Clinical Study Of Sleep Health Management Model Based On TCM Theory On Insomnia

ObjectivesBased on the theory of Chinese medicine,a sleep health management model was established to observe the effects of sleep health management on patients with insomnia,night sleep quality and daytime fatigue.Objectively evaluate the effectiveness,practicality,and generalizability of sleep health management,and explore new modes of treating insomnia.MethodsA parallel,nonrandomized clinical study was used.Four groups of people with health,sub-health,insomnia,insomnia comorbid physical diseases were selected as the study subjects,and were divided into experimental group and control group according to their respective willingness to participate in management treatment.The experimental group was required to receive standardized Chinese medicine and basic medicine interventions and sleep health management for insomnia,among which sleep health management includes sleep cognitive group therapy combined with the theory of Chinese medicine,lectures on sleep health knowledge,and the issuance of sleep education and sleep knowledge handbooks,as well as completion of sleep diaries.The control group received only the basic intervention of standardized Chinese and Western medicines for insomnia.During the study,the concomitant medication and dosage of each participant were recorded.Evaluation method:Diagnostic evaluation of physical status and sleep status of all subjects by the doctor every 3 months;Pittsburgh Sleep Quality Index(PSQI)for nighttime sleep quality of sub-health,insomnia,insomnia,comorbid illness,and daytime sleep Fatigue status was evaluated;the Symptom Checklist 90(SCL-90)evaluated the improvement of somatic symptoms in people with insomnia and comorbid illness.Evaluation time point:before intervention(baseline),3 months intervention,6 months intervention.Statistical processing:All the statistical tests involved in this study were two-sided tests with a significance level of a=0.05.The count data(gender,city,current occupation,marital status,and education level)were expressed using composition ratios and rates.Comparisons between groups werec~2 tested(or exact probabilities),and group comparisons were compared using a 2×Cc~2table test.With regard to the comparison of insomnia rate,drug-reduction rate,PSQI score,and SCL-90 score,quantitative data are expressed in mean±standard deviation format.Within the group comparison,independent sample t-test was used.Differences between groups were more consistent with the normal distribution.Factor analysis was repeated for variance analysis.Non-parametric rank sum test was used for normal distribution.Result1.A total of 62 subjects were included in this study,including 35 in the experimental group and 27 in the control group.1 cases of insomniacs were lost in the test group.In the control group,1 cases were eliminated,1 cases of insomnia and 1 cases of insomnia accompanied by somatic disease were lost.There were 58 patients who entered the statistical processing,34 patients in the trial group and 24 patients in the control group.There was no significant difference in demographic data between sex,age,marital status,education level,and occupation type(P>0.05).2.Before interventionThe number of healthy and sub-health populations meeting the criteria for the diagnosis of moderate and severe insomnia was 0.The prevalence of insomnia,PSQI scores,PSQI factors,SCL-90 total scores,and SCL-90 factor groups in the sub-health,insomnia,and insomnia-accompanied somatic diseases were not statistically significant between the experimental and control groups.3.3 months interventionThe number of healthy and sub-health populations meeting the criteria for the diagnosis of moderate and severe insomnia was 0.There was no significant difference between the experimental group and the control group on the incidence of insomnia,the total score of PSQI and the factors of PSQI,and there was no significant difference in the PSQI score of the two groups.The total effective rate of PSQI in the experimental group of insomniacs was 80%.The subjective sleep quality of PSQI and PSQI factor and the improvement of daytime function were obviously better than those before the treatment.In the control group,no improvement was found in all aspects of PSQI.The incidence of insomnia,PSQI total score and PSQI in the two groups decreased.The improvement of sleep latency in the experimental group was obviously better than that of the control group(P=0.02).The difference of the total score of PSQI and the other factors was not significant.In the experimental group with insomnia and comorbidity of somatic diseases,the total effective rate of PSQI improvement after 6 months of intervention was 60%,and the total score of PSQI,subjective sleep quality,total sleep time,sleep efficiency,SCL-90 total score,somatization,depression,The improvement of hostility,horror,and other factors was significantly better than before treatment(P<0.05).In the control group,the scores of various factors of sleep factors and SCL-90 before and after the intervention were not significantly changed.The insomnia rate,PSQI total score,PSQI factor score,SCL-90 total score,and SCL-90 factor scores in both groups decreased,but the difference between the two groups was not statistically significant.4.6 months interventionThe number of healthy populations meeting the criteria for the diagnosis of moderate and severe insomnia was 0.There was no significant difference in the improvement of insomnia rate,PSQI scores,and PSQI factor scores between the sub-health group and the control group.There was no statistically significant difference in PSQI scores between the two groups.At the end of the intervention,the average PSQI score in the experimental group decreased to less than 7 points,and there were adjustments and improvements in sleep habits,exercise and eating habits.In the insomniac group,67.7%of the patients in the trial group stopped their drug intervention according to the doctor’s advice,but the improvement in PSQI total score,sleep quality,sleep disturbance,and daytime function was significantly better than before treatment.The total effective rate of PSQI improvement was 60%.The control group had significantly better sleep quality,sleep efficiency,and daytime function than before treatment(P<0.05).During the intervention period,there was no significant improvement in sleep efficiency,sleep time,hypnotic drug use,etc.within each group.The insomnia rate,PSQI total score,and PSQI scores in both groups decreased,but there was no significant difference between the two groups.The total effective rate of PSQI improvement in the experimental group was 73.3%in the population with insomnia and somatic diseases.The total PSQI score,sleep time,sleep efficiency,daytime function,SCL-90 score,somatization,obsessive-compulsive,interpersonal sensitivity,depression,anxiety,hostility,terror,paranoia,psychosis,and other factors improved significantly better than before treatment.In the control group,the scores of various sleep factors and SCL-90 factors before and after the intervention were not significant.The insomnia rate,PSQI total score,PSQI factor score,SCL-90 total score,and SCL-90 factor scores in both groups decreased,but the difference between the two groups was not statistically significant.Conclusions1.The sleep management model used in this study has a positive effect on the prevention of insomnia.2.On the basis of intervention of standardized Chinese and western medicines for insomnia,the sleep management program can improve sleep from subjective sleep quality,sleep disturbance,daytime function,and sleep latency in terms of insomnia.After stopping drug intervention,it can still continue to play a positive role in improving sleep.3.Based on the intervention of standardized Chinese and western medicines for insomnia,the sleep management program can improve sleep quality in terms of subjective sleep quality,total sleep time,sleep efficiency,daytime function,and latency to sleep for comorbid somatic diseases in insomnia.In addition,all aspects of people’s mental and physical discomfort can be rapidly improved in all directions,and the positive impact on sleep and psychosomatic problems can gradually increase over time.4.This study tentatively confirms that the sleep health management program combined with Chinese medicine theory has a positive effect on improving patients’psychosomatic discomfort,reducing insomnia symptoms,preventing insomnia and restoring normal sleep,and is worthy of clinical application.