A Study On The Hippocampal Network Regulation Mechanism Of Acupuncture Of Hewei-Anshen Therapy For Insomnia Patients

Objective:This study chosed insomnia patients with disharmony of spleen and stomach syndrome as the research object,using functional Magnetic Resonance Imaging(fMRI)technology as the research means and the hippocampus as the seed point,to explore the changes of Functional Connectivity(FC)between the hippocampus and the whole brain of patients with insomnia by “Hewei-Anshen” acupuncture method,and to explore the mechanism of acupuncture in the treatment of insomnia,so as to provide an objective and visual evidence for the clinical application of the theory of “stomach disharmony results in disturbed sleep” and promote the improvement of clinical efficacy of acupuncture and moxibustion.Methods:Twenty-three insomnia patients with harmony of spleen and stomach syndrome were recruited and divided into treatment group and control group according to the random number table generated by computer.Twelve patients in the treatment group received “Hewei-Anshen” acupuncture.In the control group,11 patients received the sham acupuncture.To collect all the subjects' demographic data,with Pittsburgh Sleep Quality Index(PSQI)scale,Gastrointestinal Symptoms Rating Scale(GSRS),SelfRating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS)as evaluation index,and baseline period fMRI scan,comparing the difference between the two groups of subjects symptoms,brain function,characteristics,and further explore the central mechanism of acupuncture and gastric analgesia for insomnia patients.Result:1.The demographic characteristics,baseline PSQI score,GSRS score,SAS score and SDS score of the treatment group and the control group were basically consistent and comparable.After treatment,compared with the control group,the PSQI score and GSRS scores in the treatment group were improved and the treatment was effective.2.In the treatment group,after treatment,FC between the right hippocampus and bilateral auxiliary motor area,the left insula and the right insula increased,and FC between the right Dorsolateral Prefrontal Cortex(DLPFC)and the right angular gyrus decreased.FC of left hippocampus and left superior temporal gyrus,insula and left anterior insula increased,and FC of right DLPFC decreased.3.After treatment,the right hippocampal and right parietal lobules,right precuneus and right medial prefrontal lobes were decreased in the control group.The functional connectivity between the left hippocampus and the left anterior central gyrus and the right anterior central gyrus increased,while that between the left hippocampus and the right medial prefrontal lobe decreased.4.Compared with the control group,FC increased in the right hippocampus,medial prefrontal lobe and left insula of the treatment group,and decreased in the left parietal lobule,right parietal lobule and right angular gyrus of the treatment group.Increased FC in left hippocampus and left superior temporal gyrus.Conclusions:1.Acupuncture and gastric analgesia can effectively improve the sleep quality of patients with insomnia,shorten the time to fall asleep,improve the quality of life and gastrointestinal symptoms.2.Acupuncture on meridians causes changes in functional connections between hippocampus and insula,Default Mode Network(DMN)and other brain areas,among which the increase in functional connections between hippocampus and insula is the main central mechanism that acupuncture of “Hewei-Anshen” method works,and the decrease in functional connections between hippocampus and DLPFC may be related to the adjustment of emotional symptoms in insomnia patients by acupuncture.3.The change of functional connection between hippocampus and DMN is involved in the central mechanism of acupuncture for insomnia.