【目的】 观察耳穴压豆联合耳穴刮痧对神经内科睡眠障碍患者睡眠质量、睡眠结构指标及神经递质的影响。【方法】 选 取2022年6月至2024年6月南京医科大学附属南京医院神经内科收治的110例睡眠障碍患者为研究对象。按随机数字表将患 者随机分为观察组和对照组，每组各 55例。对照组给予艾司唑仑片治疗，观察组给予耳穴压豆联合耳穴刮痧治疗。疗程为 4周。治疗后，评价2组临床疗效。观察2组患者治疗前后匹兹堡睡眠质量指数（PSQI）量表评分的变化情况，以及睡眠结构 指标的情况，包括总睡眠时间（TST）、入睡潜伏期（SL）、微觉醒指数（AI）、非快速眼球运动睡眠时间（NREM）[浅睡期（S1）、 浅睡加深期（S2）、中度睡眠期（S3）、深度睡眠期（S4）]、实际睡眠时间（AST）、睡眠效率（SE）、快速眼球运动睡眠时间 （REM）的情况。比较 2 组患者治疗前后血清去甲肾上腺素（NE）、5-羟色胺（5-HT）、γ-氨基丁酸（GABA）水平的变化情况， 以及生活质量量表（SF-36）评分的变化情况。并评价 2 组的安全性及不良反应的发生情况。【结果】（1）观察组总有效率为 96.61%（53/55），对照组为 81.82%（45/55）。观察组疗效优于对照组，差异有统计学意义（P＜0.05）。（2）治疗后，2组患者的 PSQI评分均明显改善（P＜0.05），且观察组在改善患者PSQI评分方面明显优于对照组，差异有统计学意义（P＜0.05）。（3）治 疗后，观察组的睡眠结构指标，包括TST、SL、AI、S1、S2、S3、S4、AST、SE、REM均明显改善，与对照组比较，差异均 有统计学意义（P＜0.05）。（4）治疗后，2 组患者血清 NE、5-HT、GABA 水平均明显改善，且观察组在改善血清 NE、5-HT、 GABA水平方面明显优于对照组，差异有统计学意义（P＜0.05）。（5）治疗后，2组患者的SF-36评分明显改善，且观察组在改 善 SF-36 评分方面明显优于对照组，差异有统计学意义（P＜0.05）。（6）观察组不良反应总发生率为 0.00%（0/55），对照组为10.91%（6/55），观察组的不良反应发生率明显低于对照组，差异有统计学意义（P＜0.05）。【结论】 耳穴压豆联合耳穴刮痧治 疗神经内科睡眠障碍，能够显著提升患者的睡眠质量，改善睡眠结构相关指标，调节神经递质水平，从而提高患者的生活 质量，并且安全有效。

Objective To investigate the effects of auricular point seed-pressing and earpoint scraping on sleep quality， sleep structure index and neurotransmitter in patients with sleep disorders in neurology department. Methods A total of 110 patients with sleep disorders treated in the Department of Neurology at Nanjing Hospital Affiliated to Nanjing Medical University from June 2022 to June 2024 were selected as the study subjects. The patients were randomly divided into an observation group and a control group using a random number table，with 55 cases in each group. The control group was treated with Estazolam Tablets，while the observation group received auricular point seed-pressing therapy combined with ear scraping therapy. The treatment course lasted for 4 weeks. After treatment， the clinical efficacy of the two groups was evaluated. Changes in the Pittsburgh Sleep Quality Index （PSQI） scores were observed before and after treatment，as well as sleep structure indicators，including total sleep time（TST），sleep latency（SL），arousal index（AI），non-rapid eye movement sleep time （NREM） [light sleep stage（S1），light to moderate sleep stage（S2），moderate sleep stage （S3），deep sleep stage （S4）]， actual sleep time（AST），sleep efficiency （SE），and rapid eye movement sleep time （REM）. The serum levels of norepinephrine （NE），5-hydroxytryptamine （5-HT），and gamma-aminobutyric acid （GABA） were compared before and after treatment， as well as changes in the Quality of Life Scale （SF-36） scores. The safety and incidence of adverse reactions in the two groups were also evaluated. Results （1） The total effective rate in the observation group was 96.61% （53/55），while it was 81.82% （45/55） in the control group. The efficacy of the observation group was superior to that of the control group，with a statistically significant difference （P＜0.05）. （2）After treatment，the PSQI scores of both groups were significantly improved （P＜0.05），and the observation group showed significantly better improvement in PSQI scores compared to the control group，with a statistically significant difference （P＜0.05）.（3） After treatment， the sleep structure indicators in the observation group， including TST， SL， AI， S1， S2， S3， S4， AST， SE， and REM， were significantly improved， and the differences were statistically significant compared to the control group （P＜0.05）.（4） After treatment，the serum levels of NE，5-HT，and GABA in both groups were significantly improved，and the observation group showed significantly better improvement in these levels compared to the control group， with a statistically significant difference （P＜0.05）.（5） After treatment，the SF-36 scores of both groups were significantly improved，and the observation group showed significantly better improvement in SF-36 scores compared to the control group，with a statistically significant difference （P＜0.05）.（6） The total incidence of adverse reactions in the observation group was 0.00%（0/55），while it was 10.91%（6/55） in the control group. The incidence of adverse reactions in the observation group was significantly lower than that in the control group，with a statistically significant difference（P＜0.05）. Conclusion Auricular point seed-pressing therapy combined with ear scraping therapy for the treatment of sleep disorders at the Department of Neurology can significantly improve patients’ sleep quality， enhance sleep structure-related indicators，regulate neurotransmitter levels，thereby improving patients’ quality of life with high safety and efficacy.

R246.9

南京市中医药科技专项资助项目（编号：ZYYB202204）；江苏省科技资助项目（编号：BK20240256）