高压氧舱内同步脑仿生电刺激对脑卒中相关睡眠障碍的效果

doi:10.3969/j.issn.1006-9771.2025.05.001

《中国康复理论与实践》 ›› 2025, Vol. 31 ›› Issue (5): 497-504.doi: 10.3969/j.issn.1006-9771.2025.05.001

• 专题神经电刺激在康复中的应用 • 上一篇下一篇

高压氧舱内同步脑仿生电刺激对脑卒中相关睡眠障碍的效果

梁丹, 王卫宁, 李策, 吴越, 徐舒, 谢鸿宇, 吴毅, 朱玉连()

复旦大学附属华山医院康复医学科，上海市 200040

收稿日期:2025-02-18 修回日期:2025-04-11 出版日期:2025-05-25 发布日期:2025-05-26
通讯作者: 朱玉连(1969-)，女，汉族，上海市人，博士，主任治疗师，博士研究生导师，主要研究方向：神经肌肉损伤后康复治疗技术和机制研究。E-mail： hsyykfkzyl@163.com
作者简介:梁丹(1989-)，女，汉族，湖北广水市人，博士，主治医师，主要研究方向：脑卒中、颅脑外伤等神经系统疾病运动、认知功能障碍康复的临床与基础研究。
基金资助:
1.国家自然科学基金青年项目(82102666);2.上海市科技创新行动计划医学创新研究专项(22Y31900202);3.上海市创新医疗器械应用示范项目(23SHS05400-05)

Effect of synchronous brain bionic electrical stimulation in hyperbaric oxygen chamber on stroke-related sleep disorders

LIANG Dan, WANG Weining, LI Ce, WU Yue, XU Shu, XIE Hongyu, WU Yi, ZHU Yulian()

Department of Rehabilitation, Huashan Hospital, Fudan University, Shanghai 200040, China

Received:2025-02-18 Revised:2025-04-11 Published:2025-05-25 Online:2025-05-26
Contact: ZHU Yulian, E-mail: hsyykfkzyl@163.com
Supported by:
National Natural Science Foundation of China (Youth)(82102666);Shanghai Science and Technology Innovation Action Plan Medical Innovation Research Special Project(22Y31900202);Shanghai Innovative Medical Device Application Demonstration Project(23SHS05400-05)

摘要/Abstract

摘要：

目的探讨高压氧治疗时同步进行脑仿生电刺激对脑卒中相关睡眠障碍患者的效果。
方法选取2023年11月至2024年11月复旦大学附属华山医院收治的68例脑卒中伴睡眠障碍患者，随机分为对照组(n = 34)和试验组(n = 34)。对照组接受常规高压氧治疗，试验组在此基础上接受舱内同步脑仿生电刺激治疗，共4周。治疗前后，采用匹兹堡睡眠质量指数(PSQI)、睡眠监测手环、焦虑自评量表(SAS)、抑郁自评量表(SDS)进行评估。
结果对照组4例、试验组1例脱落。治疗后，两组PSQI各项因子评分均降低(t > 2.693, P < 0.05)，除催眠药物(P > 0.05)外，试验组PSQI其余各项评分均明显低于对照组(t > 2.699, P < 0.01)；两组总睡眠时间、深度睡眠时间和快速动眼时间均显著延长(|t| > 7.270, P < 0.001)，试验组显著长于对照组(|t| > 5.712, P < 0.001)；两组SAS和SDS评分均显著降低(t > 9.530, P < 0.001)，试验组SAS和SDS评分显著低于对照组(t > 4.740, P < 0.001)。
结论高压氧同步脑仿生电刺激治疗能够有效延长脑卒中相关睡眠障碍患者总睡眠时间、深度睡眠时间、快速动眼时间，缓解脑卒中后焦虑、抑郁情绪，提升睡眠质量。

关键词: 脑卒中, 睡眠障碍, 高压氧治疗, 同步脑仿生电刺激, 情绪障碍

Abstract:

Objective To explore the effect of hyperbaric oxygen combined with synchronous brain bionic electrical stimulation on patients with stroke-related sleep disorders.
Methods From November, 2023 to November, 2024, a total of 68 stroke patients with stroke-related sleep disorders admitted to Huashan Hospital, Fudan University were selected. They were randomly divided into control group (n = 34) and experimental group (n = 34). The control group received routine hyperbaric oxygen therapy, while the experimental group received routine hyperbaric oxygen therapy combined with synchronous brain bionic electrical stimulation inside the chamber, for four weeks. Pittsburgh Sleep Quality Index (PSQI), sleep-monitoring wristbands, Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were used to assess the outcomes before and after treatment..
Results Four patients in the control group and one in the experimental group dropped out. After treatment, the scores of each factors of PSQI decreased in both groups (t > 2.693, P < 0.05), and were lower in the experimental group than in the control group (t > 2.699, P < 0.01), expect hypnotic drug use (P > 0.05); the total sleep time, deep sleep time and rapid eye movement sleep time became longer in both groups (|t| > 7.270, P < 0.001), and they were longer in the experimental group than in the control group (|t| > 5.712, P < 0.001); the scores of SAS and SDS decreased in both groups (t > 9.530, P < 0.001), and they were less in the experimental group than in the control group (t > 4.740, P < 0.001).
Conclusion Synchronous brain bionic electrical stimulation in hyperbaric oxygen chamber could effectively prolong the total sleep time, deep sleep time and rapid eye movement time of patients with stroke-related sleep disorders, relieve anxiety and depression after stroke, and improve sleep quality.

Key words: stroke, sleep disorders, hyperbaric oxygen therapy, synchronized brain bionic electrical stimulation, emotional disorders

中图分类号:

R743.3

梁丹, 王卫宁, 李策, 吴越, 徐舒, 谢鸿宇, 吴毅, 朱玉连. 高压氧舱内同步脑仿生电刺激对脑卒中相关睡眠障碍的效果[J]. 《中国康复理论与实践》, 2025, 31(5): 497-504.

LIANG Dan, WANG Weining, LI Ce, WU Yue, XU Shu, XIE Hongyu, WU Yi, ZHU Yulian. Effect of synchronous brain bionic electrical stimulation in hyperbaric oxygen chamber on stroke-related sleep disorders[J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(5): 497-504.

图/表 4

表1

表2

两组治疗前后PSQI评分比较"

项目	组别	n	测试	$x - ± s$	t值	P值
睡眠质量	对照组	30	前测	2.50±0.51	7.616	< 0.001
			后测	1.83±0.46
	试验组	33	前测	2.58±0.50	12.736	< 0.001
			后测	1.30±0.47
	治疗前两组均值差			-0.08±0.13	-0.595	0.554
	治疗后两组均值差			0.53±0.12	4.530	< 0.001
入睡时间	对照组	30	前测	2.47±0.51	7.167	< 0.001
			后测	1.77±0.43
	试验组	33	前测	2.52±0.51	17.333	< 0.001
			后测	1.33±0.48
	治疗前两组均值差			-0.05±0.13	-0.379	0.706
	治疗后两组均值差			0.43±0.12	3.765	< 0.001
睡眠时间	对照组	30	前测	2.43±0.50	5.525	< 0.001
			后测	1.77±0.50
	试验组	33	前测	2.48±0.51	25.145	< 0.001
			后测	1.42±0.50
	治疗前两组均值差			-0.05±0.13	-0.404	0.688
	治疗后两组均值差			0.34±0.13	2.699	0.009
睡眠效率	对照组	30	前测	2.43±0.50	7.077	< 0.001
			后测	1.80±0.48
	试验组	33	前测	2.45±0.51	12.000	< 0.001
			后测	1.36±0.49
	治疗前两组均值差			-0.02±0.13	-0.167	0.868
	治疗后两组均值差			0.44±0.12	3.556	0.001
睡眠障碍	对照组	30	前测	2.43±0.50	6.158	< 0.001
			后测	1.87±0.51
	试验组	33	前测	2.52±0.51	10.000	< 0.001
			后测	1.45±0.51
	治疗前两组均值差			-0.08±0.13	-0.641	0.524
	治疗后两组均值差			0.41±0.13	3.225	0.002
催眠药物	对照组	30	前测	1.37±0.49	2.693	0.012
			后测	1.17±0.38
	试验组	33	前测	1.36±0.55	4.000	< 0.001
			后测	1.03±0.17
	治疗前两组均值差			0.003±0.13	0.023	0.982
	治疗后两组均值差			0.14±0.08	1.805	0.079
日间功能障碍	对照组	30	前测	2.40±0.50	4.572	< 0.001
			后测	1.83±0.59
	试验组	33	前测	2.36±0.49	14.977	< 0.001
			后测	1.21±0.42
	治疗前两组均值差			0.04±0.12	0.292	0.771
	治疗后两组均值差			0.62±0.13	4.857	< 0.001
PSQI总分	对照组	30	前测	16.03±1.13	15.502	< 0.001
			后测	12.07±1.46
	试验组	33	前测	16.27±1.35	29.942	< 0.001
			后测	9.12±1.05
	治疗前两组均值差			-0.24±0.32	-0.758	0.451
	治疗后两组均值差			2.95±0.32	9.241	< 0.001

表2

表3

两组治疗前后睡眠相关指标比较"

评价指标	组别	n	测试	$x - ± s$	t值	P值
总睡眠时间	对照组	30	前测	263.33±33.87	-10.359	< 0.001
			后测	311.33±20.97
	试验组	33	前测	264.24±36.83	-9.403	< 0.001
			后测	356.36±39.59
	治疗前两组均值差			-0.91±8.95	-0.102	0.919
	治疗后两组均值差			-45.03±7.88	-5.712	< 0.001
深睡眠时间	对照组	30	前测	57.43±8.05	-7.270	< 0.001
			后测	63.87±7.51
	试验组	33	前测	57.70±7.98	-17.806	< 0.001
			后测	82.76±6.83
	治疗前两组均值差			-0.26±2.02	-0.130	0.897
	治疗后两组均值差			-18.89±1.81	-10.462	< 0.001
快速动眼时间	对照组	30	前测	48.23±8.37	-14.054	< 0.001
			后测	64.53±6.24
	试验组	33	前测	48.67±7.97	-27.262	< 0.001
			后测	80.03±7.43
	治疗前两组均值差			-0.43±2.06	-0.210	0.834
	治疗后两组均值差			-15.50±1.74	-8.918	< 0.001

表3

表4

两组治疗前后SAS和SDS评分比较"

评价指标	组别	n	测试	$x - ± s$	t值	P值
SAS	对照组	30	前测	66.70±2.91	9.530	< 0.001
			后测	57.07±5.93
	试验组	33	前测	66.64±3.68	16.158	< 0.001
			后测	48.33±5.42
	治疗前两组均值差			0.06±0.84	0.076	0.940
	治疗后两组均值差			8.73±1.43	6.106	< 0.001
SDS	对照组	30	前测	66.57±2.24	10.059	< 0.001
			后测	55.63±6.48
	试验组	33	前测	66.55±2.86	20.120	< 0.001
			后测	49.03±4.48
	治疗前两组均值差			0.02±0.65	0.033	0.974
	治疗后两组均值差			6.60±1.39	4.740	< 0.001

表4

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组别	n	性别(男/女)/n	年龄/岁	脑卒中病程/月	体质量指数/(kg·m^-2)
对照组	30	17/13	55.03±9.42	2.29±0.79	24.75±1.74
试验组	33	18/15	55.33±7.22	2.43±0.80	24.95±1.76
χ²/t值		0.029	0.143	0.715	0.442
P值		0.866	0.887	0.477	0.660

高压氧舱内同步脑仿生电刺激对脑卒中相关睡眠障碍的效果

Effect of synchronous brain bionic electrical stimulation in hyperbaric oxygen chamber on stroke-related sleep disorders

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