探討針刺足三里穴對疼痛引起之睡眠失調的影響

Abstract

針灸足三里穴於臨床上經常被利用來治療失眠，但其缺少科學證據；本實驗證實連續30分鐘針刺足三里穴兩天後，可以增加非快速動眼期與快速動眼期睡眠。而先前實驗室研究已證實電針刺激安眠穴時，藉由刺激交感神經促使孤獨徑核釋放內生性鴉片，使非快速動眼期睡眠增加，因此，我們同樣於孤獨徑核顯微注射鴉片類受器拮抗劑後，發現針刺足三里穴之安眠效果被抑制，進而得知針刺足三里穴可藉由刺激孤獨徑核中鴉片類物質釋放而達到安眠效果。 疼痛與睡眠之間互相影響，患有長期疼痛的病人經常同時存在著睡眠失調之情形；足三里穴除了安眠之外，亦是一止痛效果顯著之穴位，因此，我們進一步探討針刺足三里穴是否能夠改善因疼痛引起之睡眠失調，結果顯示原本因疼痛而造成之非快速動眼期與快速動眼期睡眠下降的情形，在接受針刺治療以後獲得改善。

Sleep disorders and chronic pain are often comorbid conditions and patients with primary insomnia also report chronic pain at the rate over 50%. Clinical studies show that pain-induced sleep disturbance may be improved by relief of pain. In clinic, ST-36 (Zusanli) is one of commonly used acupoints for the treatment of insomnia, but there is no scientific evidence. Therefore, the goal of this study was to investigate whether manual acupuncture at ST-36 can improve sleep and the underlying mechanisms. Therefore, this study also investigated the effects of acupuncture at ST-36 on pain-induced sleep disturbance. Our results indicated that acupuncture at ST-36 per se increased spontaneous NREMS and REMS via endogenous opioid system in NT. Moreover, acupuncture of ST-36 exhibits analgesic effects and improves pain-induced sleep disturbance.