| Objective:Based on evidence-based medical evidence,the effectiveness of the combination of acupuncture and medicine in the treatment of insomnia is objectively evaluated by using the Meta analysis method.At the same time,complex network analysis is used to excavate the rules of point selection and medication.On this basis,the clinical efficacy of combining acupuncture and Chinese herbal medicine to treat drug-dependent insomnia with heart and spleen deficiency is systematically observed.Method:1.Using the method of Cochrane systematic review,the results of all published randomized controlled trials of combined acupuncture and medicine in Chinese and English for the treatment of insomnia were systematically reviewed and meta-analyzed.The main curative index is effective rate and Pittsburgh sleep quality index.The secondary efficacy indicators are sleep rate,sleep time,self-rating depression scale,and self-rating anxiety scale.At the same time,the complex network analysis method is used to deeply dig the rules of acupuncture and Chinese herbal medicine in the treatment of insomnia,and provide an objective reference for clinical decision-making.2.64 drug-dependent patients with heart and spleen deficiency who met the diagnostic criteria for insomnia and the inclusion criteria were randomly assigned to the treatment group(Chinese herbal medicine and acupuncture)and the control group(Western medicine hypnotic drugs),with 32 cases in each group.Pittsburgh Sleep Quality Index(PSQI),Hamilton Depression Scale,Self-Rating Depression Scale(SDS),Self-Rating Anxiety Scale(SAS),Insomnia Severity Index(ISI)and Polysomnography(PSG)objectively evaluate clinical efficacy.Detect plasma serotonin(5-HT),dopamine(DA)and melatonin(MT)levels before and after treatment.Result:1.Meta analysis(1)The combination of acupuncture and Chinese herbal medicine is more effective than acupuncture in the treatment of insomnia.The combination of acupuncture and Chinese herbal medicine is more effective in the Pittsburgh Sleep Quality Index and Athens Sleep Scale score,but there is no statistical significance in improving the sleep rate.(2)The combination of acupuncture and Chinese herbal medicine is more effective than Western medicine in the treatment of insomnia.The combination of acupuncture and Chinese herbal medicine is more effective in Pittsburgh Sleep Quality Index,Athens Sleep Scale score,sleep rate,sleep time,self-rated anxiety scale and self-rated depression.There is no statistical significance in the scale.(3)The combination of acupuncture and Chinese herbal medicine is better than Chinese herbal medicine in the treatment of insomnia,and the combination of acupuncture and Chinese herbal medicine is more effective in the Pittsburgh sleep quality index and self-rated anxiety scale.2.Complex network analysis(1)The network core acupoint k-core analysis shows that Baihui,Anmian,Neiguan,Shenmen,and Sanyinjiao are the main acupoints for the treatment of insomnia.Anmian,Shenmen,Baihui,Sanyinjiao,Neiguan,Sishencong,Shenting,and Zusanli can be used as optimized prescriptions for acupuncture treatment of insomnia.(2)Complex network analysis of Chinese herbal medicine:Gancao,Suanzaoren,Yejiaoteng,Danggui,Longgu,Chaihu,Muli and Shengdi are the core Chinese herbal medicine.In addition,Baizhu,Baishao,Fushen,Shichangpu,Yuanzhi,Boziren,Zhenzhumu,Shengdi,Danshen,Chuanxiong and Hehuanpi are often used in combination.3.Clinical research(1)In the scores of each dimension of the PSQI scale,the seven scores of patients in the treatment group and the control group can be reduced(P<0.05,P<0.01).The treatment group was better than the control group in terms of sleep quality,time to fall asleep,sleep time,and sleep efficiency(P<0.05,P<0.01).(2)In the Hamilton Depression Scale,Self-Rating Depression Scale and Self-Rating Anxiety Scale scores,the treatment group and the control group can be reduced(P<0.05,P<0.01),and the comparison between the two groups was statistically significant(P<0.05,P<0.01),the treatment group was better than the control group.(3)The comparison of ISI between the two groups before and after treatment was statistically significant(P<0.01),and the comparison between the two groups after treatment was statistically significant(P<0.01),indicating that the treatment group is better than control group in improving the severity index of insomnia.(4)Sleep electroencephalogram(EEG):the comparison between the two groups of S1-S4 before and after treatment was statistically significant(P<0.05,P<0.01),the comparison between the two groups after S1 and S2 treatment was not statistically significant(P>0.05),and the comparison between S3 and S4 treatment was statistically significant(P<0.01),indicating that the treatment group was significantly better than the control group in improving deep sleep.(5)After treatment,the total effective rate of the treatment group is 96.67%;the total effective rate of the control group is 66.67%(P<0.05),and the treatment group is better than the control group in treating insomnia.(6)5-HT,DA and MT after treatment in the two groups are improved to different degrees compared with before treatment,and the difference was statistically significant(P<0.01).After treatment,5-HT and DA were statistically significant compared with the control group in the treatment group(P<0.01),and MT was statistically significant compared with the control group(P<0.05).Conclusion:Self-made Chinese herbal medicine prescriptions combined with medicine for pulse differentiation and acupoints for physical condition differentiation treatments are effective for drug-dependent insomnia,and other symptoms of insomnia patients are also reduced or eliminated.It may be closely related to the regulation of 5-HT,DA and MT levels. |
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