| Objective:1.Literature research: Summarize the research status,research hotspots and research frontiers in the field of insomnia at home and abroad by building a visual knowledge map,in order to provide reference for the development trend and in-depth research of insomnia.2.Clinical study: To observe the effect of Anmei Granules on sleep quality and blood pressure circadian rhythm of patients with insomnia and hypertension deficiency syndrome,evaluate its clinical efficacy,explore the advantages of traditional Chinese medicine in treating insomnia and hypertension,and provide theoretical and experimental basis for the in-depth study and clinical application of Anmei Granules.Methods:1.Literature research: Relevant literature in the field of insomnia research from 2000 to2021 was retrieved from WOS,CNKI and other databases,and relevant analysis was conducted on the literature meeting the inclusion criteria using Cite Space,VOSviewer and other software,and the research status and development trend of insomnia were summarized.2.Clinical study: 120 patients with insomnia and hypertension deficiency syndrome who met the inclusion criteria were randomly divided into the observation group and the control group,with 60 patients in each group.Both patients in the two groups were given sleep hygiene education and basic antihypertensive treatment.The observation group took Anmei granules orally,and the control group took placebo orally.After 4 weeks of treatment,the Pittsburgh Sleep Quality Index(PSQI)score,SPIEGEL score,fatigue-14(FS-14)score AIS score,brain-derived neurotrophic factor(BDNF),glial fibrillary acidic protein(GFAP),irisin,nocturnal systolic blood pressure drop rate,nocturnal diastolic blood pressure drop rate,blood pressure variability(BPV),nocturnal systolic blood pressure variation coefficient,nocturnal diastolic blood pressure variation coefficient and morning peak blood pressure,and adverse reactions were recorded for statistical analysis and clinical efficacy evaluation.Results:1.Literature research: 20554 English literatures and 2797 Chinese literatures were selected and included.The overall number of domestic and foreign publications is on the rise.At present,it is in the stage of rapid development.The United States and China are at the core of the field of insomnia research;Foreign SLEEP MEDICINE journals and domestic Chinese Journal of Traditional Chinese Medicine journals rank first in the number of papers published in this field;The number of papers issued by research institutions is mainly from universities in the world,and from universities and affiliated hospitals in China;Foreign Roth,Thomas and domestic Wang Ping professors and teams have the largest number of papers in this field.Keyword analysis shows that the research on insomnia at home and abroad mainly focuses on the etiology,pathogenesis,treatment and comorbidity of insomnia(anxiety,depression,etc.).International research focuses more on non drug therapy,mechanism of action of related drugs,insomnia with cognitive impairment and novel coronavirus;In China,more emphasis is placed on the research of TCM on the etiology,pathogenesis,treatment of insomnia and insomnia with hypertension,coronary heart disease and other diseases.Guide formulation,system evaluation and biological clock may be the frontier of international research;Data mining,neurotransmitters,jujube soup and acupuncture may be the frontiers of domestic research.2.Clinical study: 3 cases fell off in the observation group and 57 cases completed observation;8 cases fell off in the control group and 52 cases completed observation.Sleep-related indicators:(1)Total efficacy analysis: After 4 weeks of treatment,the total effective rate of the observation group for insomnia(89.47%,51/57)was significantly higher than that of the control group(21.15%,11/52)(P<0.05).(2)PSQI score: The PSQI score was significantly lower in the observation group after treatment compared with that before treatment(P<0.05),and the difference between the control group before and after treatment was not statistically significant(P>0.05),and the PSQI score was significantly lower in the observation group compared with the control group after treatment(P<0.05).(3)SPIEGEL score: The SPIEGEL score was significantly lower in the observation group after treatment compared with that before treatment(P<0.05),and there was no statistically significant difference between the control group before and after treatment(P>0.05),and the SPIEGEL score was significantly lower in the observation group compared with the control group after treatment(P<0.05).(4)FS-14 score: The FS-14 score was significantly lower in the observation group after treatment compared with that before treatment(P<0.05),and there was no statistically significant difference between the control group before and after treatment(P>0.05),and the FS-14 score was significantly lower in the observation group compared with the control group after treatment(P<0.05).(5)AIS score: The AIS score was significantly lower in the observation group after treatment compared with that before treatment(P<0.05),and there was no statistically significant difference between the control group before and after treatment(P>0.05),and the AIS score was significantly lower in the observation group compared with the control group after treatment(P<0.05).(6)Serum BDNF level: The serum BDNF level was significantly higher in the observation group after treatment compared with that before treatment(P<0.05),while the difference between the control group before and after treatment was not statistically significant(P>0.05),and the serum BDNF level was significantly higher in the observation group compared with the control group after treatment(P<0.05).(7)Serum GFAP level: The serum GFAP level was significantly lower in the observation group after treatment compared with that before treatment(P<0.05),and there was no statistically significant difference between the control group before and after treatment(P>0.05),and the serum GFAP level was significantly lower in the observation group compared with the control group after treatment(P<0.05).(8)Serum irisin level: serum irisin level was significantly higher in the observation group after treatment compared with that before treatment(P<0.05),the difference between the control group before and after treatment was not statistically significant(P>0.05),and serum irisin level was significantly higher in the observation group compared with the control group after treatment(P<0.05).Blood pressure related indexes:(9)Nocturnal systolic blood pressure drop rate: The nocturnal systolic blood pressure drop rate was significantly higher in the observation group after treatment compared with that before treatment(P<0.05),and the difference between the control group before and after treatment was not statistically significant(P>0.05),and the nocturnal systolic blood pressure drop rate was significantly higher in the observation group compared with the control group after treatment(P<0.05).(10)Nocturnal diastolic blood pressure drop rate: The nocturnal diastolic blood pressure drop rate was significantly higher in the observation group after treatment compared with that before treatment(P<0.05),and the difference between the control group before and after treatment was not statistically significant(P>0.05),and the nocturnal diastolic blood pressure drop rate was significantly higher in the observation group compared with the control group after treatment(P<0.05).(11)Blood pressure variability: There was no statistically significant difference in blood pressure variability between the two groups before and after treatment(P>0.05),and there was no statistically significant difference in blood pressure variability after treatment in the observation group compared with the control group(P>0.05).(12)Nighttime systolic blood pressure variability coefficient: There was no statistically significant difference in the nighttime systolic blood pressure variability coefficient between the two groups before and after treatment(P>0.05),and there was no statistically significant difference in the nighttime systolic blood pressure variability coefficient between the observation group and the control group after treatment(P>0.05).(13)Nocturnal diastolic blood pressure coefficient of variation: There was no statistically significant difference in the coefficient of variation of nocturnal diastolic blood pressure between the two groups before and after treatment(P>0.05),and there was no statistically significant difference in the coefficient of variation of nocturnal diastolic blood pressure between the observation group and the control group after treatment(P>0.05).Morning peak blood pressure: the morning peak blood pressure of patients in the two groups after treatment was significantly lower than that before treatment(P<0.05),there was no significant difference in the morning peak blood pressure between the observation group and the control group after treatment(P>0.05).Conclusion:1.Anmei granules can improve the sleep quality of patients with insomnia and hypertension deficiency syndrome.2.Anmei granule can improve the rate of decline of systolic blood pressure at night,the rate of decline of diastolic blood pressure at night and morning peak blood pressure in patients with insomnia and hypertension deficiency syndrome,thus regulating the circadian rhythm of blood pressure.3.For patients with insomnia and hypertension deficiency syndrome,improving sleep can improve their blood pressure circadian rhythm,and regulating sleep can be a potential method to regulate blood pressure circadian rhythm. |
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