Clinical Observation Of Regulating Spirit Acupuncture Technique Combined With Drugs In Treatment Of Post-stroke Circadiam Rhythm Sleep-wake Disorder

Objective1.To observe the clinical efficacy of regulating spirit acupuncture technique combined with drugs in treatment of post-stroke circadiam rhythm sleep-wake disorder.To analyse the relationship between sleep quality、sleep rhythm、emotion and neurological functional rehabilitation.So as to provide a possible therapy idea of post-stroke CRSWD.Methods1.Patients with circadian rhythm sleep-wake disorder(CRSWD)who meet the criteria after stroke were divided into treatment group and control group according to the principle of random numbers.The intervention measures of the control group(drug group)used oral estazolam tablets,1 time/1mg/day,another group were combined with regulating spirit acupuncture technique on the basis of the control group,and were performed weekly 6 times of acupuncture:Sishenzhen,GV29,GV24,GB13,HT7,SP6,LI4,LR3,BL62,KI6,6 times as a course of treatment,continuous acupuncture intervention for 2 weeks,the treatment cycle of both groups is 14 days.Athens Insomnia Scale is main evaluation indicator;Hamilton Anxiety Scale and Health Stroke Scale of National Institutes are secondary evaluation indicators.And adverse reactions occurred during the trial were recorded at any time for safety evaluation.2.The descriptive analysis was performed using SPSS 22.0 software.Chi-square test was chosen for counting data.All measurement data were firstly test for normality.T-test was for the fits one while rank sum test was for the no-fits one and rank data.P<0.05 means that the difference is statistically significant while P<0.01 means that the difference has significant statistical significance.Results1.Case inclusion:the baseline data of all subjects finally included in this study:age,gender,course of disease,type of disease and pre-treatment AIS score,HAMA score,NIHSS score,AIS scores were not statistically significant(P>0.05)and they were good to comparability.2.Clinical efficacy:there were 2 recovered cases,6 markedly effective cases,20 effective cases,and 3 ineffective cases in the experimental group.The total effective rate of the experimental group was 90.30%,while that of the control group was 70.00%.There were no cured cases in the control group,3 markedly effective cases,18 effective cases,and 9 ineffective cases.And this was statistically difference(P<0.05).It revealed that the effect of experimental group was better than the drug group.3.Sleep improvement:no matter the AIS score is compared before and after treatment,or the difference between the two groups before and after treatment,the difference between the two groups is statistically significant(P<0.05).AIS scores were compared before and after treatment in the two groups.There were statistically significant differences in the time to fall asleep,early awakening at night,total sleep quality,and total sleep time(P<0.05);the treatment group was awakened earlier than expected and during the day Mood,daytime sleepiness score,and daytime physical function also improved.After treatment,the scores of the two groups were compared,and the treatment group was better in improving than waking up earlier than expected,total sleep time,total sleep quality,daytime mood,daytime body function and daytime sleep scores and the differences were statistically significant(P<0.05).4.Mood improvement:the difference in HAMA scores is statistically significant no matter the comparison of the scores before and after treatment within the group or the difference between before and after treatment(P<0.05).5.Neurological functional rehabilitation:the score of NIHSS was statistically difference before and after treatment in each group(P<0.05).6.Correlation analysis of the the scores of three scales:there was a positive correlation between AIS score and HAMA score after treatment,and a positive correlation between AIS score and NIHSS score after treatment.Conclusion1.The overall effect of regulating spirit acupuncture technique combined with drugs is superior to the hypnotic drugs.2.Both groups can significantly improve the sleep quality of subjects with CRSWD after stroke,and also effectively improve daytime dysfunction and sleep rhythm.But the combination of regulating spirit acupuncture technique and drugs was significantly better than oral drugs in improving daytime dysfunction and sleep rhythm.Regulating spirit acupuncture technique combined with drugs can effectively improve the anxiety of patients and improve neurological functional rehabilitation.3.Sleep and emotional status has a strong correlation,improve sleep quality and rhythms can contribute to the improvement of anxiety.Sleep status is related to the recovery of neurological deficits.The improvement of sleep quality and rhythm can further accelerate the neurological recovery of stroke patients.Therefore,in addition to routine limb rehabilitation,the comprehensive rehabilitation plan for post-stroke patients should pay attention to sleep quality and sleep rhythm.