Clinical efficacy of brain resuscitation method combined with vagus nerve stimulation for insomnia and its influence on sleep structure and hypothalamus-pituitary-adrenal axis related hormone
Objective To observe the clinical efficacy of brain resuscitation method combined with vagus nerve stimulation(VNS)for insomnia and its influence on sleep structure and hypothalamus-pituitary-adrenal(HPA)axis related hormone.Methods Eighty patients with insomnia were randomly assigned into treatment group(n=40)and control group(n=40).All patients were managed by estazolam tablets and VNS,and those in treatment group were additionally treated with brain resuscitation method.Treated for 4 weeks,the aim was to compare curative effect of Chinese medicine,traditional Chinese medicine(TCM)syndrome score,HPA axis related hormones,neurotransmitter(cortisol[CORT],adrenocorticotropic hormone[ACTH],5-hydroxytryptamine[5-HT],5-Hydroxyindoleacetic acid[5-HIAA]),autonomic nerve function indexes(standard deviation of the normal-to-normal intervals[SDNN],root mean square of successive RR interval differences[rMSSD],mean value of sinus RR interval[NNMean]),sleep structure(rapid eye movement sleep percentage in total sleep time[REM%],non-REM sleep phase 3 percentage in total sleep time[S3%],non-REM sleep phase 2 percentage in total sleep time[S2%],non-REM sleep Percentage in total sleep time[S1%]),Pittsburgh Sleep Quality Index(PSQI),Hamilton Depression Rating Scale-17(HAMD-17).Results The overall effective rate of TCM in the treatment group was better than that in the control group(90.00%[36/40]vs 70.00%[28/40],P<0.05).After treatment,TCM symptom(insomnia and dreaminess,chest tightness and flank pain,annoyed and irritable,dry mouth)scores in the both groups were significantly decreased(P<0.05),which decreased notably in the treatment group compared with the control group(P<0.05).CORT,ACTH,5-HT,5-HIAA in the both groups were significantly decreased(P<0.05),which were significantly lower in the treatment group than in the control group(P<0.05).SDNN,RMSSD and NNMean in the both groups were significantly increased(P<0.05),the increase in the treatment group was more common than the control group(P<0.05).After treatment,significantly increased REM%and S3%,and significantly decreased S2%and S1%were found in the two groups(all P<0.05),and the treatment group was superior to the control group for REM%,S3%,S2%,S1%(all P<0.05).PSQI and HAMD-17 scores in the both groups were significantly decreased(P<0.05),the decrease in the treatment group was more prevalent compared with the control group(P<0.05).Conclusion The brain resuscitation method combined with VNS has definite curative effect in patients with insomnia,which can improve clinical symptoms and sleep structure by regulating autonomic nervous function and HPA axis activity,and with high safety.
万方数据
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