电针调神穴对慢性失眠症患者过度觉醒的干预作用及脑功能机制的研究

注册号:

Registration number:

ITMCTR2025000495

最近更新日期:

Date of Last Refreshed on:

2025-03-10

注册时间:

Date of Registration:

2025-03-10

注册号状态:

Registration Status:

预注册

Prospective registration

注册题目:

电针调神穴对慢性失眠症患者过度觉醒的干预作用及脑功能机制的研究

Public title:

Study on the Intervention Effect of Electroacupuncture at Tiaoshen Points on Hyperarousal in Patients with Chronic Insomnia and Its Brain Functional Mechanism

注册题目简写:

English Acronym:

研究课题的正式科学名称:

电针调神穴对慢性失眠症患者过度觉醒的干预作用及脑功能机制的研究

Scientific title:

Study on the Intervention Effect of Electroacupuncture at Tiaoshen Points on Hyperarousal in Patients with Chronic Insomnia and Its Brain Functional Mechanism

研究课题的正式科学名称简写:

Scientific title acronym:

研究课题代号(代码):

Study subject ID:

2023-JYB-JBQN-032

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

张紫妍

研究负责人:

邢佳

Applicant:

ZHANGZIYAN

Study leader:

XINGJIA

申请注册联系人电话:

Applicant telephone:

15613358738

研究负责人电话:

Study leader's telephone:

13810680063

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

zhangziyanzzzy@163.com

研究负责人电子邮件:

Study leader's E-mail:

dfyyxingjia@163.com

申请单位网址(自愿提供):

Study leader's website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website
(voluntary supply):

申请注册联系人通讯地址:

北京市朝阳区北三环东路11号

研究负责人通讯地址:

北京丰台方庄芳星园一区6号

Applicant address:

No. 11 North Third Ring Road East Chaoyang District Beijing

Study leader's address:

No. 6 Fangxingyuan Phase 1 Fangzhuang Fengtai District Beijing

申请注册联系人邮政编码:

Applicant postcode:

100105

研究负责人邮政编码:

Study leader's postcode:

100078

申请人所在单位:

北京中医药大学东方医院

Applicant's institution:

Dongfang Hospital Beijing University of Chinese Medicine

是否获伦理委员会批准:

Approved by ethic committee:

伦理委员会批件文号:

Approved No. of ethic committee:

JDF-IRB-2024033202

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件

批准本研究的伦理委员会名称:

北京中医药大学东方医院临床研究伦理委员会

Name of the ethic committee:

IRB of Dongfang Hospital Beijing University of Chinese Medicine

伦理委员会批准日期:

Date of approved by ethic committee:

2025/1/20 0:00:00

伦理委员会联系人:

夏芸

Contact Name of the ethic committee:

XIAYUN

伦理委员会联系地址:

北京市丰台区方庄芳星园一区6号东方医院东楼南支444

Contact Address of the ethic committee:

Room 444 South Branch East Building Dongfang Hospital No. 6 Fangxingyuan Phase 1 Fangzhuang Fengtai District Beijing

伦理委员会联系人电话:

Contact phone of the ethic committee:

01067654807

伦理委员会联系人邮箱:

Contact email of the ethic committee:

dfyyec@126.com

研究实施负责(组长)单位:

北京中医药大学东方医院

Primary sponsor:

Dongfang Hospital Beijing University of Chinese Medicine

研究实施负责(组长)单位地址:

北京丰台方庄芳星园一区6号

Primary sponsor's address:

No. 6 Fangxingyuan Phase 1 Fangzhuang Fengtai District Beijing

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

北京市

市(区县):

丰台区

Country:

China

Province:

Beijing

City:

Fengtai District

单位(医院):

北京中医药大学东方医院

具体地址:

北京丰台方庄芳星园一区6号

Institution
hospital:

Dongfang Hospital Beijing University of Chinese Medicine

Address:

No. 6 Fangxingyuan Phase 1 Fangzhuang Fengtai District Beijing

经费或物资来源:

北京中医药大学揭榜挂帅项目

Source(s) of funding:

Beijing University of Chinese Medicine unveiled the leading project

研究疾病:

慢性失眠症

研究疾病代码:

Target disease:

Chronic insomnia

Target disease code:

研究类型:

Study type:

干预性研究

Interventional study

研究设计:

Study design:

随机平行对照

randomized controlled trial(parallel group design)

研究所处阶段:

Study phase:

其它

Others

研究目的:

探究电针调神穴对慢性失眠患者过度觉醒的干预作用及脑功能机制

Objectives of Study:

To explore the intervention effect and brain function mechanism of electroacupuncture Tiaoshen Point on excessive awakening of chronic insomnia patients

药物成份或治疗方案详述:

本研究可分为两部分,第一部分拟采用随机、单盲、对照设计,将伴过度觉醒的慢性失眠症患者分为电针调神穴、假电针调神穴及电针假调神穴三组,在治疗前后通过神 经行为学量表(拟采用匹兹堡睡眠质量指数 PSQI、艾泼沃斯嗜睡量表 ESS、入睡前觉醒 量表 PSAS、过度觉醒量表 HAS、简易抑郁自测量表 PHQ-9、广泛性焦虑障碍量表 GAD-7) 评估其临床疗效,拟回答关键科学问题:电针调神穴治疗过度觉醒的慢性失眠症患者临 床确有疗效,而非安慰剂效应。第二部分拟采用混合实验设计的研究方法,即研究包含了接受电针及假针刺治疗的 横向比较及对治疗疗程评估的纵向比较。拟借助目前较为先进的 fNIRs 技术进行脑网络 联结及脑功能的评价。fNIRs是一种无创的神经影像技术,为检测和分析大脑血氧信号 提供技术支持,可以监测局部氧合血红蛋白(Δ[HbO2])和脱氧血红蛋白(Δ[HHb]) 浓度的变化。在本研究中预拟使用近红外数据记录使用连续波 82 通道 fNIRS系统(NirSmart)进行超扫描。两组被试均需在治疗前完成 fNIRS全脑静息态任务与前额叶任 务态评估(拟采用 VFT 及 n-back 范式检测)。三组患者在治疗前、首次治疗完成后(即刻治疗效果)、接受 2 周治疗后进行相应任务的数据采集。动态探索电针调神穴治疗慢 性失眠症的疗效机制。并在治疗前后通过外周血清 GABA、GLu、MT、IL-1β、IL-4、IL-6、 IL-10 及 TNF-α、TGF-β、INF-γ等相关指标从神经-内分泌-炎症网络角度结合神经功 能评估从中枢到外周的过度激活和炎症诱导,进而诱发多种心身疾病的机制,以回答关键科学问题:揭示电针调穴可通过调节过度觉醒机制综合改善慢性失眠症患者的睡眠质 量、日间功能及情绪状态,并为进一步从调控睡眠防治心身相关疾病奠定前期基础。

Description for medicine or protocol of treatment in detail:

This study can be divided into two parts. The first part intends to adopt a randomized single-blind controlled design to divide patients with chronic insomnia accompanied by hyperarousal into three groups: electroacupuncture at Shen points sham electroacupuncture at Shen points and electroacupuncture at sham Shen points. Before and after treatment the clinical efficacy will be evaluated through neurobehavioral scales (including the Pittsburgh Sleep Quality Index PSQI Epworth Sleepiness Scale ESS Pre-Sleep Arousal Scale PSAS Hyperarousal Scale HAS Patient Health Questionnaire-9 PHQ-9 and Generalized Anxiety Disorder Scale GAD-7). The key scientific question to be answered is whether electroacupuncture at Shen points has a definite clinical effect on patients with chronic insomnia accompanied by hyperarousal rather than a placebo effect. The second part intends to adopt a mixed experimental design which includes both a cross-sectional comparison of patients receiving electroacupuncture and sham acupuncture and a longitudinal comparison of the treatment course. The current advanced fNIRs technology will be used to evaluate brain network connections and brain functions. fNIRs is a non-invasive neuroimaging technique that provides technical support for detecting and analyzing brain oxygen signals and can monitor changes in the concentrations of local oxygenated hemoglobin (Δ[HbO2]) and deoxygenated hemoglobin (Δ[HHb]). In this study it is planned to use the continuous-wave 82-channel fNIRS system (NirSmart) for hyperscanning to record near-infrared data. Both groups of subjects need to complete the fNIRS whole-brain resting-state task and prefrontal task-state assessment (using the VFT and n-back paradigms for detection) before treatment. Data collection for the corresponding tasks will be conducted for the three groups of patients before treatment immediately after the first treatment (immediate treatment effect) and after 2 weeks of treatment. The dynamic exploration of the therapeutic mechanism of electroacupuncture at Shen points for chronic insomnia will be carried out. Before and after treatment peripheral serum GABA GLu MT IL-1β IL-4 IL-6 IL-10 TNF-α TGF-β and INF-γ and other related indicators will be measured to explore the mechanism of overactivation and inflammation induction from the central to the peripheral nervous-endocrine-inflammatory network in combination with neurofunctional assessment thereby inducing various psychosomatic diseases. The key scientific question to be answered is whether electroacupuncture at Shen points can comprehensively improve the sleep quality daytime function and emotional state of patients with chronic insomnia by regulating the hyperarousal mechanism and lay the foundation for further prevention and treatment of psychosomatic diseases through sleep regulation.

纳入标准:

(1)符合慢性失眠症诊断标准; (2)PSQI≥7 分; HAS≥32分; (3)18 岁≤年龄≤65 岁; (4)能够配合完成各项量表测评及样本采集者; (5)签署知情同意书。

Inclusion criteria

(1) Meeting the diagnostic criteria for chronic insomnia disorder; (2) PSQI score ≥ 7; HAS score ≥ 32; (3) Age ranging from 18 to 65 years old; (4) Capable of cooperating with all scale assessments and sample collections; (5) Having signed the informed consent form.

排除标准:

(1)罹患恶性肿瘤及严重心、肝、肾、神经系统等严重躯体疾病者疾病; (2)焦虑、抑郁等精神障碍导致的继发性失眠患者; (3)物质使用障碍患者(包括酒精、烟草、咖啡因、镇静剂、精神活性药等物质成瘾或滥用); (4)SQ ≥5 分;SBQ ≥3 分;IRLS ≥10 分; (5)长期使用镇静安眠药及抗抑郁等精神药物; (6)GAD-7≥10 分;PHQ-9≥10 分; (7)妊娠期、哺乳期、备孕期妇女; 凡符合以上任意一条的受试者,均予以排除。

Exclusion criteria:

(1) Patients suffering from malignant tumors and serious physical diseases such as heart liver kidney and nervous system; (2) Patients with secondary insomnia caused by anxiety depression and other mental disorders; (3) People with substance use disorders (including alcohol tobacco caffeine sedatives psychoactive drugs etc.) Addiction or abuse); (4) SQ ≥5 points; SBQ ≥3 scores; IRLS ≥10 score; (5) long-term use of sedative sleeping pills and antidepressants and other psychotropic drugs; (6) GAD-7≥10 score; PHQ-9≥10 scores; (7) Women during pregnancy lactation and preparation for pregnancy; Subjects who meet any of the above criteria will be excluded.

研究实施时间:

Study execute time:

From 2023-06-01

To      2025-12-01

征募观察对象时间:

Recruiting time:

From 2025-03-20

To      2025-12-01

干预措施:

Interventions:

组别:

假电针调神穴组

样本量:

29

Group:

Fake electroacupuncture Tiaoshen point group

Sample size:

干预措施:

针刺百会、神门、内关后,实质上不予电针治疗,仅连接电针,不予通电, 其中针具的选择、取穴部位、治疗频次与周期同电针调神穴组。

干预措施代码:

Intervention:

After acupuncture Baihui Shenmen and Neiguan electroacupuncture is not treated in essence only connected with electroacupuncture no electricity in which the choice of acupuncture point location treatment frequency and cycle are the same as that of electroacupuncture Tiaoshen point group.

Intervention code:

组别:

电针假调神穴组

样本量:

29

Group:

Electroacupuncture fake tiaoshen point group

Sample size:

干预措施:

百会、神门、内关穴旁边非经非络穴浅刺。针具选择、电针部位、治疗频次与周期同电针调神穴组。

干预措施代码:

Intervention:

Baihui Shenmen Neiguan beside the non-meridian non-collaterals shallow thorn. Needle selection electroacupuncture site treatment frequency and cycle were the same as Tiaoshen point group.

Intervention code:

组别:

电针调神穴组

样本量:

29

Group:

Electroacupuncture Tiaoshen point group

Sample size:

干预措施:

针刺百会、神门、内关,除百会外均双侧取穴,百会平刺 0.8 寸;神门直刺 0.5 寸; 内关直刺1 寸;进针后百会、神门、内关接电针正负极。治疗时所有穴位均使用 0.35mm× 40mm无菌针灸针。采用疏密波,电针疏波 2Hz,密波 100Hz,针刺前需 全身放松,取坐位或仰卧位,强度以患者感觉轻度麻、胀、刺、痛或针柄微颤为 度。每次留针 30min,干预 2 周,每周 5 次,2 周均连续针刺 5 天,间隔 2 天,连 续针刺治疗累计不小于 10次(2 周)。

干预措施代码:

Intervention:

Acupuncture Baihui Shenmen Neiguan except Baihui are double-sided point selection after entering the needle Baihui Shenmen Neiguan is connected with the positive and negative electrodes of the electric needle. Keep the needle for 30min each time and intervene 5 times a week for 2 weeks

Intervention code:

样本总量 Total sample size : 87

研究实施地点:

Countries of recruitment
and research settings:

国家:

中国

省(直辖市):

北京市

市(区县):

丰台区

Country:

China

Province:

Beijing

City:

Fengtai District

单位(医院):

北京中医药大学东方医院

单位级别:

三级甲等

Institution/hospital:

Dongfang Hospital Beijing University of Chinese Medicine

Level of the institution:

Third class first class

测量指标:

Outcomes:

指标中文名:

神经行为量表

指标类型:

次要指标

Outcome:

PSAS HAS ESS PHQ-9 GAD-7

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

副作用量表

指标类型:

副作用指标

Outcome:

TESS

Type:

Adverse events

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

匹斯堡睡眠质量量表

指标类型:

主要指标

Outcome:

PSQI

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

近红外脑功能

指标类型:

次要指标

Outcome:

fNIRS

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

血清学机制指标

指标类型:

次要指标

Outcome:

Serological mechanism index

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

血液

组织:

Sample Name:

blood

Tissue:

人体标本去向

使用后销毁

说明

Fate of sample 

Destruction after use

Note:

征募研究对象情况:

尚未开始

Not yet recruiting

年龄范围:

最小 18
Min age years
最大 65
Max age years

Recruiting status:

Participant age:

性别:

Gender:

男女均可

Both

随机方法(请说明由何人用什么方法产生随机序列):

本研究由第三方通过计算机程序产生随机分配方案, 将随机号及相应的治疗方案封入不透明的信封内,观察医生按照病人入组顺序取号,选择对应编码的治疗方案,该药物编号将在整个试验过程中保持不变。

Randomization Procedure (please state who generates the random number sequence and by what method):

In this study a third party generated a random assignment plan through a computer program sealed the random number and the corresponding treatment plan into an opaque envelope and observed that doctors selected the number according to the order of patient enrollment and selected the treatment plan with the corresponding code. The drug number would remain unchanged throughout the trial.

盲法:

单盲

Blinding:

Single blind

是否共享原始数据:

IPD sharing:

No

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

病例记录表

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

CRF

数据管理委员会:

Data Managemen Committee:

暂未确定

Not yet

研究计划书或研究结果报告发表信息
(杂志名称、期、卷、页,时间;或网址):

Publication information of the protocol/research results report
(name of the journal, volume, issue, pages, time; or website):

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