时空针灸灵龟八法指导艾灸对缺血性脑卒中后睡眠障碍患者5-羟色胺及睡眠质量的影响

doi:10.3969/j.issn.1006-5725.2026.15.002

Abstract

Abstract:

Objective To investigate the clinical efficacy of acupuncture of time acupoint space based on Linggui Bafa in patients with sleep disorders secondary to ischemic stroke， and to evaluate its effects on serum 5-hydroxytryptamine （5-HT） and melatonin （MT） levels， neurological function， and emotional status. Methods A total of 78 patients with ischemic stroke and concurrent sleep disorders treated at our hospital between June 2024 and June 2025 were prospectively enrolled and randomly divided into a control group and a treatment group （n = 39 each）. The control group received conventional treatment and sleep management for ischemic stroke. The treatment group received the same conventional therapy plus Linggui Bafa-based spatiotemporal acupoint selection moxibustion. Both groups received continuous treatment for 3 weeks. The overall clinical efficacy， scores on the Fatigue Severity Scale （FSS）， Pittsburgh Sleep Quality Index （PSQI）， Hospital Anxiety and Depression Scale （HADS）， and National Institutes of Health Stroke Scale （NIHSS）， as well as serum 5-HT and MT levels， were compared between the two groups. Adverse events during the treatment period were also recorded. Results The overall effective rate in the treatment group was significantly higher than that in the control group （P < 0.05）. Repeated-measures analysis of variance （ANOVA） revealed significant main effects of time and group， as well as significant time × group interaction effects， on the FSS， PSQI， HADS， and NIHSS scores， and on serum 5-HT and MT levels （all P < 0.05）. Further simple main effect analysis demonstrated that after 3 weeks of treatment， the scores on all aforementioned scales in the treatment group were significantly lower than those in the control group， whereas serum 5-HT and MT levels were significantly higher （all P < 0.05）. No significant difference in the incidence of adverse events was observed between the two groups （P > 0.05）. Conclusions As an adjunct to conventional therapy， Linggui Bafa-based spatiotemporal moxibustion can effectively improve sleep quality， alleviate fatigue， anxiety， and depression， and promote neurological recovery in patients with sleep disorders following ischemic stroke. The underlying mechanism may be related to the regulation of sleep-associated neurotransmitters， such as 5-HT and MT. The intervention demonstrates a favorable safety profile and holds promise for clinical application.

Key words: Linggui Bafa, moxibustion, ischemic stroke, sleep disorder, 5-hydroxytryptamine, melatonin

CLC Number:

R246.6

Liangxian LIU,Li LI,Lihong HAN,Zhijuan HE,Zuhong WANG,Peidong HUANG,Xuejiao PAN. Effects of acupuncture of time acupoint space based on Linggui Bafa on serum 5-hydroxytryptamine and sleep quality in patients with sleep disorders following ischemic stroke[J]. The Journal of Practical Medicine, 2026, 42(15): 2684-2691.

Figures/Tables 5

Fig.1

Tab.1

Comparison of general data between the two groups"

项目	对照组（n = 39）	观察组（n = 39）	t/χ2值	P值
性别			0.21	0.65
男	22（56.41）	20（51.28）
女	17（43.59）	19（48.72）
年龄（x ± s）/岁	61.34 ± 8.72	62.05 ± 8.49	0.36	0.72
脑卒中病程（x ± s）/d	38.65 ± 12.47	39.12 ± 13.06	0.16	0.87
文化程度			0.40	0.82
小学及以下	10（25.64）	12（30.77）
初中及高中	19（48.72）	19（48.72）
大专及以上	10（25.64）	8（20.51）
缺血性脑卒中分型			0.53	0.91
大动脉粥样硬化型	10（25.64）	12（30.77）
小血管闭塞型	18（46.15）	15（38.46）
心源性栓塞型	6（15.38）	7（17.95）
其他	5（12.82）	5（15.38）
高血压病史			0.06	0.81
有	25（64.10）	26（66.67）
无	14（35.90）	13（33.33）
糖尿病史			0.25	0.62
有	12（30.77）	10（25.65）
无	27（69.23）	29（74.36）
心脏病史			0.08	0.77
有	8（20.51）	7（17.95）
无	31（79.49）	32（82.05）
失眠病程（ $x ˉ ± s$ ）/个月	4.72 ± 1.31	4.69 ± 1.27	0.10	0.92
肢体瘫痪程度			0.24	0.89
轻度	14（35.90）	16（41.03）
中度	18（46.15）	17（43.59）
重度	7（17.95）	6（15.38）

Tab.1

Tab.2

Tab.3

Tab.4

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项目	对照组（n = 39）	观察组（n = 39）	F_时间, P_时间	F_组间, P_组间	F_交互, P_交互
FSS评分			66.81, < 0.01	40.12, < 0.01	13.28, < 0.01
治疗前	48.35 ± 6.20	48.62 ± 6.16
治疗1周后	45.03 ± 6.02	40.35 ± 5.84^ac
治疗3周后	42.16 ± 5.95^a	32.48 ± 5.49^abc
PSQI总分			71.51, < 0.01	41.65, < 0.01	18.46, < 0.01
治疗前	12.47 ± 2.34	12.62 ± 2.31
治疗1周后	11.52 ± 2.27	9.45 ± 2.08^ac
治疗3周后	10.48 ± 2.21^a	6.53 ± 1.84^abc
HADS总分			52.17, < 0.01	40.03, < 0.01	8.16, < 0.01
治疗前	18.24 ± 4.21	18.31 ± 4.13
治疗1周后	16.38 ± 3.97	13.15 ± 3.50^ac
治疗3周后	14.26 ± 3.73^a	9.24 ± 2.98^abc
NIHSS评分			28.66, < 0.01	11.00, < 0.01	4.24, 0.02
治疗前	8.46 ± 3.06	8.53 ± 3.02
治疗1周后	7.52 ± 2.88	6.04 ± 2.49^ac
治疗3周后	6.48 ± 2.68^a	4.12 ± 2.11^abc

组别	5-HT			MT
组别	治疗前	治疗1周后	治疗3周后	治疗前	治疗1周后	治疗3周后
对照组（n = 39）	85.34 ± 15.46	90.18 ± 15.62	95.26 ± 15.88^a	25.18 ± 8.35	28.35 ± 8.67	32.14 ± 9.24^a
观察组（n = 39）	84.92 ± 15.38	105.34 ± 18.48^ac	128.45 ± 20.63^abc	24.86 ± 8.29	38.42 ± 10.41^ac	52.36 ± 12.61^abc
F_时间, P_时间	47.13， < 0.01			65.42， < 0.01
F_组间, P_组间	53.77， < 0.01			54.98， < 0.01
F_交互, P_交互	18.65， < 0.01			23.24， < 0.01

组别	显效	有效	无效	总有效率
对照组（n = 39）	12（30.77）	17（43.59）	10（25.64）	29（74.36）
观察组（n = 39）	21（53.85）	15（38.46）	3（7.69）	36（92.31）
χ2值				4.523
P值				0.033

Effects of acupuncture of time acupoint space based on Linggui Bafa on serum 5-hydroxytryptamine and sleep quality in patients with sleep disorders following ischemic stroke

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