航天医学与医学工程

目的 通过地基实验明确防治在轨航天员失眠的穴位处方并验证其有效性，为天基应用提供参考。方法 将60例天津中医药大学轻中度失眠参与者随机分为试验组和对照组，每组30例。试验组采用经皮穴位电刺激（TEAS）治疗，穴取内关、外关、神门、合谷、申脉、照海、太溪和三阴交，30 min/次，隔日1次，治疗4周；对照组采用等待治疗。在治疗前、治疗第2周、第4周和第8周随访时，通过匹兹堡睡眠质量指数（PSQI）、失眠严重程度指数（ISI）、汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表（HAMD）评分和睡眠监测仪监测各项睡眠指标，评价TEAS治疗轻中度失眠的临床疗效。结果 试验组治疗阶段和随访时的PSQI、ISI、HAMD评分呈现下降趋势，且明显优于对照组（P<0.05）；试验组治疗第4周和第8周随访时的HAMA评分改善程度显著优于对照组（P<0.05）；试验组治疗4周时在改善夜间觉醒次数和睡眠效率方面显著优于对照组（P<0.05）。结论 TEAS内关、外关、神门、合谷、申脉、照海、太溪和三阴交穴可显著改善轻中度失眠参与者的睡眠质量和焦虑抑郁情绪，为防治在轨航天员失眠提供临床数据支持。

Objective To clarify the prescription of acupoints for preventing and controlling insomnia problems of astronauts in orbit and to verify its effectiveness through ground-based experiments,so as to provide reference for space-based applications.Methods 60 patients with mild to moderate insomnia were randomly divided into 30 cases each in the experimental group and the control group.The experimental group was treated with TEAS,and the acupoints were Neiguan,Waiguan,Shenmen,Hegu,Shenmai,Zhaohai,Taixi,and Sanyinjiao for 30 min/times every other day for 4 weeks;the control group was treated with waiting.The TEAS treatment was evaluated using Pittsburgh sleep quality index(PSQI),insomnia severity index(ISI),Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD),and indicators measured by the sleep monitor at pre-treatment,2-week,4-week,and 8-week follow-ups.Clinical efficacy for mild to moderate insomnia was assessed.Results The PSQI,ISI,and HAMD scores in the experimental group exhibited a decreasing trend during treatment and at follow-up,with significantly greater improvement compared to the control group(P<0.05).The experimental group demonstrated significantly greater improvement in HAMA scores than the control group at both the 4-week and 8-week follow-up assessments(P<0.05).Additionally,the experimental group demonstrated significantly greater improvements in reducing nighttime awakenings and enhancing sleep efficiency compared to the control group at the 4-week treatment mark(P<0.05).Conclusion TEAS Neiguan,Waiguan,Shenmen,Hegu,Shenmai,Zhaohai,Taixi and Sanyinjiao acupoints can significantly improve the sleep quality and anxiety and depression of patients with mild to moderate insomnia,and provide clinical data support for the prevention and treatment of insomnia in astronauts in orbit.