The Clinical And Experimental Research On The Treatment Of Insomnia With AnMianfang

Sleep, occupying one-third time of human lives, is an important physiological process to let people keep fit. Reports indicate that good-sleep not only can help people to eliminate fatigue, recover physical fitness and vigour, raise the efficiency of work and study, but also can enhance immunity of body, counteract and recover disease.The incidence rate of insomnia becomes higher and higher because of development of society , fast living, stress of working and studying and high competition in recent years. Insomnia is a syndrome of sleep-disorder somnipathy, which dosen't work well during begining and keeping to make people feel tired in daytime. Insomnia is called "Bu mei""Bu de mian ""Bu de wo"etc in traditional Chinese medicine. Modern medical science focus on the mechanism of sleep. It begins from nerve fibric to sleeping substance with modern apparatus and advanced technique. The method of sedative and hypnosis is makeshift for insomnia because of being unaware of the mechanism of sleep nowadays. Modern medicine science pays attention to the method of reduction and ignores the concept of entirety body in the course of researching sleep and treating sleep-disorder disease. Such as drugs for insomnia, it aims at central nervous system and inhibits its function. It will make patients depend on drugs, occur abstinence syndrome and hangover. It is adverse to recover disease and the patients can't accept it. So people seek after new theory and method about insomnia in traditional Chinese medicine. Professor Chen is a famous doctor in TCM, who is goood at treating sleep-disorder disease. Based on his research on one of TCM classical works 'NeiJing', the treatment method of "Pingyinyang, Tiaowushen, Heyingwei"was put forward. It accords with the nature of TCM: concept of function, concept of entirety body, concept of change. Professor Chen also founded AnMianfang and got remarkably clinical curative effect. This paper aims at observing the clinical curative effect of treating insomnoia with AnMianfang. And explore the mechanism of treating insomnoia with AnMianfang through animal experiment. It will privide clinical and academic proof for developing AnMianfang reliably.Objective: To observe the effect of AnMianfang in treating insomnia and test the method of "Pingyinyang, Tiaowushen, Heyingwei". And to explore the mechanism of treating rats of insomnoia model with AnMianfang.Methods: Clinical observation: 80 cases are selected and devided into two groups at random: AnMianfang group and Estazolam group. Comparing the effcet before and after the treatment interclass to know the situation of sleeping at night and stutas during the daytime by the estimate tables of PSQI and TCM symptom schedule.Experiment: 1) pharmacodynamics: observing the effect of KunMing rats' autonomic activities with pharmacology and physiology instrument. 48 rats were devided into three groups at random: balnk group, estazolam group and AnMianfang group, 16 in each group. Rats were filled with distilled water, estazolam water-solution, AnMianfang decoction respectively to observe the effect of KunMing rats' sleeping time. 60 rats were devided into three groups at random: balnk group, estazolam group and AnMianfang group, 20 in each group. Rats were filled with distilled water, estazolam water-solution, AnMianfang decoction respectively to observe the effect of KunMing rats' rate of falling asleep after injecting Pentobarbital into abdominal cavity. 2) pharmacology: 80 Wistar rats were devided into four groups at random: normal group, model group, AnMianfang group and estazolam group, 20 in each group. Duplicate insomnia model rats by means of PCPA abdominal injection. Observe the express of neurotransmitter, cytokine, neuropeptide and etc in rats' brains. The observing contents conclude 5-HT, 5-HIAA, NE, GABA, IL-1β, orexin and NPY. The methods of detection conclude radioimmunoassay, immunohistochemistry, reverse transcriptase PCR and etc. Results: 1,Clinical observation: The difference among sex, age and course ofdisease is not significant between AnMianfang group and Estazolam group. The twogroups are comparable (P>0.05). The difference of the items of PSQI are significantbefore and after treating with AnMianfang or Estazolam between AnMianfang groupand Estazolam group (P<0.01) . AnMianfang and Estazolam can improve thesleeping time, the falling sleep time, the sleep efficiency, the sleep disorder and thetotal sleep marks. The difference of sleeping time and sleep efficiency is significantbetween AnMianfang group and Estazolam group after treating (P<0.01) .AnMianfang can improve sleeping time and sleep efficiency better than Estazolam.The other items of PSQI are not significant between AnMianfang group andEstazolam group after treating (P>0.05) . AnMianfang and Estazolam both canimprove symptom of TCM remakbaly before and after treating (P<0.01) . Thesymptom of restlessness and morosity can be lessened visibly after treating (P =0.031) . AnMianfang can lessen restlessness and morosity better than Estazolam.The other symptom of TCM are not significant between AnMianfang group andEstazolam group after treating (P>0.05) . The clinical curative effect betweenAnMianfang group and Estazolam group is comparable (P>0.05) . The clinicalcurative effect of TCM between AnMianfang group and Estazolam group issignificant (P<0.01) . AnMianfang can improve symptom of TCM better thanEstazolam. The difference of the items of polysomnogram are significant before andafter treating with AnMianfang or Estazolam between AnMianfang group andEstazolam group (P<0.01) . AnMianfang and Estazolam can improve the totalsleeping time, REM sleep time, the sleep incubation period and the awareness time.After treating, the items of polysomnogram are comparable between AnMianfanggroup and Estazolam group (P>0.05) . The clinical curative effect of every patternof syndrome of insomnia is comparable treated by AnMianfang (P=0.775) . Theclinical curative effect of every pattern of syndrome of insomnia is comparabletreated by Estazolam (P = 0.830) . The indexs of laboratory for patients in AnMianfang group are normal after treating, but two patients whose hepatic function are abnormal in Estazolam group. AnMianfang is safty for insomnia patients.2 Experimental research: AnMianfang and Estazolam can reduce the frequency of rats' autonomic activities, the effect of Estazolam is better than that of AnMianfang. AnMianfang and Estazolam can decrease the sleeping incubation period, the effect is comparable between AnMianfang and Estazolam (P>0.05) . AnMianfang and Estazolam can increase the sleep duration, the effect of Estazolam is better than that of AnMianfang (P = 0.000) . AnMianfang and Estazolam can raise the rate of falling sleep, the effect is comparable between AnMianfang and Estazolam. AnMianfang and Estazolam can increase the content of 5-HT in rat brain, the effect of AnMianfang is better than that of Estazolam (P = 0.000) . AnMianfang can enhance the content of 5-HIAA obviously comparing with Estazolam group (P = 0.000) . AnMianfang and Estazolam can increase the content of GABA in rat brain, the effect of AnMianfang is better than that of Estazolam (P=0.000) . AnMianfang can decrease the content of NE in rat brain, the effect of AnMianfang is better than that of Estazolam (P=0.000). AnMianfang can increase the content of IL-1βin rat brain, the effect of AnMianfang is better than that of Estazolam (P=0.000). AnMianfang can increase the express oof NPY mRNA in area of hypothalamus and hippocampus, the effect of AnMianfang is better than that of Estazolam (P=0.000) .Conclusions: 1 Clinical observation: AnMianfang can not only raise the quality of sleep at night but also can improve the state of body in daytime. It is benificial for patients to raise the efficiency of studying and working in daytime. It also can improve the state of lost of Ying and Yang, harmonize Ying Wei, WuZang and QiXue. It can cllect WuSheng for their owns and cure insomnia at all.2 Experimental research: AnMianfang can decrease the frequency of rats' autonomic activities, increase the rate of falling sleep, decrease the incubation period of sleeping, and increase the time of remaining sleeping. It can prove that AnMianfang has the function of sedative and hypnosis.AnMianfang can reduce the level of 5-HT in model rats' brains, improve the content of 5-HIAA obviously, or even than that of normal rats, debase the content of NE in rats' brains. From above, we can coclude that the mechanism of AnMianfang is enhancing the synthesis and metabolism of 5-HT, debasing the content of NE, rebounding the iter balance between 5-HT and NE, and restoring the normal rhythm between awareness and sleeping.AnMianfang can increase the content of IL-1βobviously in rats' brains, or even than that of normal rats. It shows that there is something with adjusting immune function and improving the cytokine of hypnosis for the mechanism of AnMianfang.AnMianfang can increase the content of GABA in rats' brains, enhancing the role of inhibition to improve the state of insomnia rat with injected PCPA.AnMianfang can increase the express of Orexin and NPY mRNA in the area of hippocampus and hypothalamus of rats' brains to improve the state of insomnia.The data indicates that AnMianfang possesses the property to facilitate the neroendocrine-immune network by multiple ways to exact its sedation and hypnosis and the treatment for insomnia. It also can adjust the internal environment of body and rebound the homeostasis of insomnia. It is less side effect and better curative effect than those of synthetic chemicals. It will be worthy of developping in clinic.