耳穴贴压治疗慢性肾脏病合并阻塞性睡眠呼吸暂停综合征的临床研究

刘荣玥 孔祥栋

[关键词] 阻塞性睡眠呼吸暂停综合征;慢性肾脏病;耳穴贴压;多导睡眠图;嗜睡

[中图分类号] R246.1          [文献标识码] A          [文章编号] 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综合征（Obstructive sleep apnea syndrome，OSAS）是一种临床常见疾病，其临床症状可有夜间打鼾、夜间憋醒、白天嗜睡、头晕、注意力不集中、记忆力下降及价值高血压等，长期可明显增加心血管疾病的发病风险[1]。近年来，研究发现OSAS在慢性肾脏病（Chronic kidney disease，CKD）患者中十分常见，是影响CKD患者生活质量的重要因素[2]。西医治疗OSAS缺乏有效药物，而手术的疗效不确切，持续正压通气疗法虽然有较好的疗效，但是患者的治疗依从性差。因此，对于终末期肾脏病合并OSAS的患者，西医更缺乏针对性的治疗措施。耳穴贴压疗法是一种具有悠久历史的中医外治方法，具有方便、经济、无副作用、依从性高的特点，已经应用于多种急慢性疾病的治疗，尤其是治疗睡眠障碍疗效确切[3-4]。本研究探讨耳穴贴压治疗慢性肾脏病合并OSAS的临床疗效，现报道如下。