经皮耳迷走神经刺激对老年2型糖尿病患者睡眠及自主神经功能的影响

doi:10.3969/j.issn.1003-9198.2026.06.008

摘要/Abstract

摘要： 目的观察经皮耳迷走神经刺激(taVNS)对老年T2DM患者睡眠质量及自主神经功能的影响。方法选择老年T2DM患者80例,采用随机数表法分为taVNS组和对照组。taVNS组在左侧耳甲艇区域行taVNS治疗,对照组电极位置相同,短暂递增刺激强度后关闭设备。治疗频次为2次/d,每周5 d,连续治疗4周。于治疗前1 d、治疗结束后次日及治疗结束后12周,采用ActiGraph体动记录仪、匹兹堡睡眠质量指数(PSQI)分别评估2组患者客观及主观睡眠情况,采用心率变异性(HRV)分析仪监测2组患者HRV相关指标,采用焦虑自评量表(SAS)、抑郁自评量表(SDS)评估患者情绪状况,并记录治疗相关不良反应。结果与治疗前和对照组比较,taVNS组在治疗结束后次日及12周的PSQI总分下降,睡眠开始潜伏期缩短,觉醒次数减少,总睡眠时间延长,睡眠效率提高,HRV相关参数均升高,SAS、SDS评分降低(P<0.05)。另外,与治疗前比较,taVNS组在治疗结束后次日及治疗结束后12周的深睡眠比例及快波睡眠比例提高(P<0.05)。干预期间未出现taVNS相关不良反应。本研究Jame's BI指数为0.16,提示盲法效果良好。结论 taVNS持续治疗4周能改善老年T2DM患者睡眠质量及自主神经功能,缓解患者焦虑、抑郁情绪,具有良好的安全性。

关键词: 经皮耳迷走神经刺激, 睡眠障碍, 2型糖尿病, 自主神经功能

Abstract: Objective To observe the effects of transcutaneous auricular vagus nerve stimulation (taVNS) on sleep quality and autonomic nerve function in elderly patients with type 2 diabetes mellitus (T2DM). Methods Eighty elderly T2DM patients were selected and divided into taVNS group and control group according to a random number table. Participants in the taVNS group received taVNS at the left cymba conchae region. The control group underwent identical electrode placement with the device switched off after a brief ramp-up. The intervention was administered twice daily, five days a week, for four consecutive weeks. The ActiGraph accelerometer and the Pittsburgh Sleep Quality Index (PSQI) were used to record objective and subjective sleep conditions of the two groups, respectively. Heart rate variability (HRV) was monitored, and emotional status was assessed using Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS). Assessments were conducted at baseline, immediately after, and 12 weeks after the intervention. Adverse reactions were recorded in both groups. Results Compared with baseline, the taVNS group exhibited a decrease in total PSQI score, shortened sleep onset latency, reduced times of awakenings, prolonged total sleep time, improved sleep efficiency, increased proportion of deep sleep and rapid eye movement sleep, increased HRV-related parameter values, and decreased SAS and SDS scores on the day after treatment and 12 weeks after treatment(P<0.05). These improvements were significantly greater in the taVNS group than those in the control group at both time points (all P<0.05), expect for proportion of deep sleep and rapid eye movement sleep. No taVNS-related adverse reactions occurred. James' blinding index in this study was 0.16, indicating good blinding effectiveness. Conclusions Four weeks of continuous taVNS can safely and effectively improve sleep quality and autonomic nerve function, and alleviate anxiety and depression in elderly patients with T2DM.

Key words: transcutaneous auricular vagus nerve stimulation, sleep disorders, type 2 diabetes mellitus, autonomic function

中图分类号:

R 587.1

白莉莉, 王晓亮, 史宏伟, 胡夏娟, 曹媛媛, 成中娟. 经皮耳迷走神经刺激对老年2型糖尿病患者睡眠及自主神经功能的影响[J]. 实用老年医学, 2026, 40(6): 579-584.

BAI Lili, WANG Xiaoliang, SHI Hongwei, HU Xiajuan, CAO Yuanyuan, CHENG Zhongjuan. Effect of transcutaneous aurcular vagus nerve stimulation on sleep and autonomic function in elderly patients with type 2 diabetes mellitus[J]. Practical Geriatrics, 2026, 40(6): 579-584.

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