目的 观察太极拳锻炼对慢性失眠障碍(CID)患者睡眠质量的影响，并探讨其作用机制。方法 收集2015年1月至2017年12月在睡眠障碍门诊就诊的CID患者31例。太极拳锻炼24周前后，采用匹兹堡睡眠质量指数(PSQI)评估患者睡眠质量；采用蛋白芯片检测患者血清肿瘤坏死因子(TNF)-α、TNF-β和可溶性肿瘤坏死因子受体(sTNF-R)1、sTNF-R2水平，并分析锻炼后PSQI评分与之相关性。结果 太极拳锻炼24周后，CID患者PSQI各因子(睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、日间功能)评分及PSQI总分均较锻炼前降低(t > 4.080, P < 0.05)；血清TNF-α、TNF-β水平明显下降(t > 13.580, P < 0.01)，血清sTNF-R1、sTNF-R2水平显著上升(t > 160.189, P < 0.001)；血清TNF-α、TNF-β水平与PSQI评分呈显著正相关(r > 0.638, P < 0.001)，而血清sTNF-R1、sTNF-R2水平与PSQI评分呈显著负相关(r < -0.532, P < 0.001)。结论 CID患者太极拳锻炼后睡眠质量改善，可能与降低血清TNF-α、TNF-β水平，上调血清sTNF-R1、sTNF-R2水平有关。
周清安
,
王献红
,
祝希泉
,
余海滨
,
刘金来
,
杨利杰
,
王林
,
杨波
,
李春梅
,
李红艳
. 太极拳锻炼对慢性失眠障碍患者睡眠质量的影响[J]. 中国康复理论与实践, 2019
, 25(2)
: 230
-233
.
DOI: 10.3969/j.issn.1006-9771.2019.02.019
Objective To explore the effect of Taiji Quan on the sleep quality of patients with chronic insomnia disorder (CID) and its mechanism. Methods From January, 2015 to December, 2017, 31 patients with CID were enrolled in the sleep disorder clinic. Before and 24 weeks after Taiji Quan exercise, the Pittsburgh Sleep Quality Index (PSQI) was used to assess their sleep quality, the serum levels of tumor necrosis factor (TNF)-α, TNF-β, soluble tumor necrosis factor receptor (sTNF-R)1 and sTNF-R2 were detected with protein chip, and the correlation between the total score of PSQI and the serum levels of TNF-α, TNF-β, sTNF-R1 and sTNF-R2 were analyzed after exercise. Results After Taiji Quan exercise, the scores of PSQI factors (subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, daytime dysfunction) and the total score of PSQI decreased (t > 4.080, P < 0.05). The serum levels of TNF-α and TNF-β decreased (t > 13.580, P < 0.01), however, the serum levels of sTNF-R1 and sTNF-R2 significantly increased (t > 160.189, P < 0.001). The serum levels of TNF-α and TNF-β were positively correlated with the total score of PSQI (r > 0.638, P < 0.001), while the serum levels of sTNF-R1 and sTNF-R2 were negatively correlated with the total score of PSQI (r > 0.532, P<0.001). Conclusion Taiji Quan exercise could help to improve the sleep quality of patients with CID. The mechanism may be related to the decrease of the serum levels of TNF-α and TNF-β, and the increase of the serum levels of sTNF-R1 and sTNF-R2.
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