Mechanism Study Of Insomnia(Heart And Spleen Deficiency Syndrome) Intervened By Xingnao Kaiqiao Tuina Therapy Based On BOLD

Objective:Literature study:data mining technique was used to made a statistical analysis of articles of clinical study on treating insomnia by Tuina,which can provide objective basis and reference for the clinical treatment of insomnia and provide the literature basis for the scientific and normative design of the subject and the feasibility and innovation of clinic reaserch.Clinical study:Firstly,by comparing the changes of the observation indexes before and after treatment between the treatment group and the control group in the clinical study,the clinical efficacy of the Xingnao Kaiqiao Tuina Therapy was evaluated from the subjective feeling and objective indexes of the patients.Secondly,the Re Ho and ALFF values of patients and healthy volunteers intervened by Xingnao Kaiqiao Tuina Therapy were observed by resting state functional magnetic resonance imaging based on blood-oxygen level dependent(BOLD),and explore its therapeutic mechanism,so as to provide scientific basis for the clinical feasibility of treating insomnia from the angle of the Xingnao Kaiqiao.Methods:Literature study:the literature of tuina for insomnia was searched by computer,establish the information database,and the diagnostic criteria,treatment sites,manipulation,main acupoints,and meridians were analyzed by descriptive statistical method of counting data.All acupoints were extracted and imported into SPSS Modeler software for analysis of association rules of acupoints and syndrome.Clinical study:92 patients were randomized and controlled divided into two groups of Xingnao Kaiqiao Tuina Therapy(treatment group)and conventional Tuina(control group),Changes in PSQI,SF-36 and DBAS scores as well as changes in plasma 5-HT and GABA levels in the two groups were observed and compared after 4 weeks of treatment.Among the 35 volunteers,15 were healthy volunteers and 20 were patients with insomnia.In order to observe the immediate and cumulative effects of manipulation on the changes of Re Ho and ALFF values in the brain region,resting state functional MRI has been checked for the 35 volunteers before and after a single treatment,and the 20 patients with insomnia after 4 weeks of tuina therapy.Results:Literature study: A total of 299 related literatures were included.The types of literature studies,insomnia syndrome types,intervention modes,intervention sites,techniques,acupoints and diagnostic criteria were analyzed and described in detail,and the most commonly used acupoint combination of each syndrome type was obtained by analyzing the association rules between syndrome and acupoints.In the clinical study,the clinical efficacy of the treatment group and the control group were 97.67% and 95.45%.According to the statistical analysis of various observation indicators in the two groups,only 5 of the 17 items with PSQI and SF-36 scores had no significant difference(P>0.05),and most of the other items in the treatment group were superior to the control group(P<0.05).In terms of DBAS score,there was no significant difference between the two groups(P>0.05).The changes of plasma 5-HT and GABA content in the treatment group were significantly better than those in the control group(P <0.05).Correlation analysis showed that PSQI score was negatively correlated with 5-HT and GABA content,while SF-36 score was positively correlated with both.The results of the resting state functional MRI study based on BOLD showed that Xingnao Kaiqiao Tuina Therapy induced extensive brain region functional changes in healthy volunteers and patients with insomnia.The same manipulation had a different immediate effect on the Re Ho and ALFF changes in the brain regions of healthy volunteers and patients.The immediate and cumulative effects of manipulation also differ in Re Ho and ALFF in insomnia patients.Conclusion:The literature study provides reference and basis for the feasibility and innovation of the clinical study on the Xingnao Kaiqiao Tuina Therapy,as well as the scientific and normative design of this subject,and can effectively guide the development of clinical work.Clinical research confirms that Xingnao Kaiqiao Tuina Therapy for insomnia(heart and spleen deficiency syndrome)is clinically feasible and effective.The study of the resting state functional MRI based on BOLD showed that massage therapy can significantly improved ALFF and Re Ho values in related brain areas of patients,which may be the central mechanism of massage therapy for insomnia.