Vibro-annular abdominal massage under the brain–intestine interaction in the treatment of insomnia

Study on the mechanism of regulating the hypothalamic cortical hormone releasing hormone/corticotropin releasing hormone type I receptor pathway by:

• vibro-annular abdominal massage under the brain–intestine interaction in the treatment of insomnia.

Prepared on the basis of:

Study on the mechanism of regulating the hypothalamic cortical hormone releasing hormone/corticotropin releasing hormone type I receptor pathway by vibro-annular abdominal massage under the brain-intestine interaction in the treatment of insomnia. Zhang Y, Cong D, Liu P, et al. Medicine. 2021 May 14;100(19)

Insomnia is a common disease associated with different nervous system stress response and endocrine disorders. It has been reported previously that abdominal vibration and ring massage therapy can significantly improve the symptoms of insomnia patients and enhance the activity of neurons. The purpose of this study is to investigate the relationship between the hypothalamus and intestinal interaction in the treatment of insomnia by abdominal massage. The results of this study will be used to possibly elaborate the interaction between various mechanisms in the treatment of insomnia by abdomen ring rubbing.

Introduction

Insomnia is defined as insufficient sleep time and quality and could significantly affect the subjective experience of daytime activities. Additionally, with the rapid increase in the pace of life, as a result of significant work pressure, the incidence of insomnia has gradually increased and patients may have trouble falling asleep and could exhibit sleep disorders, mood disorders, fatigue, and irritability decreasing their work and learning efficiency. Abdominal vibration and ring massage therapy in the traditional medicine of the Changbai mountain uses meridians to adjust the internal organs and combines modern brain–gut interaction theory according to the “improve the brain by treating the intestines” principle.

• The study will constitute a safe and reliable clinical trial, which will only comprise abdominal massage in patients with insomnia with almost no risk.
• The basic advantages of this study will be its safety, reliability, practicability, and high comfort level.
• Abdominal massage treatment of insomnia has been carried out for 15 years with good clinical effects, but there is still a lack of basic research.

Methods and design

The study aim is to determine the potential efficacy of treating insomnia with the ring vibrating abdominal kneading method, and elaborate various neural mechanisms of ring rubbing method for treating insomnia. The patients will be recruited from the Department of Zang-fu Massage, Affiliated Hospital of Changchun University of Chinese Medicine. The patients will be screened strictly according to the diagnostic criteria, inclusion criteria, and exclusion criteria. A sample size of 30 subjects per group meets the sample size estimation criteria.
The patients will have to display one of the following symptoms of insomnia without obvious inducement: decline in sleep quality, difficulty falling asleep, persistent disorder, early awakening, or going back to sleep after waking up without completely recovering.
After being enrolled, 30 patients will be treated with abdominal vibration and ring kneading therapy. The main techniques that will be used include rubbing, shaking, and pressing the abdomen. The main points to be considered will be Zhongwan (CV12), Shenque (CV8), Zhongji (CV3). The acupoint location that will be used refers to the 2006 National Standard of the People’s Republic of China. Patients will undergo the therapy for 30 minutes each time, once a day, 5 days as a course of treatment, the treatment interval will be 2 days, and intervention will be conducted over 4 courses. There will be a follow up conducted once during the 4th week after the treatment.
In this project, insomnia patients will be used as research subjects, and scale screening, fMRI test, MRS test, serum ¹HNMR test, and serum ELISA test will be carried out, so as to clarify the efficacy and influence on the HPA axis as a result of abdominal vibration and ring massage on insomnia patients from the clinical perspective.
Due to the delay in recruitment and preparation time, the trial run will begin in June 2021, and we expect the recruitment of the volunteers to be completed by June 2022.

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