| Objective:To evaluate the clinical efficacy of electroacupuncture Sishencong on cerebral infarction patients with insomnia and cognitive dysfunction.Using PSG to observe the effect of electroacupuncture EX-HN1 on sleep architecture.The correlation between sleep architecture improvement and cognitive function improvement was analyzed.To provide evidence for further study on the mechanism of electroacupuncture at EX-HN1.Methods:1.To observe the effect of electroacupuncture EX-HN1 on cerebral infarction patients sleep and cognitive function:I20 cases of cognitive dysfunction with insomnia after cerebral infarction were selected.The patients were randoml y divided into 4 groups,namely,the sham acupuncture group,the drug control group,the acupuncture group and the electroacupuncture group,30 cases in each group.The selected patients were all treated with routine treatment.In the sham acupuncture group,the nonacupoint point was selected,retained the needle 20 mins,once a day,and the electroacupuncture apparatus was connected a fter acupuncture,but no electrical stimulation was used.The drug control group,by oral administration of Estazolam Tablets,lmg,once a day before going to bed.In the acupuncture group,selected EX-HN1 acupoints,and retained the needle 20 mins,once a day.The electroacupuncture group is on the basis of the acupuncture group,adopted continuous wave,frequency of 2Hz;All the groups were treated for 21 days.The daytime sleepiness was assessed by ESS seale before and after treatment,respectively.PSQI scale was used to evaluate the general sleep condition of patients.Using sleep diary to record the total sleep time,sleep latency and sleep efficiency.The total effective rate was evaluated according to the criterion of insomnia efficacy.The MoCA scales were used to observe the cognitive function of the patients.Using SPSS23.0 statistical software to process and analyze the data.2.Mechanism of improving sleep structure and cognitive function by electro acupuncture on EX-HN1 based on PSG:60 cases of cognitive dysfunction with insomnia after cerebral infarction were selected.The patients were randomly divided into 3 groups,namely,the sham acupuncture group,the electroacup uncture control group and the electroacupuncture group,20 cases in each group.The selected patients were all treated with routine treatment.The operation and study 1 of sham acupuncture group and electroacupuncture group are the same.Electroacupuncture control group,intermittent wave,frequency of 50Hz,intermittent ratio of 1:1,and the rest is the same as the electroacupuncture group.Before and after treatment,the ESS scale,PSQI scale,sleep diary and Act igraph were used to assess the sleep status of the patients.PSG was used to objectively monitor sleep parameters,such as sleep architecture,sleep efficiency and arousal times.The MoCA scales were used to observe the cognitive function of the patients.Using SPSS23.0 statistical software to analyze the data.Lin ear regression analysis was used to analyze the correlation between sleep structure and cognitive functions after electroacupuncture.Results:1.Characteristics of sleep and cognitive impairment in patients with cerebral infarction:The cerebral infarction patients with insomnia and cognitive dys function were mainly characterized by reduced total sleep time,prolonged sleep latency,lower sleep efficiency,sleep structure disorder,prolonged N1 sleep time and shortened N3 sleep,and excessive daytime somnolence.They decreased overall cognitive function,mainly manifested in the loss of memory,visual space and executive ability,the power of attention and computational.There was a significant negative correlation between N1 and MoCA scores(P<0.01).The N3 period was positively correlated with the total score of MoCA(P<0.05).It is suggested that there is a correlation between sleep structure and cognitive function.With the increase of N1 phase,the N3 phase decreased,and the cognitive function of patients decreased.2.The effect of Electroacupuncture EX-HN1 on the sleep of the patients:According to the criteria for determining the curative effect of insomnia,the total effective rate of the sham acupuncture group was 46.43%,the total eff ective rate of the drug control group was 82.14%,the total effective rate of the acupuncture group was 75.86%,the total effective rate of the drug control group was 90%,and the difference has statistical significance(P<0.05).It suggested that the drug control group,acupuncture group and electroacupuncture gr oup were better than the sham acupuncture group in improving sleep efficacy,and the electroacupuncture group had the best effect.The PSQI score of sham acupuncture group,acupuncture group,drug control group and electroacupuncture group were higher than before treatment,with statistical difference(P<0.05),the comparison among the patients of each group,and the difference between each group was statistically significant(P<0.05).It suggested that each group was better than the sham acupuncture group in improving daytime sleepiness,and the electroacupuncture group had the best effect.Comparison of sleep diary and ActiGraph in electroacupuncture group:The TST,SL,SE,WASO and awakening time after sleep of each group were im proved compared with those before treatment.(P<0.05),the comparison of TST and SL among each group,there was no statistical difference between the ele ctroacupuncture group and the drug control group(P>0.05),and the differenc e between the other groups was statistically significant(P<0.05),There was a statistically significant difference in SE,WASO and awakening time after sleep comparison among all groups(P<0.05).It is suggested that the efficacy of electroacupuncture group and drug control group is similar in reducing sleep latency and increasing total sleep time,and better than the other group.Improving sleep efficiency,reducing the number of awakening,the awakening time after sleeping of each group were better than those of the sham acupuncture group,and the electroacupuncture group had the best effect.The ESS score of sham acupuncture group,acupuncture group,drug control group and electroacupuncture group were higher than before treatment,with statistical difference(P<0.05),the comparison among the patients of each group,and the difference between each group was statistically significant(P<0.05).It suggested that each group was better than the sham acupuncture group in improving daytime sleepiness,and the electroacupuncture group had the best effect.The parameters of PSG in the acupuncture group,the electroacupuncture control group and the electroacupuncture group were compared with that before the treatment.The REM-SL and REM(%)in the electroacupuncture group were significantly higher than before the treatment(P<0.05),and the difference was statistically significant.The N1(%),N3(%)and ArI in the electroacupuncture group and the electroacupuncture group were significantly improved after the treatment(P<0.01),there was no significant difference in N2(%)before and after treatment(P>0.05).SE,SL,N1(%),N3(%)and Arl comparison among the patients of each group,the electroacupuncture group and the electroacup uncture control group and the sham acupuncture group had statistical difference(P<0.05),suggesting that the electroacupuncture improvement of sleep structure disorder was better than the other groups,so that the time of N3 phase sleep was prolonged,the N1 sleep time was shortened,and sleep efficiency was improved.3.Effect of Electroacupuncture on cognitive function of patients:The MoCA score of,acupuncture group and electroacupuncture group were higher than before treatment,with statistical difference(P<0.05).There was no significant difference between the sham acupuncture group and the drug control group compared with those before treatment(P>0.05),The comparison among the patients of acupuncture group and electroacupuncture group,and the difference between each group was statistically significant(P<0.05).It suggested that the sham acupuncture group and the drug control group had no obvious effect on improving the cognitive function of the patients.each Electroacupuncture group and acupuncture group can improve cognitive function,electroacupuncture group is better than acupuncture group.The score of visual space and executive ability,attention and computational ability,abstract ability,delayed recall and orientation ability were significantly higher in the electroacupuncture control group and the electroacupuncture group than before the treatment(P<0.05),and the difference was statistically significant.The comparison among the patients of each group,visual space and executive ability,abstract ability,orientation,delayed recall,attention and computational ability,and there were statistically significant differences between the electroacupuncture groups and the other groups(P<0.05).Electroacupuncture group had the best effect in improving visual space and executive ability,abstract ability,delayed memory,orientation ability,attention and computational ability.4.Correlation analysis of sleep architecture and cognitive function:After the treatment of electroacupuncture,the improvement of the sleep architecture was correlated with the improvement of the total score of MoCA.The difference in N1 period and MoCA were positively related to visual space and executive ability,attention and computing power,language and orientation(P<0.05).The difference between N3 and MoCA was positively correlated with visual space and executive ability,abstract ability and delayed memory in MoCA(P<0.05).It suggested that electroacupuncture improves the cognitive function of the patient while improving the patient's sleep architecture.The electroacupuncture reduces the patient's N1 sleep,increases the patient's N3 sleep,and then improves the overall cognitive function,recollection,attention and computational power of the patient.Conclusion:1.Electroacupuncture of EX-HN1 can improve the quality of sleep in cerebral infarction patients with insomnia and cognitive dysfunction,especially in increasing total sleep time,reducing sleep latency,improving sleep quality and improving daytime sleepiness.Electroacupuncture can improve the overall cognitive function of patients and improve delayed recall,orientation,attention.and computational ability.2.Electroacupuncture group and electroacupuncture control group have a definite effect on improving the symptoms of the patients,but the electroacupuncture group is better than the electroacupuncture control group in improving the sleep architecture and cognitive function.Continuous wave is superior to intermittent wave.3.Electroacupuncture is beneficial to the improvement of sleep architecture in patients with insomnia and cognitive dysfunction after cerebral infarction.The period of N1 is reduced,the period of N3 is increased,the efficiency of sleep is increased,and the number of awakening after falling asleep is reduced.4.The recovery of the overall cognitive function of the patients was significantly correlated with the decrease in N1 phase and the increase in the N3 period.The mechanism of electroacupuncture may be by adjusting the sleep structure,reducing the N1 phase,increasing the N3 stage,and promoting,the patient's ability to delay memory,orientation,attention and computational ability. |
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