| Objective:1 The cross-sectional survey was conducted to study the relationship between the general factors,the constitution type of traditional Chinese medicine,and the sleep quality of the elderly population in cold cities,and provide evidence for improving the sleep quality of the elderly population in cold cities.2 To study the effect of cold factors on sleep in rats.3 To explore the effect of electroacupuncture stimulation of "Zhaohai" and "Shenmai" points on the sleep of rats with insomnia under cold factors,and provide a more scientific basis for acupuncture treatment of insomnia in cold areas.Methods:1 Epidemiological investigationFrom September 2022 to February 2023,this study randomly selected550 elderly people over 60 years old from 4 communities and three pension institutions in Harbin as research objects with the random cluster sampling method.The general data questionnaire,Pittsburgh Sleep Index Scale,and Traditional Chinese Medicine Physique Rating Scale were used for cross-sectional investigation.2 Experimental study ⅠForty SPF Wistar male rats were randomly divided into four groups:room temperature group,cold group,insomnia model group,and cold insomnia group.There are ten rats in each group.The rats in the room temperature group and the insomnia model group were fed normally in the animal house.The rats in the cold group and the cold insomnia group were exposed to a cold environment at-10℃ for 1.5h/d,and they were fed at room temperature for the other time.After 15 d,the rats in the insomnia model group and the cold insomnia group were intraperitoneally injected with PCPA suspension(350mg/kg)for three consecutive days to establish the insomnia model,and the rats in the room temperature group and the cold group were injected with an equal volume of normal saline.The general state,behavioral differences,pathological changes of the hypothalamus,and the content of5-HT neurotransmitters in serum were observed and recorded.3 Experimental study IIThe model of insomnia under cold factors was established by PCPA combined cryogenic freezing method.The rats were randomly divided into model groups,acupuncture treatment groups,and electroacupuncture treatment groups,with ten rats in each group as the control group.In the experimental treatment,the rats in the four groups were treated in the same fixed way.Based on this,the rats in the acupuncture treatment group and the electroacupuncture treatment group were selected as the acupuncture points with bilateral Zhahai and Shenmai.The stimulation parameters in the electroacupuncture treatment group were selected as 2Hz sparse wave,and the current intensity was adjusted to the needle handle slightly quivered,20 min each time,once a day,and continuously treated for 7d.The general state,behavioral differences,and serum levels of neurotransmitters Glu and GABA were observed and recorded in each group.Results:1 Epidemiological investigationA total of 516 elderly people in cold cities were investigated,with an average age of(71.35±8.23)years,243 cases with PSQI>7,and the prevalence of sleep disorders was 47.09%.Through the single-factor analysis of 2 tests,there was no statistical significance between sleep disorder and age,smoking or not(P> 0.05),but there was statistical significance between sex,education level,drinking,chronic disease,and season(P< 0.05).The top three physical types of the elderly population with PSQI>7 were qi deficiency,Yang deficiency,and Yin deficiency;the top three physical types of the elderly population with PSQI≤7 were peace quality,blood stasis quality,and damp-heat quality.By single-factor analysis of 2 tests,there was no statistical significance in the composition ratio of sleep disorders to phlegm-dampness quality,damp-heat quality,qi-stagnation quality,blood-stasis quality,and characteristic quality(P> 0.05).However,there was statistical significance in the composition ratio of peace quality,qi deficiency quality,Yang deficiency quality,and Yin deficiency quality(P< 0.05).The correlation factors were screened out by single factor analysis,and the binary Logistic regression analysis was carried out on the correlation factors.It was concluded that education background,drinking,type of chronic diseases,season,Yang deficiency quality,qi deficiency quality,Yin deficiency quality,and peace quality were correlated with the prevalence of sleep disorders in the elderly,among which there was a negative correlation with peace quality and positive correlation with other variables.2 Experimental study ⅠCompared with the room temperature group,the rats in the other three groups exhibited dry hair,increased daytime activities,less sleep time,and abnormal sleep rhythm.Before the experiment,all groups had no significant difference in body weight(P> 0.05).After the experiment,the body weight of rats in the cold group and insomnia model group was decreased compared with the room temperature group(P< 0.05).And the body weight of rats in the cold insomnia group was decreased compared with the other three groups(P<0.05).Overhead cross maze experiment showed that OT% and OE% of rats in the cold group and insomnia model group were decreased compared with the room temperature group(P< 0.05),and OT% and OE% of rats in the cold insomnia group were decreased compared with the other three groups(P<0.05).HE staining of the hypothalamus showed that the cells in the room temperature group were clear and complete,neatly arranged and dense,with abundant neuronal cytoplasm and clear nucleoli.In the cold group,some cells were seriously deformed,and some cells showed vacuole and loose arrangement.In the insomnia model group,the shape of the cells changed obviously,and many cells showed vacuole phenomenon and loose arrangement.In the cold insomnia group,the cell deformation was serious,and a large number of cells showed vacuole phenomenon and loose arrangement.Comparison of 5-HT content: Compared with the room temperature group,the serum 5-HT content in the cold group and insomnia model group was decreased(P< 0.05),and the serum 5-HT content in the cold insomnia group was less than that in the other three groups(P< 0.05).3 Experimental study IIAfter model building,compared with the blank group,the hair of the other three groups exhibited dry and dull,daytime activities increased,easy to anger,aggression increased,sleep time decreased,sleep rhythm was abnormal,and body weight increased slowly(P< 0.01),OT%,OE% values significantly decreased(P< 0.05),serum Glu content increased(P< 0.05).The content of GABA was decreased(P< 0.05).After the treatment,the excitability of rats in the model group was decreased,the spirit was listless,and the body weight increased slowly(P<0.05).In the acupuncture treatment group and the electric acupuncture treatment group,the hair was glossy,the daytime activity was reduced,the aggression was weakened,the sleep time was prolonged,and the body weight was recovered and increased(P< 0.05).Compared with the model group,OT% and OE% of the acupuncture treatment group and electric acupuncture treatment group were increased(P< 0.05),serum Glu content was decreased(P< 0.05),and GABA content was increased(P < 0.05).Compared with the acupuncture treatment group,the OT% and OE% values of the electroacupuncture treatment group were increased(P< 0.05),serum Glu content was decreased(P< 0.05),and GABA content was increased(P< 0.05).Conclusion:1 The prevalence rate of sleep disorders among elderly people in cold cities is 47.09%.Low education,more types of chronic diseases,drinking,and season are the risk factors for sleep disorders.Yang deficiency quality,Qi deficiency quality,and Yin deficiency quality are the susceptible preconditions of sleep disorders.2.Low temperature may affect sleep in rats by decreasing serum 5-HT and affecting hypothalamic histopathology.3.Acupuncture and electroacupuncture can improve the general state and behavioral symptoms of insomnia rats under cold factors.The improvement of sleep status of insomnia rats under cold factors is related to decreased serum Glu and increased GABA content.Furthermore,the effect of electroacupuncture is superior to acupuncture. |
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