| Objective: Based on the hyperawakening state of chronic insomnia,the regulato ry mechanism of “vibro-annular” abdominal massage therapy in treating chronic inso mnia with deficiency of heart and spleen was discussed.Methods:1.Clinical effect of “vibro-annular” abdominal massage therapy on chronic insomnia with deficiency of heart and spleen42 patients who met the research criteria were randomly divided into a massage group and a medication group,taking chronic insomnia patients with deficiency of both the heart and spleen as the research subjects.The massage group was treated with “vibro-annular”abdominal massage therapy,while the drug group was treated with Ginseng Guipi Wan.A5-day course of treatment lasted for a total of 4 course of treatments.Through Pittsburgh Sleep Index(PSQI),Athens Insomnia Scale(AIS),Hyperarousal Scale(HAS)and other scales as well as polysomnography(PSG),we observed the improvement of “vibro-annular”abdominal massage therapy on sleep status and cognitive hyperawakefulness.2.Effect of “vibro-annular” abdominal massage therapy on brain functional network in patients with chronic insomnia of deficiency of heart and spleen Taking patients with chronic insomnia of both heart and spleen deficiency type(n=20)and healthy people(n=20)as research objects,healthy people did not intervene after entering the group,but only performed functional magnetic resonance imaging imaging at rest.The patient received a 4-week treatment with“vibro-annular” abdominal massage therapy,and performed functional magnetic resonance imaging imaging at rest before the first treatment and after the end of the last treatment to study the effect of “vibro-annular” abdominal massage therapy on the brain function network of patients with chronic insomnia of both heart and spleen deficiency type,From the perspective of brain functional imaging,analyze the mechanism of “vibro-annular” abdominal massage therapy in improving cortical hyperawakefulness in chronic insomnia patients.3.Study on the Effect of “vibro-annular” abdominal massage therapy on HRV in Patients with Chronic Insomnia of Deficiency of Heart and Spleen The study subjects were chronic insomnia patients with deficiency of both the heart and spleen(n=20)and healthy volunteers(n=20).After enrollment,healthy individuals did not receive any intervention and only underwent 24-hour dynamic electrocardiogram monitoring.The patient received a 4-week treatment with “vibro-annular” abdominal massage therapy,and 24-hour dynamic electrocardiogram monitoring was conducted before the first treatment and after the end of the last treatment.The neural mechanism of the“vibro-annular” abdominal massage therapy in improving physical hyperawakefulness in chronic insomnia patients was explored through heart rate variability(HRV).4.Study on the Neuromechanism of the Effect of “vibro-annular” abdominal massage therapy on Insomnia Model Rats of PCPATwenty four SD rats were randomly divided into a blank group,a model group,and a massage group(n=8).The insomnia model was prepared by PCPA method.The blank group was not intervened.The model group was restrained in the supine position for seven consecutive days.The massage group was intervened with “vibro-annular” abdominal massage therapy for seven days.The water maze navigation and positioning experiment was conducted on the 4th to 7th days of treatment,and the space exploration experiment was conducted on the 8th day.After the water maze experiment,the rats were anesthetized with gas,and the hypothalamus was taken out for ELISA experiment,determination of 5-HT and GABA levels in the hypothalamus.To explore the neural mechanism of the “vibro-annular”abdominal massage therapy in the intervention of PCPA insomnia model rats.Results:1.One case was excluded from the massage group due to errors,while one case was removed from the drug group due to poor compliance.In the end,20 cases in each group completed all the trials.The PSQI,AIS,and HAS scores of the massage group and the drug group decreased after treatment(P<0.05).The results of PSG showed that both groups increased sleep duration,sleep efficiency,and the proportion of deep sleep increased after treatment.The total sleep time increase in the massage group was significantly higher than that in the drug group(P<0.01)2.Compared with the healthy group,the local efficiency of the patient group was reduced,and the difference was statistically significant(P<0.05).In terms of node attributes,the node efficiency,node clustering coefficient and node local efficiency of the patient group in Insula＿R(right insula)were all lower than those of the healthy group.Node efficiency and degree centrality in Hippocampus＿L(left hippocampus)were lower than those in healthy group,and node efficiency in Amygdala＿L(left amygdala)was lower than those in healthy group(P<0.05).Compared with the patient group,the global efficiency of the massage group was increased,and the difference was statistically significant(P<0.05).Among node attributes,nodal efficiency,nodal clustering coefficient,nodal local efficiency,and centrality of the massage group were higher than those of the patient group in Hippocampus＿L(left hippocampus)(P<0.05).Node efficiency,node clustering coefficient and node local efficiency in Amygdala＿L(left amygdala)were higher than those in patient group(P<0.05).Node efficiency and degree centrality in Insula＿L(left insula)were higher than those in patient group(P<0.05).3.LF in healthy group was lower than that in patient group,while HF,SDANN,RMSSD and PNN50 in healthy group were higher than that in patient group,the differences were statistically significant(P<0.01).Compared with the patient group,the LF in the massage group was decreased,the difference was statistically significant(P<0.01),and the HF and SDANN were increased,the differences were statistically significant(P<0.05).4.The time of finding the platform in model group was higher than that in blank group,and the time of finding the platform in massage group was lower than that in model group.The content of 5-HT in the hypothalamus of model group was lower than that of blank group,the content of 5-HT in the hypothalamus of massage group was higher than that of model group,the content of GABA in the hypothalamus of model group was lower than that of blank group,and the content of GABA in the hypothalamus of massage group was higher than that of model group,the above results were statistically significant(P<0.01).Conclusion:1.The “vibro-annular” abdominal massage therapy can improve the insomnia symptoms and cognitive awakening of patients with chronic insomnia;The “vibro-annular” abdominal massage therapy can increase the duration of sleep,improve sleep efficiency,reduce the number of wakefulness,and increase the proportion of deep sleep.2.Hippocampus,insula and amygdala may be the important targets for the improvement of insomnia and related symptoms by “vibro-annular” abdominal massage therapy;The treatment of chronic insomnia with “vibro-annular” abdominal massage therapy may be related to the improvement of cortical hyperawakening.3.The “vibro-annular” abdominal massage therapy can improve the sympathetic and parasympathetic balance ability of patients with chronic insomnia of deficiency of heart and spleen,and improve the state of excessive awakening.4.The “vibro-annular” abdominal massage therapy can improve the memory and cognitive ability of insomnia model rats;The “vibro-annular” abdominal massage therapy can increase the content of 5-HT and GABA in the hypothalamus and improve the over-excited state of the cerebral cortex. |
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