Insomnia,as one of the emotional diseases,has been increasing in recent years,which has a great impact on people's life and work.Therefore,researchers are eager to find a more perfect treatment.The microbiome-gut-...Insomnia,as one of the emotional diseases,has been increasing in recent years,which has a great impact on people's life and work.Therefore,researchers are eager to find a more perfect treatment.The microbiome-gut-brain axis is a new theory that has gradually become popular abroad in recent years and has a profound impact in the field of insomnia.In recent years,traditional Chinese medicine(TCM)has played an increasingly important role in the treatment of insomnia,especially acupuncture and Chinese herbal medicine.It is the main method of TCM in the treatment of insomnia.This paper mainly reviews the combination degree of"microorganism-gut-brain axis"theory with TCM and acupuncture under the system of TCM.To explore the mechanism of TCM and acupuncture in the treatment of insomnia under the guidance of"microorganismgut-brain axis"theory,in order to provide a new idea for the diagnosis and treatment of insomnia.展开更多
Insomnia is among the most common sleep disorders worldwide.Insomnia in older adults is a social and public health problem.Insomnia affects the physical and mental health of elderly hospitalized patients and can aggra...Insomnia is among the most common sleep disorders worldwide.Insomnia in older adults is a social and public health problem.Insomnia affects the physical and mental health of elderly hospitalized patients and can aggravate or induce physical illnesses.Understanding subjective feelings and providing reasonable and standardized care for elderly hospitalized patients with insomnia are urgent issues.AIM To explore the differences in self-reported outcomes associated with insomnia among elderly hospitalized patients.METHODS One hundred patients admitted to the geriatric unit of our hospital between June 2021 and December 2021 were included in this study.Self-reported symptoms were assessed using the Athens Insomnia Scale(AIS),Generalized Anxiety Disorder Scale-7(GAD-7),Geriatric Depression Scale-15(GDS-15),Memorial University of Newfoundland Scale of Happiness(MUNSH),Barthel Index Evaluation(BI),Morse Fall Scale(MFS),Mini-Mental State Examination,and the Short Form 36 Health Survey Questionnaire(SF-36).Correlation coefficients were used to analyze the correlation between sleep quality and self-reported symptoms.Effects of insomnia was analyzed using Logistic regression analysis.RESULTS Nineteen patients with AIS≥6 were included in the insomnia group,and the incidence of insomnia was 19%(19/100).The remaining 81 patients were assigned to the non-insomnia group.There were significant differences between the two groups in the GDA-7,GDS-15,MUNSH,BI,MFS,and SF-36 items(P<0.05).Patients in the insomnia group were more likely to experience anxiety,depression,and other mental illnesses,as well as difficulties with everyday tasks and a greater risk of falling(P<0.05).Subjective well-being and quality of life were poorer in the insomnia group than in the control group.The AIS scores positively correlated with the GAD-7,GDS-15,and MFS scores in elderly hospitalized patients with insomnia(P<0.05).Logistic regression analysis showed that GDS-15≥5 was an independent risk factor for insomnia in elderly hospitalized patients(P<0.05).CONCLUSION The number of self-reported symptoms was higher among elderly hospitalized patients with insomnia.Therefore,we should focus on the main complaints of patients to meet their care needs.展开更多
BACKGROUND Healthcare workers(HCWs)are at increased risk of contracting coronavirus disease 2019(COVID-19)as well as worsening mental health problems and insomnia.These problems can persist for a long period,even afte...BACKGROUND Healthcare workers(HCWs)are at increased risk of contracting coronavirus disease 2019(COVID-19)as well as worsening mental health problems and insomnia.These problems can persist for a long period,even after the pandemic.However,less is known about this topic.AIM To analyze mental health,insomnia problems,and their influencing factors in HCWs after the COVID-19 pandemic.METHODS This multicenter cross-sectional,hospital-based study was conducted from June 1,2023 to June 30,2023,which was a half-year after the end of the COVID-19 emergency.Region-stratified population-based cluster sampling was applied at the provincial level for Chinese HCWs.Symptoms such as anxiety,depression,and insomnia were evaluated by the Generalized Anxiety Disorder-7,Patient Health Questionnaire-9,and Insomnia Severity Index.Factors influencing the symptoms were identified by multivariable logistic regression.RESULTS A total of 2000 participants were invited,for a response rate of 70.6%.A total of 1412 HCWs[618(43.8%)doctors,583(41.3%)nurses and 211(14.9%)nonfrontline],254(18.0%),231(16.4%),and 289(20.5%)had symptoms of anxiety,depression,and insomnia,respectively;severe symptoms were found in 58(4.1%),49(3.5%),and 111(7.9%)of the participants.Nurses,female sex,and hospitalization for COVID-19 were risk factors for anxiety,depression,and insomnia symptoms;moreover,death from family or friends was a risk factor for insomnia symptoms.During the COVID-19 outbreak,most[1086(76.9%)]of the participating HCWs received psychological interventions,while nearly all[994(70.4%)]of them had received public psychological education.Only 102(7.2%)of the HCWs received individual counseling from COVID-19.CONCLUSION Although the mental health and sleep problems of HCWs were relieved after the COVID-19 pandemic,they still faced challenges and greater risks than did the general population.Identifying risk factors would help in providing targeted interventions.In addition,although a major proportion of HCWs have received public psychological education,individual interventions are still insufficient.展开更多
The gut microbiome is an extensive variety of bacteria with a range of metabolic capabilities that can be pathogenic,beneficial,or opportunistic.Changes in the gut microbiota's composition can affect the link betw...The gut microbiome is an extensive variety of bacteria with a range of metabolic capabilities that can be pathogenic,beneficial,or opportunistic.Changes in the gut microbiota's composition can affect the link between gut integrity and host health as well as cause disruptions to numerous neurological systems.The second most prevalent mental health problem,insomnia has a negative social and economic impact.Currently,it is becoming increasingly obvious how crucial it is to preserve the delicate balance of gut microbiota to treat illness-related symptoms like insomnia.Although traditional Chinese medicine has proposed an effective strategy against insomnia through gut microbiota alteration in animal models,studies in human models are limited.This decreases the predictive value of the studies in terms of human outcomes.This editorial places an emphasis on cultural sensitivity rather than scientific reasoning that promotes the use of traditional Chinese medicine(TCM).We aim to emphasize the concern that promoting TCM could divert resources from conventional medical research,leading to suboptimal care.展开更多
Objective:To analyze the effectiveness of applying ShuGan JieYu Capsules(SGJYC)combined with trazodone in patients with post-stroke depression(PSD)with insomnia.Methods:60 cases of PSD with insomnia patients admitted ...Objective:To analyze the effectiveness of applying ShuGan JieYu Capsules(SGJYC)combined with trazodone in patients with post-stroke depression(PSD)with insomnia.Methods:60 cases of PSD with insomnia patients admitted to the hospital from May 2022 to May 2023 were selected and randomly divided into a reference group(trazodone)and a research group(SGJYC combined with trazodone)of 30 cases each.Statistics were analyzed using the Hamilton Depression Rating Scale(HAM-D),Pittsburgh Sleep Quality Index(PSQI),and Activities of Daily Living(ADL)scale before treatment and 4,8,and 12 weeks after treatment.Results:Before treatment,The results of HAM-D,PSQI,and ADL scale studies in the two groups before treatment were not statistically significant(P>0.05);4,8,and 12 weeks after treatment,the results of HAM-D and PSQI studies in the research group were lower than that of the reference group,and the results of ADL scale studies were higher than that of the reference group.There was a significant difference between the groups(P<0.05).The total adverse reaction rate of the research group was lower than that of the reference group,and there was a significant difference between the groups(P<0.05).Conclusion:The combination of SGJYC and trazodone reduced depression in post-stroke patients,corrected insomnia,improved sleep quality,was safe,and had a low rate of adverse reactions.展开更多
Background:Traditional Chinese medicine(TCM)is commonly used for the diagnosis and treatment of insomnia,with tongue diagnosis being particularly important.The aim of our study was to develop and validate a novel tong...Background:Traditional Chinese medicine(TCM)is commonly used for the diagnosis and treatment of insomnia,with tongue diagnosis being particularly important.The aim of our study was to develop and validate a novel tongue imaging-based radiomics(TIR)method for accurately diagnosing insomnia severity.Methods:This two-center analysis prospectively enrolled 399 patients who underwent tongue imaging between July and October 2021 and divided them into primary and validation cohorts by study center.Here,we referred to the Insomnia Severity Index(ISI)standard and the degree of insomnia was evaluated as absent,subthreshold,moderate,or severe.For developed the TIR diagnostic tool,a U-Net algorithm was used to segment tongue images.Subsequently,seven imaging features were selected from the extracted high-throughout radiomics features using the least absolute shrinkage and selection operator algorithm.Then,the final radiomics model was developed in the primary cohort and tested in the independent validation cohort.Finally,we assessed and compared the diagnostic performance differences between TCM tongue diagnosis and our TIR diagnostic tool with the ISI gold standard.The confusion matrix was calculated to evaluate the diagnostic performance.Results:Seven tongue imaging features were selected to build the TIR tool,with showing good correlations with the insomnia degree.The TIR method had an accuracy of 0.798,a macro-average sensitivity of 0.78,a macro-average specificity of 0.906,a weighted-average sensitivity of 0.798,and a weighted specificity of 0.916,showing a significantly better performance compared to the average performance of three experienced TCM physicians(mean accuracy of 0.458,P<0.01).Conclusions:The preliminary study demonstrates the potential application of TIR in the diagnosis of insomnia degree and measurement of sleep health.The integration of quantitative imaging analysis and machine learning algorithms holds promise for advancing both of TCM and precision sleep medicine.展开更多
Objective:To explore the relationship between organizational identification,occupational stress,and insomnia among nurses and to analyze the moderating role of organizational identification between occupational stress...Objective:To explore the relationship between organizational identification,occupational stress,and insomnia among nurses and to analyze the moderating role of organizational identification between occupational stress and insomnia.Methods:Through stratified sampling,720 nurses working in a tertiary A-level hospital in Shandong Province from March to May 2021 were surveyed using an effort-reward imbalance questionnaire,an organizational identification questionnaire,and the Athens Insomnia scale.Results:Organizational identification was negatively correlated with occupational stress and insomnia(r_(1)=-0.121,P_(1)<0.01;r_(2)=-0.144,P_(2)<0.01).Occupational stress was positively correlated with insomnia(r=0.379,P<0.01).Organizational identity significantly moderated nurses’occupational stress and insomnia(β=-0.192,t=-2.558,P<0.05).Conclusion:Occupational stress and organizational identification can predict insomnia.Organizational identification could negatively mediate the relationship between occupational stress and insomnia.Improving organizational identification may help alleviate insomnia symptoms by relieving occupational stress.展开更多
Objective:To determine the impact of applying the theory of human becoming and self-care deficit theory of nursing in overcoming insomnia in patients of urinary incontinence(UI)after stroke.Insomnia is a sleep disorde...Objective:To determine the impact of applying the theory of human becoming and self-care deficit theory of nursing in overcoming insomnia in patients of urinary incontinence(UI)after stroke.Insomnia is a sleep disorder experienced by UI patients after stroke which can exacerbate problems related to brain damage and can complicate the recovery process.Methods:This study was a quasi-experimental conducted in 4 hospitals.Fifty-six patients were selected by convenience sampling and divided into 2 groups(the intervention and control group).Participants in the intervention group received“applying the theory of Human becoming and self-care deficit theory of nursing,”starting when the patient is about to go home from the hospital and continuing at the house.Measurement of insomnia is done using the Pittsburgh Sleep Quality Index(PSQI).Results:The mean insomnia scores of participants from both groups increased in the first and third measurements.The second and third insomnia measurements found a significant difference(P<0.001).This intervention decreased the average score of insomnia by 4.11 times in the second measurement and 5.82 times in the third measurement.The most important item that decreased in the third measurement of insomnia was sleep efficiency.Conclusions:Applying the theory of human becoming and self-care deficit theory of nursing in this study significantly decreased the insomnia score of post-stroke UI patients.It can be used as a guide for nurses,patients,and families in managing insomnia.In addition,the application of nursing theory in nursing practice can systematize nursing care plans and organize the knowledge of professionals into a conceptual framework,as well as provide effective guidance for nurses on what to do.展开更多
Objective:To study the effect of head meridian massage combined with auricular acupoint plasters on patients with insomnia.Methods:The sample consisted of 50 cases,and all of them were admitted to Yixing Hospital of T...Objective:To study the effect of head meridian massage combined with auricular acupoint plasters on patients with insomnia.Methods:The sample consisted of 50 cases,and all of them were admitted to Yixing Hospital of Traditional Chinese Medicine from January 2022 to December 2023.The patients were divided into an observation group and a control group,with 25 cases in each group.The observation group was treated with a combination of head meridian massage and auricular acupoint plaster while the control group underwent conventional nursing care.The improvement of sleep quality and nursing effect were used as evaluation criteria to compare the clinical effects of the nursing programs.Results:After nursing intervention,the Pittsburgh sleep quality index(PSQI)score of the observation group,which was 7.17±1.41 points was lower than that of the control group(9.04±1.96 points),(t=3.8724,P<0.05).The total efficacy was 96.00%for the observation group and 76.00%for the control group(2=4.1528,P<0.05).Conclusion:Head meridian massage combined with auricular acupoint can improve the sleep quality of patients with insomnia.展开更多
Insomnia has become an urgent clinical problem in modern society.Current research has found that the gut flora-gut-brain axis plays an important role in regulating insomnia.The state-target theory is a product of the ...Insomnia has become an urgent clinical problem in modern society.Current research has found that the gut flora-gut-brain axis plays an important role in regulating insomnia.The state-target theory is a product of the combination of traditional Chinese medicine and modern molecular biology technology.This paper clarifies the correlation between the state-target theory,the intestinal flora-gut-brain axis,and liver-depression-spleen-deficiency insomnia.The use of traditional Chinese medicine to regulate the structure and abundance of intestinal flora was also explored,aiming to integrate traditional Chinese medicine with Western medicine for the prevention and treatment of liver-depression-spleen-deficiency insomnia.展开更多
Objective:To explore and analyze the clinical efficacy of Chinese medicine combined with acupuncture and moxibustion in the treatment of insomnia.Method:80 patients with primary insomnia were selected as the study sam...Objective:To explore and analyze the clinical efficacy of Chinese medicine combined with acupuncture and moxibustion in the treatment of insomnia.Method:80 patients with primary insomnia were selected as the study sample,with 20 cases randomly selected as the control group and the rest as the observation group.The control group was treated with ordinary western medicine,while the observation group patients were treated with traditional Chinese medicine combined with acupuncture and moxibustion based on this syndrome differentiation.The comparison items were treatment effect,sleep quality,mental health,quality of life,specific sleep indicators,cerebral blood flow and neurotransmitters.Result:The treatment effectiveness showed that the observation group had a higher treatment effectiveness rate than the control group(P<0.05);The results of sleep quality showed that after treatment,the scores of the observation group were lower than those of the control group in seven dimensions:sleep quality,sleep time,sleep onset time,sleep efficiency,sleep disorders,hypnotic drugs,and daytime dysfunc‐tion score(P<0.05);The quality of life results showed that after treatment,the observa‐tion group had higher scores than the control group in eight dimensions:physiological function,physiological function,physical pain,health status,energy,social function,emotional function,and mental health(P<0.05);The results of slow wave sleep time and fast eye movement sleep time showed that after treatment,the HAMA and HAMD scores of the physiological mechanism in the observation group were lower than those in the control group(P<0.05);The results of cerebral blood flow and neurotransmitter indica‐tors show that after treatment,glutamateγ-The peak systolic blood flow velocity of ami‐nobutyric acid,vertebral artery,and basilar artery in the observation group was higher than that in the control group(P<0.05).Conclusion:The clinical treatment of Chinese medicine combined with acupuncture and moxibustion in the treatment of insomnia patients can significantly improve the clinical treatment effect,and improve the cerebral hemorrhage and neurotransmitter status of patients,promote the improvement of their physical and mental status,can more significantly improve the quality of sleep,reduce sleep difficulties,reduce the dosage of sleeping pills,which has important clinical application value.展开更多
[Objectives]The research aimed to carry out a retrospective analysis on the characteristics of the drug composition in the treatment of insomnia by external bath prescription of traditional Chinese medicine,to provide...[Objectives]The research aimed to carry out a retrospective analysis on the characteristics of the drug composition in the treatment of insomnia by external bath prescription of traditional Chinese medicine,to provide ideas for the research and development of new Chinese medicine for insomnia.[Methods]The external bath prescriptions of traditional Chinese medicine related to insomnia were collected,and the appearance frequency of drug was analyzed,and statistical analysis of drug with high appearance frequency was conducted.[Results]In the external bath prescriptions of traditional Chinese medicine related to insomnia,the top ten herbs with high appearance frequency were as follows:Chaozaoren,Drgonsbones,Margaritifera,Yejiaoteng,Schisandrae Chinensis Fructus,Lilii Bulbus,Platycladi Semen,Poria,Coptidis Rhizoma,and Scutellariae Radix.According to the classification by efficacy,these herbs mostly have the effects of calming,nourishing and heat clearing.[Conclusions]Traditional Chinese medicine is most closely related to heart,kidney,liver and other viscera.Tranquilizing and sedative drugs should be chosen,which corresponds with the understanding on pathogenesis of insomnia in traditional Chinese medical science,and embodies the characteristics of external bath prescription of traditional Chinese medicine in the treatment of insomnia.展开更多
Objective This study aimed to reveal the insomnia burden and relevant influencing factors among informal caregivers(ICs)of hospitalized patients with lung cancer.Methods A cross-sectional study on ICs of hospitalized ...Objective This study aimed to reveal the insomnia burden and relevant influencing factors among informal caregivers(ICs)of hospitalized patients with lung cancer.Methods A cross-sectional study on ICs of hospitalized patients with lung cancer was conducted from December 31,2020 to December 31,2021.ICs’burden was assessed using the Caregiver Reaction Assessment(CRA),Hospital Anxiety and Depression Scale(HADS),and Insomnia Severity Index(ISI).Linear and logistic regression models were used to identify the influencing factors.Results Among 289 ICs of hospitalized patients with lung cancer,83(28.72%),53(18.34%),and 14(4.84%)ICs experienced mild,moderate,and severe insomnia,respectively.The scores concerning self-esteem,lack of family support,financial problems,disturbed schedule,and health problems were 4.32±0.53,2.24±0.79,2.84±1.14,3.63±0.77,and 2.44±0.95,respectively.ICs with higher Activities of Daily Living Scale(ADLS)scores were associated with a lower risk of insomnia,with an odd ratio(OR)and 95%confidence interval(CI)of 0.940(0.898–0.983).Among the ICs,female gender(OR=2.597),alcohol consumption(OR=3.745),underlying medical conditions(OR=11.765),long-term caregiving experience(OR=37.037),and higher monthly expenses(OR=5.714)were associated with a high risk of insomnia.Conclusion Of the hospitalized patients with lung cancer,51.9%experienced insomnia.Patients’ADL,ICs gender,alcohol consumption,underlying medical conditions,caregiving duration,and monthly expenses were influencing factors.Therefore,prompt screening and early intervention for ICs of patients with lung cancer is necessary.展开更多
BACKGROUND Insomnia is a disease where individuals cannot maintain a steady and stable sleep state or fail to fall asleep.Western medicine mainly uses sedatives and hypnotic drugs to treat insomnia,and long-term use i...BACKGROUND Insomnia is a disease where individuals cannot maintain a steady and stable sleep state or fail to fall asleep.Western medicine mainly uses sedatives and hypnotic drugs to treat insomnia,and long-term use is prone to drug resistance and other adverse reactions.Acupuncture has a good curative effect and unique advantages in the treatment of insomnia.AIM To explore the molecular mechanism of acupuncture at Back-Shu point for the treatment of insomnia.METHODS We first prepared a rat model of insomnia,and then carried out acupuncture for 7 consecutive days.After treatment,the sleep time and general behavior of the rats were determined.The Morris water maze test was used to assess the learning ability and spatial memory ability of the rats.The expression levels of inflammatory cytokines in serum and the hippocampus were detected by ELISA.qRTPCR was used to detect the mRNA expression changes in the ERK/NF-κB signaling pathway.Western blot and immunohistochemistry were carried out to evaluate the protein expression levels of RAF-1,MEK-2,ERK1/2 and NF-κB.RESULTS Acupuncture can prolong sleep duration,and improve mental state,activity,diet volume,learning ability and spatial memory.In addition,acupuncture increased the release of 1L-1β,1L-6 and TNF-αin serum and the hippocampus and inhibited the mRNA and protein expression of the ERK/NF-κB signaling pathway.CONCLUSION These findings suggest that acupuncture at Back-Shu point can inhibit the ERK/NF-κB signaling pathway and treat insomnia by increasing the release of inflammatory cytokines in the hippocampus.展开更多
Background:Insomnia is a sleep disorder,which seriously affects people's physical and mental health.Our experimental study will further explain the efficacy and mechanism of the traditional Chinese medicine prescr...Background:Insomnia is a sleep disorder,which seriously affects people's physical and mental health.Our experimental study will further explain the efficacy and mechanism of the traditional Chinese medicine prescription Sanwei Anmian Decoction as well as the single drug treatment for insomnia,and provide scientific basis for TCM decoction to cure more insomnia patients.Methods:42 mices,half male and half female,were randomly divided into 7 groups,6 in each group,Blank group,Model group,Positive group,Sanwei Anmian Decoction group(abbreviated as Sanwei group),Suanzaoren group,Maidong group,Yuanzhi group.Intraperitoneal injection(ip)of PCPA 350 mg·kg^-1 in other groups except Blank group to establish a mice model of insomnia.On the next day after the successful modeling,10ml·kg^-1 corresponding decoction was given to Sanwei group,Suanzaoren group,Yuanzhi group and Maidong group respectively,0.8mg·kg^-1 estazolam for Positive group,Blank group and the Model group with the same amount of normal saline,three times a day for two days.The body weight and the number of autonomous activities of mice were observed.The sleep rate,sleep latency and sleep time were recorded after the last administration,and the contents of serum 5-hydroxytryptamine(5-HT)and dopamine(DA)were detected.Results:The changes of hair yellowing,alarm,food loss and weight loss in mice showed that the model was successful.After the last administration,compared with the Model group and the Blank group,the weight of mice in Sanwei Anmian Decoction and each disassembled prescription group increased,the autonomous activity decreased,the number of mice fell asleep increased,the concentration of 5-HT in serum increased and the concentration of DA decreased,P<0.01,which was statistically significant.Conclusions:Sanwei Anmian Decoction can effectively improve the symptoms of PCPA insomnia mice model.For single drug,Suanzaoren Decoction has the most obvious effect on the treatment of insomnia.展开更多
Background:The Tibetan medicine Sug-Mel-sum-thang(SMST)is often used to treat insomnia disorder(ID);however,the underlying mechanism remains unclear.In this study,network pharmacology prediction was conducted to analy...Background:The Tibetan medicine Sug-Mel-sum-thang(SMST)is often used to treat insomnia disorder(ID);however,the underlying mechanism remains unclear.In this study,network pharmacology prediction was conducted to analyze the molecular mechanisms of SMST in treating ID.Methods:The active ingredients of the three herbs used in SMST were obtained from the Shanghai Institute of Organic Chemistry,Chinese Academy of Sciences.Chemistry Database[DB/OL].The chemical formulae of the active ingredients were downloaded from PubChem in canonical SMILES format.These were then imported into the SwissTargetPrediction platform to identify drug targets.ID targets were obtained from databases such as DrugBank,GeneCards,and DisGeNET.Potential targets of SMST for the treatment of ID were identified using the online Venny mapping platform.The potential target protein-protein interaction was constructed using the STRING platform,and the obtained protein-protein interaction information was imported into Cytoscape 3.7.1 for image optimization and core gene extraction and ClueGO in Cytoscape 3.7.1 was used for the enrichment analysis of potential targets.Cytoscape 3.7.1 was also used to construct the regulatory network of the Tibetan medicine compound target pathway and conduct a topological analysis.Results:The mechanism of action of SMST in the treatment of ID involved 72 compounds,including nerolidol,apigenin,luteolin,and piperine.The key targets identified were COMT,CNR1,AKT1,SLC6A4,TNF,CTNNB1,and CHRNA4.The enrichment analysis obtained 69 KEGG pathways,mainly related to Alzheimer’s disease,cAMP signaling pathway,serotonergic synapse,and other pathways.The core active ingredient molecule docked with the target to a higher degree.The results showed that the active ingredient exhibited good binding activity with the related targets.Some parts with good docking fractions were selected for surface plasmon resonance analysis.Conclusion:Various active components in SMST play a role in the treatment of ID by acting on key targets,such as COMT and CNR1,to regulate multiple signaling pathways.展开更多
文摘Insomnia,as one of the emotional diseases,has been increasing in recent years,which has a great impact on people's life and work.Therefore,researchers are eager to find a more perfect treatment.The microbiome-gut-brain axis is a new theory that has gradually become popular abroad in recent years and has a profound impact in the field of insomnia.In recent years,traditional Chinese medicine(TCM)has played an increasingly important role in the treatment of insomnia,especially acupuncture and Chinese herbal medicine.It is the main method of TCM in the treatment of insomnia.This paper mainly reviews the combination degree of"microorganism-gut-brain axis"theory with TCM and acupuncture under the system of TCM.To explore the mechanism of TCM and acupuncture in the treatment of insomnia under the guidance of"microorganismgut-brain axis"theory,in order to provide a new idea for the diagnosis and treatment of insomnia.
文摘Insomnia is among the most common sleep disorders worldwide.Insomnia in older adults is a social and public health problem.Insomnia affects the physical and mental health of elderly hospitalized patients and can aggravate or induce physical illnesses.Understanding subjective feelings and providing reasonable and standardized care for elderly hospitalized patients with insomnia are urgent issues.AIM To explore the differences in self-reported outcomes associated with insomnia among elderly hospitalized patients.METHODS One hundred patients admitted to the geriatric unit of our hospital between June 2021 and December 2021 were included in this study.Self-reported symptoms were assessed using the Athens Insomnia Scale(AIS),Generalized Anxiety Disorder Scale-7(GAD-7),Geriatric Depression Scale-15(GDS-15),Memorial University of Newfoundland Scale of Happiness(MUNSH),Barthel Index Evaluation(BI),Morse Fall Scale(MFS),Mini-Mental State Examination,and the Short Form 36 Health Survey Questionnaire(SF-36).Correlation coefficients were used to analyze the correlation between sleep quality and self-reported symptoms.Effects of insomnia was analyzed using Logistic regression analysis.RESULTS Nineteen patients with AIS≥6 were included in the insomnia group,and the incidence of insomnia was 19%(19/100).The remaining 81 patients were assigned to the non-insomnia group.There were significant differences between the two groups in the GDA-7,GDS-15,MUNSH,BI,MFS,and SF-36 items(P<0.05).Patients in the insomnia group were more likely to experience anxiety,depression,and other mental illnesses,as well as difficulties with everyday tasks and a greater risk of falling(P<0.05).Subjective well-being and quality of life were poorer in the insomnia group than in the control group.The AIS scores positively correlated with the GAD-7,GDS-15,and MFS scores in elderly hospitalized patients with insomnia(P<0.05).Logistic regression analysis showed that GDS-15≥5 was an independent risk factor for insomnia in elderly hospitalized patients(P<0.05).CONCLUSION The number of self-reported symptoms was higher among elderly hospitalized patients with insomnia.Therefore,we should focus on the main complaints of patients to meet their care needs.
文摘BACKGROUND Healthcare workers(HCWs)are at increased risk of contracting coronavirus disease 2019(COVID-19)as well as worsening mental health problems and insomnia.These problems can persist for a long period,even after the pandemic.However,less is known about this topic.AIM To analyze mental health,insomnia problems,and their influencing factors in HCWs after the COVID-19 pandemic.METHODS This multicenter cross-sectional,hospital-based study was conducted from June 1,2023 to June 30,2023,which was a half-year after the end of the COVID-19 emergency.Region-stratified population-based cluster sampling was applied at the provincial level for Chinese HCWs.Symptoms such as anxiety,depression,and insomnia were evaluated by the Generalized Anxiety Disorder-7,Patient Health Questionnaire-9,and Insomnia Severity Index.Factors influencing the symptoms were identified by multivariable logistic regression.RESULTS A total of 2000 participants were invited,for a response rate of 70.6%.A total of 1412 HCWs[618(43.8%)doctors,583(41.3%)nurses and 211(14.9%)nonfrontline],254(18.0%),231(16.4%),and 289(20.5%)had symptoms of anxiety,depression,and insomnia,respectively;severe symptoms were found in 58(4.1%),49(3.5%),and 111(7.9%)of the participants.Nurses,female sex,and hospitalization for COVID-19 were risk factors for anxiety,depression,and insomnia symptoms;moreover,death from family or friends was a risk factor for insomnia symptoms.During the COVID-19 outbreak,most[1086(76.9%)]of the participating HCWs received psychological interventions,while nearly all[994(70.4%)]of them had received public psychological education.Only 102(7.2%)of the HCWs received individual counseling from COVID-19.CONCLUSION Although the mental health and sleep problems of HCWs were relieved after the COVID-19 pandemic,they still faced challenges and greater risks than did the general population.Identifying risk factors would help in providing targeted interventions.In addition,although a major proportion of HCWs have received public psychological education,individual interventions are still insufficient.
文摘The gut microbiome is an extensive variety of bacteria with a range of metabolic capabilities that can be pathogenic,beneficial,or opportunistic.Changes in the gut microbiota's composition can affect the link between gut integrity and host health as well as cause disruptions to numerous neurological systems.The second most prevalent mental health problem,insomnia has a negative social and economic impact.Currently,it is becoming increasingly obvious how crucial it is to preserve the delicate balance of gut microbiota to treat illness-related symptoms like insomnia.Although traditional Chinese medicine has proposed an effective strategy against insomnia through gut microbiota alteration in animal models,studies in human models are limited.This decreases the predictive value of the studies in terms of human outcomes.This editorial places an emphasis on cultural sensitivity rather than scientific reasoning that promotes the use of traditional Chinese medicine(TCM).We aim to emphasize the concern that promoting TCM could divert resources from conventional medical research,leading to suboptimal care.
基金Research Project on Heilongjiang Province Traditional Chinese Medicine No.ZHY2022-057。
文摘Objective:To analyze the effectiveness of applying ShuGan JieYu Capsules(SGJYC)combined with trazodone in patients with post-stroke depression(PSD)with insomnia.Methods:60 cases of PSD with insomnia patients admitted to the hospital from May 2022 to May 2023 were selected and randomly divided into a reference group(trazodone)and a research group(SGJYC combined with trazodone)of 30 cases each.Statistics were analyzed using the Hamilton Depression Rating Scale(HAM-D),Pittsburgh Sleep Quality Index(PSQI),and Activities of Daily Living(ADL)scale before treatment and 4,8,and 12 weeks after treatment.Results:Before treatment,The results of HAM-D,PSQI,and ADL scale studies in the two groups before treatment were not statistically significant(P>0.05);4,8,and 12 weeks after treatment,the results of HAM-D and PSQI studies in the research group were lower than that of the reference group,and the results of ADL scale studies were higher than that of the reference group.There was a significant difference between the groups(P<0.05).The total adverse reaction rate of the research group was lower than that of the reference group,and there was a significant difference between the groups(P<0.05).Conclusion:The combination of SGJYC and trazodone reduced depression in post-stroke patients,corrected insomnia,improved sleep quality,was safe,and had a low rate of adverse reactions.
基金supported by the Shandong Province Traditional Chinese Medicine Science and Technology Project (M-2022012)。
文摘Background:Traditional Chinese medicine(TCM)is commonly used for the diagnosis and treatment of insomnia,with tongue diagnosis being particularly important.The aim of our study was to develop and validate a novel tongue imaging-based radiomics(TIR)method for accurately diagnosing insomnia severity.Methods:This two-center analysis prospectively enrolled 399 patients who underwent tongue imaging between July and October 2021 and divided them into primary and validation cohorts by study center.Here,we referred to the Insomnia Severity Index(ISI)standard and the degree of insomnia was evaluated as absent,subthreshold,moderate,or severe.For developed the TIR diagnostic tool,a U-Net algorithm was used to segment tongue images.Subsequently,seven imaging features were selected from the extracted high-throughout radiomics features using the least absolute shrinkage and selection operator algorithm.Then,the final radiomics model was developed in the primary cohort and tested in the independent validation cohort.Finally,we assessed and compared the diagnostic performance differences between TCM tongue diagnosis and our TIR diagnostic tool with the ISI gold standard.The confusion matrix was calculated to evaluate the diagnostic performance.Results:Seven tongue imaging features were selected to build the TIR tool,with showing good correlations with the insomnia degree.The TIR method had an accuracy of 0.798,a macro-average sensitivity of 0.78,a macro-average specificity of 0.906,a weighted-average sensitivity of 0.798,and a weighted specificity of 0.916,showing a significantly better performance compared to the average performance of three experienced TCM physicians(mean accuracy of 0.458,P<0.01).Conclusions:The preliminary study demonstrates the potential application of TIR in the diagnosis of insomnia degree and measurement of sleep health.The integration of quantitative imaging analysis and machine learning algorithms holds promise for advancing both of TCM and precision sleep medicine.
文摘Objective:To explore the relationship between organizational identification,occupational stress,and insomnia among nurses and to analyze the moderating role of organizational identification between occupational stress and insomnia.Methods:Through stratified sampling,720 nurses working in a tertiary A-level hospital in Shandong Province from March to May 2021 were surveyed using an effort-reward imbalance questionnaire,an organizational identification questionnaire,and the Athens Insomnia scale.Results:Organizational identification was negatively correlated with occupational stress and insomnia(r_(1)=-0.121,P_(1)<0.01;r_(2)=-0.144,P_(2)<0.01).Occupational stress was positively correlated with insomnia(r=0.379,P<0.01).Organizational identity significantly moderated nurses’occupational stress and insomnia(β=-0.192,t=-2.558,P<0.05).Conclusion:Occupational stress and organizational identification can predict insomnia.Organizational identification could negatively mediate the relationship between occupational stress and insomnia.Improving organizational identification may help alleviate insomnia symptoms by relieving occupational stress.
文摘Objective:To determine the impact of applying the theory of human becoming and self-care deficit theory of nursing in overcoming insomnia in patients of urinary incontinence(UI)after stroke.Insomnia is a sleep disorder experienced by UI patients after stroke which can exacerbate problems related to brain damage and can complicate the recovery process.Methods:This study was a quasi-experimental conducted in 4 hospitals.Fifty-six patients were selected by convenience sampling and divided into 2 groups(the intervention and control group).Participants in the intervention group received“applying the theory of Human becoming and self-care deficit theory of nursing,”starting when the patient is about to go home from the hospital and continuing at the house.Measurement of insomnia is done using the Pittsburgh Sleep Quality Index(PSQI).Results:The mean insomnia scores of participants from both groups increased in the first and third measurements.The second and third insomnia measurements found a significant difference(P<0.001).This intervention decreased the average score of insomnia by 4.11 times in the second measurement and 5.82 times in the third measurement.The most important item that decreased in the third measurement of insomnia was sleep efficiency.Conclusions:Applying the theory of human becoming and self-care deficit theory of nursing in this study significantly decreased the insomnia score of post-stroke UI patients.It can be used as a guide for nurses,patients,and families in managing insomnia.In addition,the application of nursing theory in nursing practice can systematize nursing care plans and organize the knowledge of professionals into a conceptual framework,as well as provide effective guidance for nurses on what to do.
基金Wuxi Municipal Health Commission"Promotion of Meridian-Based Head Massage Combined with Auricular Acupressure for Insomnia Patients"(Project No.T202245)。
文摘Objective:To study the effect of head meridian massage combined with auricular acupoint plasters on patients with insomnia.Methods:The sample consisted of 50 cases,and all of them were admitted to Yixing Hospital of Traditional Chinese Medicine from January 2022 to December 2023.The patients were divided into an observation group and a control group,with 25 cases in each group.The observation group was treated with a combination of head meridian massage and auricular acupoint plaster while the control group underwent conventional nursing care.The improvement of sleep quality and nursing effect were used as evaluation criteria to compare the clinical effects of the nursing programs.Results:After nursing intervention,the Pittsburgh sleep quality index(PSQI)score of the observation group,which was 7.17±1.41 points was lower than that of the control group(9.04±1.96 points),(t=3.8724,P<0.05).The total efficacy was 96.00%for the observation group and 76.00%for the control group(2=4.1528,P<0.05).Conclusion:Head meridian massage combined with auricular acupoint can improve the sleep quality of patients with insomnia.
文摘Insomnia has become an urgent clinical problem in modern society.Current research has found that the gut flora-gut-brain axis plays an important role in regulating insomnia.The state-target theory is a product of the combination of traditional Chinese medicine and modern molecular biology technology.This paper clarifies the correlation between the state-target theory,the intestinal flora-gut-brain axis,and liver-depression-spleen-deficiency insomnia.The use of traditional Chinese medicine to regulate the structure and abundance of intestinal flora was also explored,aiming to integrate traditional Chinese medicine with Western medicine for the prevention and treatment of liver-depression-spleen-deficiency insomnia.
文摘Objective:To explore and analyze the clinical efficacy of Chinese medicine combined with acupuncture and moxibustion in the treatment of insomnia.Method:80 patients with primary insomnia were selected as the study sample,with 20 cases randomly selected as the control group and the rest as the observation group.The control group was treated with ordinary western medicine,while the observation group patients were treated with traditional Chinese medicine combined with acupuncture and moxibustion based on this syndrome differentiation.The comparison items were treatment effect,sleep quality,mental health,quality of life,specific sleep indicators,cerebral blood flow and neurotransmitters.Result:The treatment effectiveness showed that the observation group had a higher treatment effectiveness rate than the control group(P<0.05);The results of sleep quality showed that after treatment,the scores of the observation group were lower than those of the control group in seven dimensions:sleep quality,sleep time,sleep onset time,sleep efficiency,sleep disorders,hypnotic drugs,and daytime dysfunc‐tion score(P<0.05);The quality of life results showed that after treatment,the observa‐tion group had higher scores than the control group in eight dimensions:physiological function,physiological function,physical pain,health status,energy,social function,emotional function,and mental health(P<0.05);The results of slow wave sleep time and fast eye movement sleep time showed that after treatment,the HAMA and HAMD scores of the physiological mechanism in the observation group were lower than those in the control group(P<0.05);The results of cerebral blood flow and neurotransmitter indica‐tors show that after treatment,glutamateγ-The peak systolic blood flow velocity of ami‐nobutyric acid,vertebral artery,and basilar artery in the observation group was higher than that in the control group(P<0.05).Conclusion:The clinical treatment of Chinese medicine combined with acupuncture and moxibustion in the treatment of insomnia patients can significantly improve the clinical treatment effect,and improve the cerebral hemorrhage and neurotransmitter status of patients,promote the improvement of their physical and mental status,can more significantly improve the quality of sleep,reduce sleep difficulties,reduce the dosage of sleeping pills,which has important clinical application value.
基金the Hospital-level Project of Shiyan Taihe Hospital in 2018(2018JJXM092)Shiyan Science and Technology Research and Development Project in 2018(18Y17)。
文摘[Objectives]The research aimed to carry out a retrospective analysis on the characteristics of the drug composition in the treatment of insomnia by external bath prescription of traditional Chinese medicine,to provide ideas for the research and development of new Chinese medicine for insomnia.[Methods]The external bath prescriptions of traditional Chinese medicine related to insomnia were collected,and the appearance frequency of drug was analyzed,and statistical analysis of drug with high appearance frequency was conducted.[Results]In the external bath prescriptions of traditional Chinese medicine related to insomnia,the top ten herbs with high appearance frequency were as follows:Chaozaoren,Drgonsbones,Margaritifera,Yejiaoteng,Schisandrae Chinensis Fructus,Lilii Bulbus,Platycladi Semen,Poria,Coptidis Rhizoma,and Scutellariae Radix.According to the classification by efficacy,these herbs mostly have the effects of calming,nourishing and heat clearing.[Conclusions]Traditional Chinese medicine is most closely related to heart,kidney,liver and other viscera.Tranquilizing and sedative drugs should be chosen,which corresponds with the understanding on pathogenesis of insomnia in traditional Chinese medical science,and embodies the characteristics of external bath prescription of traditional Chinese medicine in the treatment of insomnia.
基金supported by Technical field fund of the basic strengthening plan of the military science and Technology Commission[2021-JCJQ-JJ-0528]The Project of Beijing Science and Technology“capital characteristics”[Z181100001718007]+1 种基金Construction project of military medical teaching at PLA Medical College[145bxl090009000x]Central Military Health Care Commission[20BJZ46].
文摘Objective This study aimed to reveal the insomnia burden and relevant influencing factors among informal caregivers(ICs)of hospitalized patients with lung cancer.Methods A cross-sectional study on ICs of hospitalized patients with lung cancer was conducted from December 31,2020 to December 31,2021.ICs’burden was assessed using the Caregiver Reaction Assessment(CRA),Hospital Anxiety and Depression Scale(HADS),and Insomnia Severity Index(ISI).Linear and logistic regression models were used to identify the influencing factors.Results Among 289 ICs of hospitalized patients with lung cancer,83(28.72%),53(18.34%),and 14(4.84%)ICs experienced mild,moderate,and severe insomnia,respectively.The scores concerning self-esteem,lack of family support,financial problems,disturbed schedule,and health problems were 4.32±0.53,2.24±0.79,2.84±1.14,3.63±0.77,and 2.44±0.95,respectively.ICs with higher Activities of Daily Living Scale(ADLS)scores were associated with a lower risk of insomnia,with an odd ratio(OR)and 95%confidence interval(CI)of 0.940(0.898–0.983).Among the ICs,female gender(OR=2.597),alcohol consumption(OR=3.745),underlying medical conditions(OR=11.765),long-term caregiving experience(OR=37.037),and higher monthly expenses(OR=5.714)were associated with a high risk of insomnia.Conclusion Of the hospitalized patients with lung cancer,51.9%experienced insomnia.Patients’ADL,ICs gender,alcohol consumption,underlying medical conditions,caregiving duration,and monthly expenses were influencing factors.Therefore,prompt screening and early intervention for ICs of patients with lung cancer is necessary.
文摘BACKGROUND Insomnia is a disease where individuals cannot maintain a steady and stable sleep state or fail to fall asleep.Western medicine mainly uses sedatives and hypnotic drugs to treat insomnia,and long-term use is prone to drug resistance and other adverse reactions.Acupuncture has a good curative effect and unique advantages in the treatment of insomnia.AIM To explore the molecular mechanism of acupuncture at Back-Shu point for the treatment of insomnia.METHODS We first prepared a rat model of insomnia,and then carried out acupuncture for 7 consecutive days.After treatment,the sleep time and general behavior of the rats were determined.The Morris water maze test was used to assess the learning ability and spatial memory ability of the rats.The expression levels of inflammatory cytokines in serum and the hippocampus were detected by ELISA.qRTPCR was used to detect the mRNA expression changes in the ERK/NF-κB signaling pathway.Western blot and immunohistochemistry were carried out to evaluate the protein expression levels of RAF-1,MEK-2,ERK1/2 and NF-κB.RESULTS Acupuncture can prolong sleep duration,and improve mental state,activity,diet volume,learning ability and spatial memory.In addition,acupuncture increased the release of 1L-1β,1L-6 and TNF-αin serum and the hippocampus and inhibited the mRNA and protein expression of the ERK/NF-κB signaling pathway.CONCLUSION These findings suggest that acupuncture at Back-Shu point can inhibit the ERK/NF-κB signaling pathway and treat insomnia by increasing the release of inflammatory cytokines in the hippocampus.
基金This work was supported by the National College Students Innovation and Entrepreneurship Training Program(Grant No:201610471013).
文摘Background:Insomnia is a sleep disorder,which seriously affects people's physical and mental health.Our experimental study will further explain the efficacy and mechanism of the traditional Chinese medicine prescription Sanwei Anmian Decoction as well as the single drug treatment for insomnia,and provide scientific basis for TCM decoction to cure more insomnia patients.Methods:42 mices,half male and half female,were randomly divided into 7 groups,6 in each group,Blank group,Model group,Positive group,Sanwei Anmian Decoction group(abbreviated as Sanwei group),Suanzaoren group,Maidong group,Yuanzhi group.Intraperitoneal injection(ip)of PCPA 350 mg·kg^-1 in other groups except Blank group to establish a mice model of insomnia.On the next day after the successful modeling,10ml·kg^-1 corresponding decoction was given to Sanwei group,Suanzaoren group,Yuanzhi group and Maidong group respectively,0.8mg·kg^-1 estazolam for Positive group,Blank group and the Model group with the same amount of normal saline,three times a day for two days.The body weight and the number of autonomous activities of mice were observed.The sleep rate,sleep latency and sleep time were recorded after the last administration,and the contents of serum 5-hydroxytryptamine(5-HT)and dopamine(DA)were detected.Results:The changes of hair yellowing,alarm,food loss and weight loss in mice showed that the model was successful.After the last administration,compared with the Model group and the Blank group,the weight of mice in Sanwei Anmian Decoction and each disassembled prescription group increased,the autonomous activity decreased,the number of mice fell asleep increased,the concentration of 5-HT in serum increased and the concentration of DA decreased,P<0.01,which was statistically significant.Conclusions:Sanwei Anmian Decoction can effectively improve the symptoms of PCPA insomnia mice model.For single drug,Suanzaoren Decoction has the most obvious effect on the treatment of insomnia.
基金supported by grants from the Projects of the National Social Science Foundation of China(20XMZ026)the Qinghai Provincial Natural Science Foundation Applied Basic Research Project(2019-ZJ-7088).
文摘Background:The Tibetan medicine Sug-Mel-sum-thang(SMST)is often used to treat insomnia disorder(ID);however,the underlying mechanism remains unclear.In this study,network pharmacology prediction was conducted to analyze the molecular mechanisms of SMST in treating ID.Methods:The active ingredients of the three herbs used in SMST were obtained from the Shanghai Institute of Organic Chemistry,Chinese Academy of Sciences.Chemistry Database[DB/OL].The chemical formulae of the active ingredients were downloaded from PubChem in canonical SMILES format.These were then imported into the SwissTargetPrediction platform to identify drug targets.ID targets were obtained from databases such as DrugBank,GeneCards,and DisGeNET.Potential targets of SMST for the treatment of ID were identified using the online Venny mapping platform.The potential target protein-protein interaction was constructed using the STRING platform,and the obtained protein-protein interaction information was imported into Cytoscape 3.7.1 for image optimization and core gene extraction and ClueGO in Cytoscape 3.7.1 was used for the enrichment analysis of potential targets.Cytoscape 3.7.1 was also used to construct the regulatory network of the Tibetan medicine compound target pathway and conduct a topological analysis.Results:The mechanism of action of SMST in the treatment of ID involved 72 compounds,including nerolidol,apigenin,luteolin,and piperine.The key targets identified were COMT,CNR1,AKT1,SLC6A4,TNF,CTNNB1,and CHRNA4.The enrichment analysis obtained 69 KEGG pathways,mainly related to Alzheimer’s disease,cAMP signaling pathway,serotonergic synapse,and other pathways.The core active ingredient molecule docked with the target to a higher degree.The results showed that the active ingredient exhibited good binding activity with the related targets.Some parts with good docking fractions were selected for surface plasmon resonance analysis.Conclusion:Various active components in SMST play a role in the treatment of ID by acting on key targets,such as COMT and CNR1,to regulate multiple signaling pathways.