Study On The Characteristics Of Brain Response To Chronic Insomnia By Abdominal Rubbing Method

Objective: To explore the clinical effect of rubbing the abdomen in the treatment of chronic insomnia and the changes in brain response characteristics.Methods: A randomized controlled clinical research program was used to enroll 114 patients with chronic insomnia who met the criteria.They were randomly divided into abdominal rubbing group(n=57)and cognitive behavior group(n=57).Patients in the abdominal rubbing group will receive the rubbing treatment 7 times a week,about 30 minutes each time,for a total of 8 weeks according to the intervention method of the prolong life with nine turn method(Yan Nian Jiu Zhuan);the patients in the cognitive behavior group will receive cognitive behavioral therapy,the treatment cycle between the groups are the same.The study uses Pittsburgh Sleep Quality Index(PSQI)as the main efficacy indicator,insomnia severity index(ISI),Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD-17),Gastrointestinal Symptom Rating Scale(GSRS)view would be the secondary efficacy indicators.The clinical efficacy of patients with chronic insomnia was evaluated by follow-up at 4 and 8 weeks before the intervention.To study the characteristics of the brain response,30 patients with chronic insomnia who volunteered to participate in f MRI were selected to explore the changes in brain area low frequency amplitude(ALFF)and functional link(FC)of patients with chronic insomnia at 2 points before and after treatment,so as to explain the effects of rubbing the abdomen method on the insomnia symptoms,mental state,gastrointestinal function and related brain activity in patients with chronic insomnia.Results: A total of 114 subjects with chronic insomnia were included in the trial,of which 55 cases were completed in the abdominal rubbing group(2 cases were dropped),and 55 ca Study on the Characteristics of Brain Response to Chronic Insomnia by Abdominal Rubbing Methodses were completed in the cognitive behavior group(2cases were dropped).1.Clinical efficacy of patients with chronic insomnia(1)Baseline analysis: There was no significant difference in PSQI,ISI,HAMA,HAMD-17,GSRS scale scores between the abdominal rubbing group and the cognitive behavior group of chronic insomnia patients before the test(2)Comparison between groups: the PSQI,ISI,HAMA,HAMD-17 scales of the abdominal rubbing group and the cognitive behavior group were not statistically different(p>0.05),and the GSRS scale score of the Rubbing Abdominal group was better than Cognition Behavior group(p<0.05).(3)Intra-group comparison: The differences in PSQI,ISI,HAMA,HAMD-17,GSRS scales between the abdominal rubbing group and the cognitive behavior group were statistically significant(p<0.05).2.Research results of brain response characteristics in patients with chronic insomnia(1)Intergroup comparison of ALFF: Compared with the cognitive behavior group,the activity of neurons in the posterior central gyrus and paracentral lobule of patients with chronic insomnia in the abdominal rubs group increased,and the activity of neurons in the paracentral gyrus,orbital inferior frontal gyrus,lactiform putamen and superior marginal gyrus decreased,which was closely related to the clinical manifestations.(2)Intra-group comparison of ALFF: Compared with before the test,the activity of neurons in the suboccipital gyrus and putamen of patients with chronic insomnia was enhanced after rubbing the abdomen method.(3)Intergroup comparison of FC: Taking the superior marginal gyrus as the area of interest,compared with the cognitive behavior group,the functional connection strength of the left anterior cingulate and lateral cingulate gyrus of patients with chronic insomnia in the abdominal rubbing group increased.Taking the central posterior gyrus as the area of interest,compared with the cognitive behavior group,the patients with chronic insomnia in the abdominal rubbing group have bilateral insula,bilateral middle frontal gyrus,bilateral upper marginal gyrus,left medial upper frontal gyrus,and right wedge the increased functional connection strength of the anterior lobe and right side supplementary motor area is closely related to clinical manifestations.(4)Intra-group comparison of FC : Taking the left inferior occipital gyrus as the area of interest,the neuronal activity in the superior frontal gyrus and the parietal and inferior angular gyrus of the orbital gyrus in patients with chronic insomnia was enhanced after the treatment by rubbing the abdomen method.Taking the right putamen as the region of interest,neuronal activity in the left suboccipital gyrus of patients with chronic insomnia increased after rubbing the abdomen.Conclusions: 1.Both abdominal rubbing and cognitive behavioral therapy can improve the sleep quality of patients with chronic insomnia,reduce anxiety and depression,as well as improve the digestive function of the gastrointestinal tract.2.Rubbing the abdomen is better than cognitive behavioral therapy in improving the digestive function of patients with chronic insomnia.3.Rubbing the abdomen method can change the functional connection of brain neuron function and brain function in patients with chronic insomnia.