针刺对睡眠不足所致认知障碍的临床观察及相关机制的初步研究OA

Objective:Sleep deprivation can lead to cognitive impairment,and acupuncture has been shown to symptoms associated with insufficient sleep;however,effects on cognitive impairment and the underlying mechanisms remain unclear.Following a"clinical observation-basic validation"approach,this study aimed to investigate the impact of acupuncture on cognitive function in both sleep-deprived patients and rats. Methods:A total of 22 middle-aged and elderly patients with chronic insomnia were enrolled and randomly assigned to either an acupuncture group(receiving bilateral needling at Shenmen,Sanyinjiao,and Taichong acupoints)or a placebo group.Sleep quality and cognitive function were assessed before and after treatment using the Athens Insomnia Scale-5(AIS-5)and verbal fluency test(VFT).In the animal experiment,24 rats were randomly divided into four groups:a blank control group,a sleep deprivation(SD)group,a SD+acupoint electroacupuncture(SDA)group,and an SD+sham acupuncture(SDS)group.Emotional state and learning and memory performance were recorded in all rats.Serum levels of hypothalamic-pituitary-adrenal(HPA)axis hormones,including adrenocorticotrophic hormone(ACTH),corticotropin releasing hormone(CRH),and corticosteroid(CORT)],as well as oxidative stress enzymes[superoxide dismutase(SOD)and malonaldehyde(MDA)],and proinflammatory cytokines[interleukin(IL)-6,IL-1β,and tumor necrosis factor-α(TNF-α)]were measured.The morphology and density of neurons and glial cells in the cornu ammonis1(CA1)of the hippocampus were also examined. Results:In the 22 middle-aged and elderly patients with chronic insomnia,acupuncture treatment significantly reduced both the total AIS-5 score and individual subscale scores compared to baseline(all P<0.05),and VFT scores showed meaningful improvement(P=0.022).The effects of acupuncture on SD rats were observed across five main dimensions.(1)Behavioral outcomes:compared with the SD group,both the SDA and SDS groups exhibited prolonged sleep duration(P<0.001 and P=0.001,respectively);the SDA group showed an increased number of entries into the central area of the open field(P=0.027),and both the SDA and SDS groups demonstrated a significant greater number of platform crossings in the Morris water maze(P=0.002 and P=0.012,respectively).(2)HPA axis hormone levels:compared with the SD group,the SDA group showed elevated CRH levels and reduced CORT levels,while ACTH levels remained unchanged(P=0.014,0.020,and 0.436,respectively);the SDS group exhibited increased ACTH levels,with no significant difference in CRH or CORT(P=0.017,0.371 and 0.944,respectively).(3)Oxidative stress response:compared with the SD group,SOD levels were significantly lower in the SDA group(P=0.018).(4)Inflammatory response:compared with the SD group,the SDA group showed markedly reduced levels of TNF-α,IL-1β and IL-6(P=0.017,0.006 and 0.007,respectively).(5)Histopathological findings:compared to the SD group,the SDA group demonstrated greater preservation of neurons and a reduction in glial cells in the hippocampal CA1 region. Conclusion:Acupuncture can ameliorate cognitive impairment induced by acute SD,potentially through pathways involving HPA axis-mediated oxidative stress and inflammatory responses.