| Objective: In this study,a randomized controlled trial was used to select patients with insomnia of the heart and spleen deficiency type from the TCM evidence group.By observing the changes in the evaluation indicators after combining Qijiao moxibustion with repetitive transcranial magnetic stimulation(r TMS),ordinary acupuncture combined with r TMS and r TMS alone in the treatment of insomnia,the differences in clinical efficacy between the groups were compared to provide a clinical basis for seeking new ideas and new solutions for the treatment of insomnia.Methods: Based on the inclusion and exclusion criteria,90 patients with insomnia of the heart and spleen deficiency type who met the diagnostic criteria were selected and randomly divided into Group A(r TMS alone),Group B(general acupuncture combined with r TMS)and Group C(Qijiao moxibustion combined with r TMS),with 30 patients in each group treated for 2 weeks.The three groups were analysed to compare whether there were any differences in the basic data of the patients.The Pittsburgh Sleep Quality Index(PSQI),Insomnia Severity Index(ISI),Self-Rating Depression Scale(SDS),and Self-Rating Anxiety Scale(SAS)were administered to the patients at three time points before treatment,after 2 weeks of treatment,and 1 month after the end of treatment,respectively.Compare the changes in indicators and observe the clinical efficacy.Results: 1.The age,gender and duration of illness were not statistically significant(P >0.05)and comparable among the three groups.The comparison of PSQI,ISI,SAS and SDS scores of the three groups before treatment was not statistically different(P >0.05)and was comparable.2.Comparison of PSQI scores: at follow-up after 2 weeks and 1 month of treatment,all three groups had lower PSQI scores than before treatment,with significant differences in intra-group comparisons(P<0.01);comparison between groups after 2 weeks of treatment: group A had higher scores than groups B and C.Compared with group A,group B had statistically significant differences(P<0.05),and group C had significant differences(P<0.01),group B had higher scores than group C,and B and C There was no statistical significance in the comparison between the two groups(P>0.05);comparison between groups at the follow-up after 1 month: group A had higher scores than groups B and C,and there was statistical significance in groups B and C compared with group A(P<0.05),group B had higher scores than group C,and there was no statistical significance in group B compared with group C(P>0.05).3.Comparison of ISI scores: after 2 weeks of treatment and at follow-up after 1 month,ISI scores in all three groups were lower than before treatment,with significant differences in intra-group comparisons(P<0.01);between-group comparisons after 2 weeks of treatment: group A scores were higher than those in groups B and C,and compared with group A,there were significant differences in groups B and C(P<0.01),group B scores were higher than those in group C,and compared with group B,there were statistically significant differences in group C(P< 0.05).comparison between groups at follow-up after 1 month: group A scores were higher than those of groups B and C.Compared with group A,there was a significant difference between groups B and C(P<0.01),group B scores were higher than those of group C,and there was no statistical significance compared with groups B and C(P>0.05).4.Comparison of SDS scores: at follow-up after 2 weeks and 1 month of treatment,SDS scores were lower in all three groups than before treatment.For intra-group comparison,group A was statistically significant(P < 0.05),and groups B and C were significantly different(P < 0.01).Between-group comparison after 2 weeks of treatment: group A scores were higher than those of groups B and C.Compared with group A,there was a statistically significant difference between groups B and C(P < 0.05),group B scores were slightly lower than those of group C, and there was no statistically significant difference between group B and group C(P > 0.05).Between-group comparison after 1 month of follow-up,group A scores were higher than those of groups B and C,and group B scores were higher than those of group C,but there was no statistically significant difference between the three groups(P > 0.05)5.Comparison of SAS scores: at follow-up after 2 weeks and 1 month of treatment,SAS scores were lower in all three groups than before treatment,and there was a statistically significant difference(P < 0.05)in group A and a significant difference(P < 0.01)in groups B and C when compared within groups.Comparison between groups after 2 weeks of treatment: group A scores were higher than those of groups B and C.Compared with group A,group B had statistically significant(P < 0.05)and group C had significant differences(P < 0.01),group B scores were higher than those of group C.Compared with group B and group C,the difference was not statistically significant(P > 0.05).Comparison between groups after 1 month of follow-up: group A scores were higher than those of groups B and C.Compared with group A,groups B and C both statistically significant(P < 0.05),group B had higher scores than group C,and there was no statistically significant difference between group B and group C compared to group C(P > 0.05).6.Comparison of clinical efficacy: After 2 weeks of treatment,the clinical efficacy of the three groups was statistically significant(P<0.05).Compared with group A,group B had statistical significance(P<0.05),group C had significant difference(P<0.01),and group B had no statistical significance compared with group C(P>0.05)After 1 month follow-up,the clinical efficacy of the three groups was still statistically significant(P<0.05).Compared with group A,group B had no statistical significance(P>0.05),group C had significant difference(P<0.01),and compared with group B,group C had statistical significance(P<0.05).Conclusion: All three protocols significantly alleviated negative moods,improved sleep quality and reduced the severity of insomnia in insomnia patients.In terms of improving anxiety and depression and improving sleep quality,Qijiaomoxibustion combined with repetitive transcranial magnetic stimulation was as effective as regular acupuncture combined with r TMS treatment and better than r TMS treatment alone;in regard to reducing the severity of insomnia,the short-term efficacy was better than regular acupuncture combined with r TMS treatment.In terms of overall efficacy,qi jiao moxibustion combined with repetitive transcranial magnetic stimulation was better than r TMS alone,and the long-term efficacy was better than regular acupuncture combined with r TMS,but there was no significant difference between the two in terms of short-term efficacy. |
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