耳穴貼壓治療慢性腎臟病合并阻塞性睡眠呼吸暫停綜合征的臨床研究

劉榮玥 孔祥棟

[關鍵詞] 阻塞性睡眠呼吸暫停綜合征;慢性腎臟病;耳穴貼壓;多導睡眠圖;嗜睡

[中圖分類號] R246.1? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1673-9701（2021）20-0032-03

Clinical study of auricular point sticking therapy in chronic kidney disease with obstructive sleep apnea syndrome

LIU Rongyue1? ?KONG Xiangdong2

1.Department of Otorhinolaryngology， the First People′s Hospital of Fuyang District in Hangzhou， Hangzhou? ?311400， China; 2.Department of Nephrology， the First People′s Hospital of Fuyang District in Hangzhou， Hangzhou? ?311400， China

[Abstract] Objective To explore the clinical effect of ear acupoint pressing on chronic kidney disease （CKD） combined with obstructive sleep apnea syndrome （OSAS）. Methods Forty patients with CKD （stage 3-5） combined with OSAS who were admitted to the First People′s Hospital of Fuyang District from January 2018 to June 2019 were selected as the research subjects. All of them received ear acupoint pressing Wangbuliuxing seed treatment.The selected ear acupoints were Shenmen， sympathetic and subcortical，spleen，lung， anterior pituitary， stomach， large intestine and inner and outer nose. The course of treatment was 2 weeks. The polysomnography （PSG） indicators of the patients after treatment were compared， including the apnea-hypopnea index （AHI）， hypopnea index （HI）， pause index （AI） and minimum blood oxygen saturation （SaO2） changes. At the same time， Epworth Sleepiness Scale （ESS） was used to evaluate the degree of daytime sleepiness. Results After treatment， Ahi， AI and HI were （13.4±3.8） Times/h， （9.8±3.1） times/h and （4.1±1.5） Times/h， which were significantly lower than （18.3±4.9） Times/h， （13.9±4.5） Times/h and （5.7±1.6） times/h before treatment The lowest SAO2 was （85.2±12.4）%， significantly higher than that before treatment （79.4±9.7）%， the difference was statistically significant （P<0.05）. After treatment， the average ESS score was （5.2±1.4）points， significantly lower than that before treatment （7.1±2.3）points， the difference was statistically significant（P<0.05）. Conclusion Ear acupoint pressing in the treatment of chronic kidney disease complicated with obstructive sleep apnea syndrome can improve the sleep structure and sleep quality of patients， thereby improving the quality of life of patients.

[Key words] Obstructive sleep apnea syndrome; Chronic kidney disease; Ear acupoint pressing; Polysomnography; Somnolence

阻塞性睡眠呼吸暫停綜合征（Obstructive sleep apnea syndrome，OSAS）是一種臨床常見疾病，其臨床癥狀可有夜間打鼾、夜間憋醒、白天嗜睡、頭暈、注意力不集中、記憶力下降及價值高血壓等，長期可明顯增加心血管疾病的發病風險[1]。近年來，研究發現OSAS在慢性腎臟病（Chronic kidney disease，CKD）患者中十分常見，是影響CKD患者生活質量的重要因素[2]。西醫治療OSAS缺乏有效藥物，而手術的療效不確切，持續正壓通氣療法雖然有較好的療效，但是患者的治療依從性差。因此，對于終末期腎臟病合并OSAS的患者，西醫更缺乏針對性的治療措施。耳穴貼壓療法是一種具有悠久歷史的中醫外治方法，具有方便、經濟、無副作用、依從性高的特點，已經應用于多種急慢性疾病的治療，尤其是治療睡眠障礙療效確切[3-4]。本研究探討耳穴貼壓治療慢性腎臟病合并OSAS的臨床療效，現報道如下。