The Clinical Study Of Jin’s Three-Needle Therapy In Treating Insomnia After Stroke

Stroke, which is also called cerebrovascular accident, is a series of craniocerebral injuries caused by cerebrovascular diseases, it includes atherosclerotic thrombotic cerebral infarction, cerebral embolism, lacunar cerebral infarction and cerebral hemorrhage, etc; The disease usually happens in elderly patients. With the development of an ageing population, the incidence of stroke in our country has a tendency to rise. Stroke patients are often with hemiplegia, anepia, dysphagia or cognitive impairment, etc as the main symptoms, its clinical disability rate is high; However, apart from the above function damaged, patients are often accompanied by sleep disorders after stroke. Studies have found that sleep disorder after stroke often occurred in patients with heavier neurologic impairment; Compared with patients without sleep disorder, patients with sleep disorder after stroke have severer neurologic impairment and worse ability of daily life. So sleep disorder after stroke is an indicator of disease severity, it not only affects the patient’s function rehabilitation and psychosomatic health, but also will induce cerebrovascular accident again. However, Sleep disorder after stroke have been ignored in clinical practice. Therefore, how to improve sleep quality of patients with sleep disorder after stroke will be a new content in the research process of stroke rehabilitation; to understand the status of the patients’sleep would help to evaluate the prognosis of patients with cerebrovascular accident.Objective1To make sure the clinical curative effect of Jin’s three-needle in treating insomnia after stroke and its influence to the neurological function through clinical research2To analyse the relationship between sleep quality and neurological function rehabilitation, and discuss the mechanism of Jin’s three-needle in treating insomnias.Methods1Literature researchLiterature research is mainly about the generalizations of the research process of sleep disorder after stroke and its treatment, to analyse the situation Since ancient times and from traditional medicine to modern medicine, then do the studies on the mechanism of sleep disorder after stroke in the summary.2Clinical studies99patients were divided into Jin’s three-needle therapy group and the hypnotic agents control group, the two groups of patients were given basic drug treatment and rehabilitation training. Jin’s three-needle treatment group (49cases) using The Four-Shen Points combined with The Shouzhi points, plus points on symptom; Hypnotic agents control group(50cases), taking estazolam tablets before sleep.15days as a course of treatment. To evaluate the PSQI, AIS, FCA and NDS of the two groups of patients respectively before and after treatment, then to compare the change of sleep quality and the level of neurological function rehabilitation between the two groups. And finishing follow-up evaluation of PSQI, AIS, FCA and NDS of the two groups after one month.Results1Literature research resultsThe treatment of sleep disorder after stroke is diversiform, the treatment of western medicine are effective but having many disadvantages. The treatment of Chinese medicine are diversification, in the majority with acupuncture and massage method, but the effect is not consistent, and evaluation standard of therapeutic effect not unified, lack of standardized treatment and evaluation scheme; As to the pathogenesis of sleep disorder after stroke, it is still not completely clear.2Clinical research results2.1General informationTwo groups of patients on the factors such as gender, age, course of the disease is no significant difference (P>0.05), the scales of patients had no significant difference between two groups (P>0.05), so the source of two groups can be consistent, and comparable.2.2Sleep scores of groups before and after the treatmentAfter statistics analysis, the PSQI, AIS scores of two groups of patients had significant difference before and after the treatment, the difference of them was statistically significant (P<0.05); Compared between groups, after the treatment the PSQI, AIS scores of two groups had no significant difference (P>0.05); The influence of the two groups in sleep scores was consistent.2.3Neurologic evaluations before and after treatmentAfter statistics analysis, the FCA^NDS assessment of two groups had respectively significant difference before and after the treatment, the difference had statistical significant (P<0.05); After treatment, the FCA, NDS assessment of both groups was no significant difference between groups (P>0.05);it points out that the effect of the two groups in neurological function is roughly close before and after treatment.2.4Sleep scores in two groups of the follow-up patientsAfter statistics analysis, the PSQI, AIS scores of two groups of the follow-up patients had significant difference before the treatment and the follow-up point, the difference of them was statistically significant (P<0.05); After treatment, the PSQI, AIS scores of Two groups of patients had no significant difference between groups (P>0.05);1months after treatment, the sleep scores of two groups of follow-up patients had significant difference (P<0.05). It points out that A month after the treatment, Jin’s three-needle long-term outcomes on the improving sleep quality was better than that of the Hypnotic agents control group.2.5Neurologic function evaluation in two groups of the follow-up patients.After statistics analysis, the FCA, NDS assessments of two groups of the follow-up patients had significant difference before treatment and follow-up point, the difference of them was statistically significant (P<0.05);After treatment, the FCA, NDS assessments of Two groups of patients had no significant difference between groups (P>0.05);A months after treatment, the FCA, NDS assessments of two groups of follow-up patients had no significant difference (P>0.05).At the follow-up point, the neurologic function evaluation results roughly close to each other.Conclusion:1Jin’s three-needle therapy can improve the sleep quality of insomnia after stroke patientsWith basic drug treatment and rehabilitation treatment, the curative effect of Jin’s three-needle in treating patients with insomnia after stroke was equivalent to the effect of hypnotic agents control group; But Jin’s three-needle therapy does not appear a hangover, drug dependence, or resistance, drug withdrawal rebound, et al. From the analysis of scales of follow-up patients, we can see that Jin’s three-needle therapy’s long-term outcomes in treating insomnia after stroke is superior to the hypnotic drugs.2Sleep quality directly affect the neurological function rehabilitation progressThe magnitude of improvement in Sleep quality of patients with insomnia after stroke and the improvement of the neurological function were directly related; The improvement of patients’sleep quality can raise the speed of neurological function rehabilitation. During the rehabilitation of cerebrovascular accident, we should paid great attention to the sleep quality of patients.3Continuous rehabilitation training is indispensability on functional recovery of stroke.Through Analysing the result of follow-up, we can find that,to two groups of follow-up patients, the improvement of FCA, NDS assessments between the end of treatment and follow-up point are worse than the improvement between the beginning of treatment and the end of it. And at the time of the follow-up, two groups of patients did not receive the standard rehabilitation treating, so we consider that rehabilitation training plays an important role in the process of the functional recovery after stroke. Its mechanism may be that standard rehabilitation training can reduce the symptoms of somatization, and promote brain function restructuring and reorganizations by neural facilitation technology, promote axon sprout, then prepare morphological basis for the functional recovery of central nerve damage. So continuous comprehensive rehabilitation training is good for neural function rehabilitation.