Ultrasound-Guided Stellate Ganglion Block with Cervicotemporal Myofascial Trigger Point Acupuncture for Insomnia with Comorbid Anxiety and Depression: A Retrospective Observational Study.

IF 3.4 2区医学 Q2 CLINICAL NEUROLOGY

Nature and Science of Sleep Pub Date : 2025-09-05 eCollection Date: 2025-01-01 DOI:10.2147/NSS.S551748

Zhenzhen Li, Lifeng Wang, Peilin Cong, Siyu Chen, Jingxuan Wang, He Zhang, Juan Zhao, Guiting Li, Fengmei Jiao, Linyan Li, Ruitao Wang, Qianqian Wu, Moxuan Gong, Zheping Chen, Yaozhu Wang

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引用次数: 0

Abstract

Purpose: Insomnia is a prevalent sleep-wake disturbance that significantly impairs the quality of life and adversely affects physical and mental health. This study aimed to evaluate the clinical efficacy of ultrasound-guided stellate ganglion block (SGB) combined with acupuncture at cervicotemporal myofascial trigger points (MTrPs) in patients with insomnia accompanied by anxiety and depression.

Patients and methods: This retrospective study included 42 patients diagnosed with insomnia and comorbid anxiety and depression who were treated at the Anesthesia and Sleep Clinic of the Shandong Second Provincial General Hospital between November 2024 and April 2025. All patients received ultrasound-guided SGB combined with acupuncture at cervicotemporal MTrPs. Treatment efficacy was assessed by comparing Pittsburgh Sleep Quality Index (PSQI), Hamilton Anxiety Scale (HAMA), and Hamilton Depression Scale (HAMD) scores before treatment initiation and four weeks after completion of the intervention.

Results: Compared with baseline, post-treatment PSQI scores (5.00 ± 2.84 versus 17.10 ± 2.61; mean difference, -12.10; 95% Cl, -12.91 to -11.28; P < 0.001), HAMA scores (5.05 ± 2.80 versus 19.00 ± 4.23; mean difference, -13.95; 95% Cl, -15.0912.82 to -12.82; P < 0.001), and HAMD scores (3.41 ± 2.68 versus 15.76 ± 4.43; mean difference, -12.36; 95% Cl, -13.56 to -11.15; P < 0.001) were all significantly reduced after four weeks of therapy.

Conclusion: The preliminary study suggests that ultrasound-guided SGB combined with acupuncture at the cervicotemporal MTrPs is an effective, comprehensive intervention for insomnia with comorbid anxiety and depression. The benefits may result from synergistic mechanisms involving autonomic balance regulation, suppression of excessive sympathetic activity, reduction of myofascial tension, and modulation of the sleep-wake cycle. These findings warrant further clinical application and investigation.

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超声引导星状神经节阻滞颈颞肌筋膜触发点针刺治疗失眠伴焦虑抑郁的回顾性观察研究

目的：失眠是一种普遍存在的睡眠-觉醒障碍，严重影响生活质量，对身心健康产生不利影响。本研究旨在评价超声引导星状神经节阻滞（SGB）联合针刺颈颞肌筋膜触发点（MTrPs）治疗失眠伴焦虑抑郁患者的临床疗效。患者和方法：本回顾性研究纳入了2024年11月至2025年4月在山东省第二总医院麻醉与睡眠门诊就诊的42例诊断为失眠并伴发焦虑和抑郁的患者。所有患者均接受超声引导下的SGB联合颈椎颞叶MTrPs针刺治疗。通过比较治疗开始前和干预完成后四周的匹兹堡睡眠质量指数（PSQI）、汉密尔顿焦虑量表（HAMA）和汉密尔顿抑郁量表（HAMD）评分来评估治疗效果。结果：与基线相比，治疗后PSQI评分（5.00±2.84比17.10±2.61，平均差值为-12.10;95% Cl, -12.91至-11.28,P < 0.001）、HAMA评分（5.05±2.80比19.00±4.23，平均差值为-13.95;95% Cl, -15.0912.82至-12.82,P < 0.001）和HAMD评分（3.41±2.68比15.76±4.43，平均差值为-12.36;95% Cl, -13.56至-11.15,P < 0.001）在治疗四周后均显著降低。结论：初步研究提示超声引导下的SGB联合针刺颈颞叶MTrPs是一种有效的综合干预失眠伴焦虑抑郁的方法。这些益处可能来自自主神经平衡调节、过度交感神经活动的抑制、肌筋膜张力的减少和睡眠-觉醒周期的调节等协同机制。这些发现值得进一步的临床应用和研究。

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来源期刊

Nature and Science of Sleep Neuroscience-Behavioral Neuroscience

CiteScore

5.70

自引率

5.90%

发文量

245

审稿时长

16 weeks

期刊介绍： Nature and Science of Sleep is an international, peer-reviewed, open access journal covering all aspects of sleep science and sleep medicine, including the neurophysiology and functions of sleep, the genetics of sleep, sleep and society, biological rhythms, dreaming, sleep disorders and therapy, and strategies to optimize healthy sleep. Specific topics covered in the journal include: The functions of sleep in humans and other animals Physiological and neurophysiological changes with sleep The genetics of sleep and sleep differences The neurotransmitters, receptors and pathways involved in controlling both sleep and wakefulness Behavioral and pharmacological interventions aimed at improving sleep, and improving wakefulness Sleep changes with development and with age Sleep and reproduction (e.g., changes across the menstrual cycle, with pregnancy and menopause) The science and nature of dreams Sleep disorders Impact of sleep and sleep disorders on health, daytime function and quality of life Sleep problems secondary to clinical disorders Interaction of society with sleep (e.g., consequences of shift work, occupational health, public health) The microbiome and sleep Chronotherapy Impact of circadian rhythms on sleep, physiology, cognition and health Mechanisms controlling circadian rhythms, centrally and peripherally Impact of circadian rhythm disruptions (including night shift work, jet lag and social jet lag) on sleep, physiology, cognition and health Behavioral and pharmacological interventions aimed at reducing adverse effects of circadian-related sleep disruption Assessment of technologies and biomarkers for measuring sleep and/or circadian rhythms Epigenetic markers of sleep or circadian disruption.