| Chronic insomnia is the most common type of sleep disorder in the clinic.It is mainly caused by sleep disorders such as difficulty falling asleep and difficulty in sleeping,and is accompanied by daytime dysfunction.Under the development of its chronic disease course,it seriously endangers the individual's physical and mental health,quality of life,work ability and public safety,and has a serious impact on individuals and society.Chronic insomnia is one of the health problems that urgently need to be addressed and addressed.The treatment of chronic insomnia mainly includes drug therapy and non-drug therapy.Western medicine drug therapy has the characteristics of clinical curative effect,fast onset,and short-term application effect,but long-term application may produce drug tolerance and drug dependence.Once discontinued,insomnia symptoms rebound and withdrawal effects may occur.Acupuncture as a special treatment for traditional Chinese medicine for non-drug therapy has advantages in the treatment of chronic insomnia,and more evidence-based support is needed in the study of the mechanism of acupuncture treatment of chronic insomnia.The theory of excessive awakening of chronic insomnia is an important mechanism for the occurrence of insomnia,including three relatively independent levels of cortex,cognition and physiology.In this study,acupuncture combined with excessive arousal was applied to the treatment of chronic insomnia.From the adjustment of chronic insomnia to the state of insomnia,Pittsburgh sleep quality index,excessive arousal scale,fatigue scale and heart rate variability were treated.The evaluation index of chronic insomnia provides a clinical basis for acupuncture to improve excessive arousal in patients with chronic insomnia.At the same time,based on the changes of local consistency of resting state functional magnetic resonance brain,comprehensive evaluation of the possible ways of acupuncture treatment of chronic insomnia associated with excessive arousal.To explore the clinical treatment feasibility,efficacy advantages,and possible peripheral(heart rate variability)and central(resting state functional magnetic resonance brain local consistency)pathways of acupuncture as a non-drug therapy for chronic insomnia.Study one:OBJECTIVE:To observe the clinical effectiveness of acupuncture on Pittsburgh sleep quality scale,arousal scale,fatigue scale and heart rate variability in patients with chronic insomnia.METHODS:Randomized,single-blind,controlled clinical research methods were used to randomly classify patients with chronic insomnia due to deficiency of heart and spleen according to the standard of Napao.The treatment group was divided into two groups according to the "Thirteenth Five-Year Plan" textbook "Acupuncture and Moxibustion".The heart and spleen deficiency type acupuncture treatment was gi-ven acupuncture treatment,the control group was given non-acupoint shallow acupuncture treatment,acupuncture once every other day,3times a week for a total of 12treatments.The total course of treatment is 4weeks.The Pittsburgh Sleep Quality Scale(PSQI),the Arousal Scale(HAS),the Fatigue Scale(FS-14),and heart rate variability were evaluated before treatment and at 2 hours after treatment.Simultaneously recording the sleep diary continuously monitors sleep.Statistical evaluation scales and changes in heart rate variability.According to age stratification and disease stratification analysis,the comprehensive clinical efficacy of acupuncture to regulate sleep and over-awakening status in patients with chronic insomnia was observed.RESULT:1.In the PSQI scales,the treatment group was on the PSQI scale for sleep quality,sleep time,sleep time,sleep efficiency,sleep disturbance,hypnotic drugs,daytime dysfunction,and PSQI total score and their age stratification.The disease stratification study has significant clinical efficacy and is highly effective in improving sleep quality,daytime dysfunction and PSQI total score.The control group had statistical differences in improving sleep quality,daytime dysfunction,and PSQI total score.2.In the comparison of HAS scale scores,it is suggested that the treatment group has a very significant effect in improving the degree of arousal.And there was statistically significant statistical significance in the study of age stratification and disease stratification.The control group did not have a significant effect.3.In the FS-14 scale comparison,the treatment group was shown to have significant efficacy in improving patient fatigue.And there was statistically significant statistical significance in the study of age stratification and disease stratification.The control group did not have a significant effect.4.In the comparison of heart rate variability,the improvement of heart rate variability PNN50,RMSSD,HRV triangle index,VLF and LF/HF in the treatment group was statistically different,suggesting that the treatment group can regulate the sympathetic and parasympathetic excitation in both directions.Sexuality,in turn,has a therapeutic effect in down-regulating sympathetic excitability and up-regulating parasympathetic tone excitability.Study two:OBJECTIVE:To observ-e the clinical effectiveness of acupuncture on local consistency(ReHo)changes in the brain of patients with chronic insomnia based on resting-state functional magnetic resonance imagin g.METHODS:A randomized,single-blind,controlled clinical study was conducted in subjects in the first trial of subjects aged 20-40 years before and at 2 hours after treatment.Functional magnetic resonance imaging,simultaneous assessment of the patient's Pittsburgh Sleep Quality Scale(PSQI),Arousal Scale(HAS),Fatigue Scale(FS-14),and heart rate variability.Correlation analysis was performed between the two groups before and after treatment,and the ReHo value in the brain area was significantly correlated with the significant difference scale.To observe the comprehensive clinical effect of acupuncture on the sleep condition and excessive arousal state of patients with chronic insomnia in 20-40 years old and the local consistency of brain regions and their correlation.RESULT:1.In the scoring of each dimension of the PSQI scale,the treatment group had a curative effect before and after treatment,especially in the sleep time,daytime dysfunction and the total score of PSQI.There was no statistical difference in the control group before and after treatment.However,after the difference between the treatment group and the control group,the treatment group showed significant difference in sleep time and PSQI total score.There was no statistical difference in other PSQI sleep dimension scores.In the sleep quality and daytime dysfunction scores,the treatment group showed a better trend,but not statistically significant.2.In the comparison of HAS scores,it is suggested that the treatment group has a significant effect in improving the degree of arousal of patients.The control group was not statistically significant.Although the HAS score of the treatment group was significantly lower than that of the control group after treatment,it suggested that the treatment group had a therapeutic advantage in improving the patient's arousal compared with the control group,but it was not statistically significant.3.In the comparison of FS-14 scores,it is suggested that the treatment group has statistical significance in improving the degree of fatigue of patients.Compared with the control group,the treatment group had a curative effect in improving the degree of fatigue of the patient,but it was not statistically significant.4.The changes of HRV triangulation index,VLF and LF/HF in the treatment group before and after heart rate varnability were statistically significant,suggesting that the treatment group is effective in down-regulating sympathetic excitability and up-regulating parasympathetic regulation.However,compared with the control group,there was no statistical significance.There was no statistically significant difference between the two groups before and after heart rate variability.It is suggested that the clinical efficacy of the treatment group did not show statistical advantage in regulating heart rate variability in patients with chronic insomnia.5.The local consistency of resting brain function before and after treatment in the treatment group showed in the left temporal gyrus,right upper frontal gyrus,frontal middle gyrus,right anterior anterior wedge anterior lobes,right thalamus anterior nucleus,right side There was a significant difference between the shell core,the right central back,and the left back buckle.After comparing the changes in the brain area of the control group,only the right frontal gyrus,the median gyrus,and the right anterior anterior wedge showed a statistical difference.It is suggested that the acupuncture efficacy of the treatment group is statistically significant in the three brain regions of the right frontal gyrus,the mid-anterior gyrus,and the right anterior anterior wedge.6.To observe the statistically significant difference between the local consistency of brain regions and the PSQI sleep time score and PSQI total score,the right parietal anterior wedge was positively correlated with PSQI total score,and had no significant correlation with sleep time in PSQI.Sexually;the rnght upper frontal gyrus was negatively correlated with PSQI total score,and had no significant correlation with sleep time;there was no significant correlation between right frontal gyrus and PSQI total score,but negatively correlated with sleep time score in PSQI scale.CONCLUSION:1.Acupuncture has a significant improvement effect on sleep quality,awakening state and fatigue degree of chronic insomnia,and provides a clinical basis for the study of acupuncture treatment of chronic insomnia.2.Observation of acupuncture based on resting state functional magnetic resonance may improve the sleep quality of patients with chronic insomnia by adjusting the local consistency of the prefrontal cortex and anterior cranial anterior leaflet,and the imaging of acupuncture for chronic amblyopia.Academic research provides a scientific basis. |
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