Gastrointestinal symptoms in chronic migraine patients / 中华神经科杂志

Objective To discuss the correlation between gastrointestinal symptoms concomitant with chronic migraine and sleep disorders,anxiety and depression.Methods Self-rating Anxiety Scale (SAS),Self-rating Depression Scale (SDS),Pittsburgh Sleep Quality Index (PSQI) and Gastrointestinal Symptom Rating Scale (GSRS) were adopted to conduct comparative analysis on gastrointestinal symptoms,anxiety,depression,sleep disorders,and related risk factors in 151 chronic migraine patients who conformed to International Headache Society International Classification of Headache Diseases-Ⅱ diagnostic code and 151 healthy controls in the Third Affiliated Hospital of Qiqihar Medical University from January 2015 to December 2017.Results PSQI scores (8.46±2.54 vs 4.53±1.95,t=2.913,P＜0.05),SAS scores (53.24± 11.66 vs 39.58±8.63,t=3.112,P＜0.05),SDS scores (51.09±8.80 vs 36.11±5.74,t=3.520,P＜0.05),and GSRS scores (4.53 (3.74,5.32) vs 1.29 (0.73,1.31),Z=30.804,P＜0.05) were all higher in migraine patients than that in healthy controls,and the differences were all statistically significant.In chronic migraine patients,139 (92.05％) had one gastrointestinal symptom at least,and the overall incidence of each gastrointestinal symptom was abdominal distension (60 cases,39.74％),exhaust increase (51 cases,33.77％),and endless defecation (43 cases,28.48％),etc.,in turn.Multiple regression analysis showed that headache degree,frequency,PSQI scores,SAS scores,and SDS scores were the main risk factors of gastrointestinal symptoms concomitant with chronic migraine.GSRS scores of chronic migraine patients presented positive correlation with PSQI scores (r=0.65,P=0.000),SAS scores (r=0.42,P=0.000),and SDS scores (r=0.48,P=0.000),respectively.Conclusion Chronic migraine patients are easy to be accompanied with gastrointestinal symptoms,and headache degree and frequency,sleep disorders,depression and anxiety are the main risk factors of concomitant gastrointestinal symptoms.

Challenges in fibromyalgia diagnosis: from meaning of symptoms to fibromyalgia labeling

Fibromyalgia (FM) is a contested illness with ill-defined boundaries. There is no clearly defined cut-point that separates FM from non-FM. Diagnosis of FM has been faced with several challenges that occur, including patients' health care-seeking behavior, symptoms recognition, and FM labeling by physicians. This review focuses on important but less visible factors that have a profound influence on under- or over-diagnosis of FM. FM shows different phenotypes and disease expression in patients and even in one patient over time. Psychosocial and cultural factors seem to be a contemporary ferment in FM which play a major role in physician diagnosis even more than having severe symptom levels in FM patients. Although the FM criteria are the only current methods which can be used for classification of FM patients in surveys, research, and clinical settings, there are several key pieces missing in the fibromyalgia diagnostic puzzle, such as invalidation, psychosocial factors, and heterogeneous disease expression. Regarding the complex nature of FM, as well as the arbitrary and illusory constructs of the existing FM criteria, FM diagnosis frequently fails to provide a clinical diagnosis fit to reality. A physicians' judgment, obtained in real communicative environments with patients, beyond the existing constructional scores, seems the only reliable way for more valid diagnoses. It plays a pivotal role in the meaning and conceptualization of symptoms and psychosocial factors, making diagnoses and labeling of FM. It is better to see FM as a whole, not as a medical specialty or constructional scores.

Clinical Observation of Acupuncture plus Long Dan Xie Gan Decoction in Treating Insomnia Due to Liver Depression Transforming into Fire / 上海针灸杂志

Objective To observe the clinical efficacy of acupuncture plus Long Dan Xie Gan decoction in treating insomnia due to liver depression transforming into fire. Method Ninety eligible patients with insomnia due to liver depression transforming into fire were randomized into an acupuncture group, a Chinese medication group and an acupuncture-medication group. The acupuncture group was given acupuncture treatment, the Chinese medication group was given Chinese medication Long Dan Xie Gan decoction for treatment, and the acupuncture-medication group was intervened by acupuncture plus Long Dan Xie Gan decoction, 2 weeks as a treatment course, for successive 3 courses. The clinical efficacies of the three groups and the changes in Pittsburgh Sleep Quality Index (PSQI) score after the treatment were observed. Result The total effective rate was 96.7% in the acupuncture-medication group, significantly better than 80.0% in the acupuncture group and 83.3% in the Chinese medication group (P<0.05); there was no significant difference in comparing the total effective rate between the acupuncture group and Chinese medication group (P>0.05). The PSQI scores dropped significantly in the three groups after the treatment (P<0.05), and the decrease was most significant in the acupuncture-medication group; after the treatment, the PSQI score in the acupuncture-medication group was significantly different from that in both acupuncture and Chinese medication groups (P<0.05). Conclusion Acupuncture plus Long Dan Xie Gan decoction can produce a more significant efficacy in treating insomnia due to liver depression transforming into fire compared to independent use of acupuncture and Long Dan Xie Gan decoction, and can better improve the quality of life of the patients.

Observations on the Therapeutic Effect of Acupuncture on Dyssomnia in Children with Mental Retardation / 上海针灸杂志

Objective To investigate the clinical efficacy of acupuncture in treating dyssomnia in children with mental retardation. Methods Sixty patients with mental retardation (4-6 years old) were randomly allocated to treatment and control groups, 30 cases each. The control group received routine rehabilitation therapy (family training guidance, and aetiological, psychological and behavioral intervention) and the treatment group, acupuncture in addition. Sleep latency, rapid eye movement (REM) sleep state and sleep efficiency were monitored by polysomnography in the two groups of patients. The clinical therapeutic effects were compared between the two groups. Results The total efficacy rate was 93.3%in the treatment group and 73.3%in the control group;there was a statistically significant difference between the two groups (P<0.05). There were statistically significant differences in pre-/post-treatment sleep latency, REM sleep state and sleep efficiency difference values between the treatment and control groups (P<0.05). Conclusion Acupuncture is an effective way to treat dyssomnia in children with mental retardation.

Psychosocial Factors in Patients with Chronic Kidney Disease / 한양의대학술지

This review article is intended to show and understand psychosocial factors in patients with chronic kidney disease (CKD) including end-stage renal disease (ESRD) on renal replacement therapy. These patients suffered from many psychosocial factors such as depression, sleep disorder, and chronic pain, etc. The prevalence of major depression or a defined psychiatric illness in ESRD patients is not clearly defined, but is roughly estimated between 5% and 50%. Unfortunately many sufferers do not seek treatment, and of those who do, significant numbers are improperly diagnosed or are not appropriately treated. They should be managed by psychiatric medication and interview, because depression could affect medical outcomes in ESRD patients through several mechanisms. Sleep disorders are common in ESRD patients treated with dialysis and are associated with patients' perceptions of quality of life, assessed by diverse measures, as well as depressive mood. Although pain has been considered as a problem for ESRD patients for more than 20 years, few studies exist on this subject. Pain appears to be an undervalued problem for ESRD patients. These psychosocial factors could affect morbidity, mortality and life quality in CKD and ESRD patients. The physicians, especially managing CKD patients, need to consider these factors.

"Study on the relationship between dyssomnia and PTSD of earthquake survivors two years following ""5.12"" earthquake" / 中国实用护理杂志

Objective To investigate the incidence of dyssomnia,posttraumatic stress disorder (PTSD) and their relationship in earthquake survivors in Jiangyou and Beichuan area,and supply evidence for prediction and treatment of PTSD.Methods Dyssomnia was accessed by Pittsburgh Sleep Quality Index (PSQI),posttraumatic symptoms were measured using the PTSD Checklist-Civilian Version (PCL-C).Results The prevalence of dyssomnia was 33.8％,the PTSD was 7.5％.In good sleep group,the number of people who didn't suffer from PTSD was 358 (96.5％),the number of people who suffered from PTSD was 13 (3.5％); In dyssomnia group,the number of people who didn't suffer from PTSD was 160(84.7％),the number of people who suffer from PTSD was 29(15.3％).In PTSD negative group,the number of people who had good sleep was 358 (69.1％); the number of people who had dyssomnia was 160 (30.9％).In PTSD positive group,the number of people who had good sleep was 13(31.0％),the number of people who had dyssomnia was 29(69.0％).The correlation analysis showed that total scores of PCL-C were positively related with total score of PSQI.The logistic regression showed that the very hard-hit area,serious posttraumatic symptoms,were the dangerous factors of dyssomnia.Conclusions The dyssomnia and PTSD are still common among victims two years after 5.12 earthquake.PTSD can cause sleeping problem,meanwhile sleep problem could increase the risk of PTSD.

Clinical Study on Combined Needle-embedding and Medication for Depressive Sleep Disorder / 针灸推拿医学（英文版）

Objective: To observe the clinical efficacy of combined needle-embedding and SSRIs for depressive sleep disorder. Method: Upon admission, 71 depression cases were randomized into needle-embedding group of 24 cases, using combined needle-embedding and SSRIs, acupuncture group of 21 cases, using combined acupuncture and SSRIs, and medication group of 26 cases, using SSRIs alone. After 1, 2, 4 and 6 weeks of treatment, the HAMD sleep scores were compared. Result: The HAMD sleep scores in the needle-embedding and acupuncture group were remarkably superior to the medication group and there was significant statistical difference after 1, 2 and 4 weeks of treatment (P<0.01). However, there was no statistical difference after 6 weeks of treatment. Conclusion: SSRIs can improve HAMD sleep scores. The combined needle-embedding or acupuncture with SSRIs can work faster and better than medication alone. There was no statistical difference between needle-embedding and acupuncture group, however, needle-embedding can reduce the treatment frequencies and therefore has more active clinical meaning.

Efficacy of Sertraline Combine with Shumian Capsule in the Depression of Dyssomnia / 中国药房

OBJECTIVE:To observe the efficacy and safety of sertraline combined with Shumian capsule for depression of dyssomnia.METHODS:86 patients with depression were randomly assigned to receive sertraline alone(single group) or in combination with Shumian capsule(combined group) for 8 weeks.Clinical effectiveness was evaluated using HAMD and PSQI,and TESS was used to assess the adverse effects.RESULTS:After treatment for 8 weeks,the total effective rate was 88.2% for combined group and 85.7% for single group(P