ评分升高(P<0.01),且治疗后各时间点观察组MEQ评分均高于对照组(P<0.01)。观察组治疗后ISI、FSS、ESS评分及随访1、3个月ISI、ESS评分均较治疗前下降(P<0.01,P<0.05),且观察组治疗后各时间点ISI、FSS、ESS评分均低于对照组(P<0.01,P<0.05)。治疗后,观察组血浆CORT含量较治疗前降低(P<0.01),且低于对照组(P<0.05)。结论:针刺可改善DSWPD患者睡眠觉醒时相,提高其睡眠质量和日间功能状态,其机制可能与降低血浆CORT含量相关。展开更多
Sleep-wake disorders play an important role among non-motor symptoms in Parkinson’s Disease, being a constant subject of research in recent years. There are a multitude of sleep-wake disturbances that worsen the pati...Sleep-wake disorders play an important role among non-motor symptoms in Parkinson’s Disease, being a constant subject of research in recent years. There are a multitude of sleep-wake disturbances that worsen the patient’s quality of life, insomnia and excessive daytime sleepiness being two of the most frequent complaints. The aim of this review is to highlight the most relevant clinical trials conducted during the last 5 years, focusing on the problematic of insomnia and daytime sleepiness correlated with Parkinson’s Disease and its treatment. Three electronic databases (Pubmed, Science Direct and Google Scholar) were searched during March and April 2020 for articles on this topic, finally selecting 21 most relevant articles that we have included in this review. Interesting aspects regarding correlation between sleep-wake disorders and Parkinson’s disease were found, showing that non-motor symptoms may be independent of the disease itself. We discussed the most recent advances in treatment opportunities and the adverse effects, with insomnia and daytime sleepiness among the most common complaints. Besides newly developed pharmacological therapy, consisting in mostly dopaminergic agonists or levodopa adjuvant drugs. Other possibly effective therapies on sleep-wake disorders such as deep brain stimulation, dietary changes, bright light therapy and alternative medicine protocols are also reviewed. Insomnia and excessive daytime sleepiness are common complaints in Parkinson’s disease patients, being either self-standing non-motor symptoms or adverse effects of the antiparkinsonian medication, diminishing patient’s quality of life. The effervescence of research on this topic shows promising results, with new clinical trials still to come in the near future.展开更多
目的:系统评价褪黑素对老年住院病人谵妄的预防效果。方法:计算机检索中国知网(CNKI)、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、EMbase、CINAHL、the Cochrane Library、Web of Science等中关于褪黑素预防老年住院病...目的:系统评价褪黑素对老年住院病人谵妄的预防效果。方法:计算机检索中国知网(CNKI)、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、EMbase、CINAHL、the Cochrane Library、Web of Science等中关于褪黑素预防老年住院病人谵妄效果的随机对照试验,检索时限均为数据库建立至2020年12月31日。由2名研究员独立进行文献筛选、数据提取及质量评估后,采用RevMan 5.3软件对纳入研究进行Meta分析。结果:共纳入8篇文献,Meta分析结果显示,褪黑素可降低老年住院病人谵妄发生率[RR=0.33,95%CI(0.19,0.56),Z=4.16,P=0.01],但对改善睡眠⁃觉醒周期紊乱效果不明显[RR=0.92,95%CI(0.75,1.14),Z=0.76,P=0.45]。结论:当前证据表明,补充外源性褪黑素能降低老年住院病人谵妄发生率,但其最佳剂量、配方以及治疗时间尚不清楚,需要更多大样本研究进一步探索。展开更多
文摘目的:观察针刺治疗睡眠觉醒时相延迟障碍(DSWPD)的临床疗效。方法:将84例DSWPD患者随机分为观察组(42例,脱落2例)和对照组(42例,脱落3例)。两组均予睡眠卫生健康宣教,在此基础上,观察组针刺申脉、照海、合谷、太冲、足三里、三阴交,对照组于相同穴位予安慰针刺,均治疗8周,第1~4周隔日1次,每周3次;第5~8周隔2 d 1次,每周2次。治疗前后,观察两组患者睡眠体动记录仪(ACT)客观睡眠指标(总卧床时间、总睡眠时间、睡眠效率、觉醒次数、入睡后觉醒时间)及血浆皮质醇(CORT)含量;治疗前后及治疗结束后1、3个月随访时,观察两组患者早-晚问卷(MEQ)、失眠严重程度指数(ISI)、疲劳严重程度量表(FSS)、Epworth嗜睡量表(ESS)评分。结果:与治疗前比较,治疗后观察组总睡眠时间延长、睡眠效率提高、觉醒次数减少、入睡后觉醒时间缩短(P<0.01,P<0.05),且治疗后观察组上述指标均优于对照组(P<0.01,P<0.05)。与治疗前比较,两组治疗后及观察组随访1、3个月MEQ评分升高(P<0.01),且治疗后各时间点观察组MEQ评分均高于对照组(P<0.01)。观察组治疗后ISI、FSS、ESS评分及随访1、3个月ISI、ESS评分均较治疗前下降(P<0.01,P<0.05),且观察组治疗后各时间点ISI、FSS、ESS评分均低于对照组(P<0.01,P<0.05)。治疗后,观察组血浆CORT含量较治疗前降低(P<0.01),且低于对照组(P<0.05)。结论:针刺可改善DSWPD患者睡眠觉醒时相,提高其睡眠质量和日间功能状态,其机制可能与降低血浆CORT含量相关。
文摘Sleep-wake disorders play an important role among non-motor symptoms in Parkinson’s Disease, being a constant subject of research in recent years. There are a multitude of sleep-wake disturbances that worsen the patient’s quality of life, insomnia and excessive daytime sleepiness being two of the most frequent complaints. The aim of this review is to highlight the most relevant clinical trials conducted during the last 5 years, focusing on the problematic of insomnia and daytime sleepiness correlated with Parkinson’s Disease and its treatment. Three electronic databases (Pubmed, Science Direct and Google Scholar) were searched during March and April 2020 for articles on this topic, finally selecting 21 most relevant articles that we have included in this review. Interesting aspects regarding correlation between sleep-wake disorders and Parkinson’s disease were found, showing that non-motor symptoms may be independent of the disease itself. We discussed the most recent advances in treatment opportunities and the adverse effects, with insomnia and daytime sleepiness among the most common complaints. Besides newly developed pharmacological therapy, consisting in mostly dopaminergic agonists or levodopa adjuvant drugs. Other possibly effective therapies on sleep-wake disorders such as deep brain stimulation, dietary changes, bright light therapy and alternative medicine protocols are also reviewed. Insomnia and excessive daytime sleepiness are common complaints in Parkinson’s disease patients, being either self-standing non-motor symptoms or adverse effects of the antiparkinsonian medication, diminishing patient’s quality of life. The effervescence of research on this topic shows promising results, with new clinical trials still to come in the near future.
