| Obj ective:1.To evaluate the clinic al efficacy and safety of acupuncture treatment for post stroke insomnia through systematic evaluation and meta-analy sis(Meta)methods and analyze the therapeutic effect and characteri stics of acupuncture on post stroke insomnia,and provide evidence-based evidence for acupuncture treatment of post stroke insomnia.2.By observing the Pittsburgh Sleep Quality Index,Modified Barthel Index,NIHS S Scale score,polysomnography monitoring data,and changes in serum markers of patients with post stroke in s omnia treated with Tongluo Anshen Acupuncture,the clinical efficacy of Tongluo Anshen Acupuncture in treating post stroke insomnia was evaluated.Method:1.By searching the China National Knowledge Infrastructure(CNKI),Wanfang Academic Journal Full Text Database,China Biomedic al Literature Database(CBM),PubMed,Embase,and Cochrane Lib rary databases,clinical research literature on acupuncture treatment of in somnia after stroke was published from its establishment until February 2023.Using STATA14.0 and RevMan software version 5.3 for metaanaly sis,evaluate the clinical efficacy and safety of acupuncture treatment for insomnia after stroke.2.Establish a clinic al trial treatment plan and evaluate the clinical efficacy using the Tongluo Anshen acupuncture method.100 hospitalized patients who were assessed to meet the inclu sion criteria for post stroke insomnia were randomly assigned to the Tongluo Anshen acupuncture treatment group and the conventional acupuncture control group in a 1:1 ratio,with 50 patients in each group.During the treatment process,both groups of patients were given basic support treatment for stroke to control the underlying disease and risk factors.On this basi s,the treatment group was given Tongluo Anshen acupuncture therapy,while the control group was given routine acupuncture treatment.All included patients were treated once a day for 6 consecutive days,followed by 1 day of rest and 4 weeks of continuous treatment.Two groups of patients were evaluated using the Pittsburgh Sleep Quality Index,Modifie d Barthel Index,and National In stitutes of Health Stroke Scale before treatment,4 weeks after treatment,and 1 month after treatment follow-up.Use a poly somnography monitor to collect obj ective sleep data of patients before and after treatment.Measure the levels of serotonin,melatonin,and dopamine in the patient’s serum before and after treatment.Perform stati stic al analysis on the obtained data using SPSS 24.0 statistical software.Result:1.Meta analysis results show that acupuncture treatment is significantly superior to western medicine treatment in improving patient sleep efficiency,clinical efficacy,and reducing PSQI,NIHSS,and HAMA scores.The incidence of adverse reactions in acupuncture treatment is about 8.82%,and the incidence of adverse reactions in western medicine treatment is ab out 29.97%.2.There was no stati stic ally signific ant difference in the general situation,scale scores,PSG monitoring data,and serum levels of serotonin,melatonin,and dopamine between the two groups of patients before treatment,indicating that there was no difference in the baseline statistical data between the two groups of patients before treatment.(P>0.05)3.Compared with the control group,after 4 weeks of continuous treatment,the treatment group showed better improvement in the Pittsburgh Sleep Quality Index score,with a statistically significant difference(P<0.0 5).At the 1-month follow-up after treatment,there was no statistically si gnificant difference in the scores of the Pittsburgh Sleep Quality Index scale between the treatment group and the control group compared to the end of treatment(P>0.05).4.After 4 weeks of continuous treatment,the improvement in scores on the Modified Barthel Index Scale and the National Institutes of Health Stroke Scale was similar between the treatment group and the control group,with no stati stically significant difference(P>0.05).At a follow-up of one month after the end of treatment,there was no statistic ally signific ant difference in the scores of the modified Barthel index scale and the National Institutes of Health Stroke Scale between the treatment group and the control group compared to the end of treatment(P>0.05).5.After 4 weeks of continuous treatment,serum levels of serotonin and melatonin were upregulated(P<0.05)and dopamine levels were downregulated(P<0.05)in both groups of patients,and the regulatory effect of the treatment group was better than that of the control group(P<0.05).6.PSG monitoring dataAfter treatment,TST and S E in both groups of patients showed signific ant improvement compared to before treatment,and the difference was statistic ally signific ant(P<0.05).After treatment,the treatment group showed a more significant improvement compared to the control group,with a statistically signific ant difference(P<0.05).After treatment,the S L and A RI of both groups of patients significantly decreased compared to before treatment,with a statisti cally significant difference(P<0.05),and the treatment group showed a more significant decrease,with a statistically signific ant difference(P<0.05).In terms of sleep structure,the N1 and N 2 phases in the treatment group and control group were signific antly reduced after treatment compared to before treatment,and the difference was statistic ally significant(P<0.05).The treatment group showed a greater reduction in N 1 phase compared to the control group(P<0.05).However,there was no statistic ally signific ant difference between the N 2 treatment group and the control group after treatment(P>0.05).The N3 and REM phases in the treatment group and control group were significantly increased after treatment compared to before treatment(P<0.05),and the difference was stati stic ally signific ant.The treatment group showed a greater increase in N3 phase compared to the control group(P<0.05).There was no signific ant difference between the REM treatment group and the control group after treatment(P>0.05).Conclusion:1.Through meta-analy sis,it was found that acupuncture treatment can significantly improve the symptoms of post stroke insomnia compared to Western medicine treatment,with high safety and fewer side effects.2.The Tongluo Anshen acupuncture method can effectively improve the symptoms of insomnia after stroke and has a stable therapeutic effect.In terms of improving sleep structure,prolonging sleep time,improving sleep efficiency,and regulating sleep related serol ogical markers,the Tongluo Anshen acupuncture method is superior to conventional acupuncture treatment.However,there was no statisti cally significant difference in the improvement of patients’ ability to engage in daily activities and neurological function deficits between the effects of the Tongluo Anshen acupuncture method and conventional acupuncture treatment.3.Tongluo Anshen acupuncture can improve the insomnia symptoms of patients with in somnia after stroke,and its mechanism may be related to upregulating the levels of serotonin and melatonin,and downregulating the levels of dopamine. |
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