| Objective :(1)The effects of REM sleep deprivation on behavior(anxiety behavior,learning and memory behavior)and the contents of No and NOS in hippocampus of rats were observed by establishing sleep deprivation model.To explore the effect of sleep deprivation on anxiety behavior and learning and memory ability of rats and its possible mechanism;(2)To study the relationship between TCM syndromes and PSQI(Pittsburgh Sleep Index scale)and Hama(Hamilton anxiety scale)in patients with insomnia and anxiety,to combine the TCM syndrome type with the scale,and to make the clinical differentiation of TCM syndrome more objectively.Methods:(1)Animal experiment: 50 adult,male and healthy rats were fed for 1 week,and42 mice were randomly divided into 7 groups,normal control group(CC group),sleep deprivation of 24 h、48 h、96 h、120 h group(SD2424h、48h、72h、96h、120h group),and big platform control group(TC group).Establishing sleep deprivation model in rats,Observation of REM sleep deprivation at different stages The changes of No and NOS in hippocampus of rats were detected by using OFT test and LDB test to observe anxiety behavior and Morris water maze test to observe learning and memory behavior,and enzyme linked immunosorbent assay(Elisa)to detect the content of no and NOS in hippocampus of rats.(2)Clinical study: 98 patients with insomnia and anxiety were selected for general data investigation,information collection of traditional Chinese medicine,PSQI,HAMA.A preliminary study on the general situation of patients with insomnia with anxiety,the relationship between amnesia and insomnia quality and anxiety state,the type of insomnia,the relationship between TCM syndromes and the total score of PSQI and HAMA scale and each factor score.Results: Animal experiment:(1)The results of OFT test showed that compared with CC and TC group,the retention time and standing times of SD 24h、48 h、72 h group in the center grid of open field and the times of standing upright showed a decreasing trend,the difference is statistically significant(P<0.05,P<0.01),There was no significant difference in the difference between the two groups of SD24 h and 48h(P>0.05),there was no significant difference among the three groups in SD72h、96h、120h;The results of LDB experiment showed that the time of open box and the number of shuttle in each group showed a decreasing trend with the prolongation of sleep deprivation time,The SD24h、48h 、 72 h 、 96 h 、 120 h group was significantly different from the CC and TC group(P<0.05,P<0.01),There was a significant difference in SD24h、 48 h 、72h 、96 h 、120h group(P<0.05).(2)Before REM sleep deprivation,the positioning navigation experiment and space exploration experiment of Morris water maze were carried out 4times a day for 5 days.During the whole training process,the escape latency of all rats gradually decreased,and the target quadrant time gradually increased.There was no significant difference among the groups(P>0.05),compared with the first one,the 2、3、4 、 5 times difference was statistically significant(P<0.05),there was no significant difference in the ratio between the groups on the 3、4、5 times(P>0.05);The Morris water maze space exploration experiment was carried out immediately after the corresponding time of REM sleep deprivation.The percentage of target quadrant time of each group was analyzed by single factor variance analysis,there was no significant difference between SD24 h and SD48 h after modeling(P>0.05);There was a significant difference between SD24 h and SD72h、 96h、120h after modeling(P<0.05),.there was no significant difference in SD72h、96h、120h group(P>0.05).(3)Compared with CC and TC groups,the levels of No and NOS increased,but there was no significant difference(P>0.05).Compared with CC group and TC group,the levels of no and NOS increased after sleep deprivation(P<0.05,P<0.01).The increase of no and NOS in hippocampal tissue of rats increased with the prolongation of sleep time for 48 to 72 hours.Clinical research:(1)The population characteristics of insomnia with anxiety state: the age composition was mainly youth and middle age,the female was more,the culture was low,married,the course of disease was not short,some of them had taken western medicine treatment.There was a positive correlation between PSQI and total HAMA score.The results indicated that there was a positive correlation between the severity of insomnia and anxiety in the patients with insomnia and anxiety,the total score of HAMA and PSQI in the group with amnesia was higher than that in the group without amnesia.The most common symptoms of TCM are upset,irritable,forgetful,palpitation,red tongue,nervous,dizzying head.The TCM syndromes are liver depression and fire,phlegm heat internal disturbance,deficiency of heart and spleen,Yin deficiency fire,and heart asthenia and timidity.The types of insomnia are more difficult to fall asleep,sleep is not real / easy to wake up,and many dreams,etc.The patients with insomnia and anxiety mainly had difficulty falling asleep.(3)there was no statistical difference in the total score of PSQI between the five groups by ANOVA analysis of variance.But in the following three factors,there are differences in the scores of each syndrome type: in the time of falling asleep,the PSQI score of liver depression and phlegm heat disturbance is longer than that of the deficiency of heart and spleen,and in sleep time and sleep efficiency,the liver is depressed.The PSQI score of fire,phlegm and heat disturbance was less than that of heart and spleen deficiency.(4)The total scores of HAMA from high to low were liver fire disturbing heart type,phlegm heat disturbing heart type,heart and kidney disjoint type,heart and spleen deficiency type,heart and gallbladder qi deficiency type,HAMA factor score,in anxiety mood,tension,cardiovascular system symptom,respiratory system symptom.During the talks,the behavioral performance factors were higher in the types of liver fire and heart disturbance and phlegm heat disturbing heart type;in depression,gastrointestinal system symptom factors were higher in liver heat disturbance heart type,phlegm heat disturbance heart type,heart and spleen deficiency type;in cognitive function,muscle system symptom,The sensory system symptom factor score was higher than that in the genitourinary system symptom score and the vegetative nervous system symptom factor score in the five groups.There was no significant difference between the types of medical syndromes.Conclusion :(1)Animal experiments showed that with the prolongation of sleep deprivation time,anxiety level increased,learning and memory ability decreased,no level and NOS increased in hippocampus.Sleep deprivation for 72 hours was the key point for the change of learning,memory and anxiety behavior.No and NOS in hippocampus changed significantly at 48h-72 h after sleep deprivation.The changes of anxiety behavior and learning and memory ability of rats may be 48-72 hours before sleep deprivation.In hippocampus,no and NOS play normal physiological roles and play a part of the role.The neurotoxic effects of no and NOS play a dominant role after 48-72 hours.(2)clinical observation shows that there is a positive correlation between the severity of insomnia associated with anxiety in patients with insomnia symptoms and symptoms of anxiety,the anxiety status of patients with sleep quality and forgetful symptoms worse,syndrome of liver fire syndrome of phlegm heat in the highest proportion,the second.How long sleep time.Sleep time is reduced and the characteristics of low sleep efficiency.The relationship between liver fire type and phlegm heat type and anxiety syndromes in the most closely,not only the high incidence and severity of anxiety,followed by two empty cases. |
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