| Objective:To investigate the clinical curative effect and to comment on the characteristics of both "connecting and regulating Ren-Du Meridian" and routine conventional acupuncture methods for the elderly insomnia which caused by incoordination between heart and kidney, by comparing the changes of the scores of different questionnaires before and after the treatment process, which include:Pittsburgh sleep quality Index (PSQI), clinical TCM symptoms accumulate points and the Epworth Sleepiness Scale(ESS). Also, by comparing the changes of actigraphy data of these two acupuncture therapies, thus to provide further clinical foundation of "connecting and regulating Ren-Du Meridian" theory, and brain-storm a new acupuncture therapy for insomnia in elderly.Methods:1.61 elderly patients of the Banyan Elderly Services Association of Hong Kong during the date between April 2014 and January 2015 who suffered from primary insomnia caused by incoordination between heart and kidney. These elderly participants were randomized divided into The "connecting and regulating Ren-Du Meridian" acupuncture group (treatment group) and The routine conventional acupuncture group (control group).2. In treatment group, there were 13 male and 18 female, their age range from 63 to 84; average at 72.4±6.0 years old. The PSQI value was 16.1±1.3, the TCM symptoms accumulation points was 25.3±3.3 and ESS score is 8.6±1.0. In control group, there were 12 male and 18 female, their age range from 60 to 82; average at 70.7±6.4 years old. The PSQI value was 16.0±1.4, the TCM symptoms accumulation points was 24.7±2.9 and ESS score is 8.5±1.4.3. In the treatment group,4 acupoints of Ren Meridian (RM) and Du Meridian (DM) were used to strengthen the communication of yin yang. In the routine group, apply tranquilization acupoints that can calm the nerves. In both groups, Shu-back acupoints, and acupoints-yuan were used combinedly. Participants were treated in every other day, each treatment retaining needles for 1 hour. The entire treatment procedure last for 4 weeks, after the second week and the fourth week of treatment, assess the curative effect by reviewing questionnaires; finally visiting after 1 month to follow-up the residue effect.4. To compare and contrast inter-group curative effect and to inspect the sleeping factors, before and after treatment clinical TCM symptoms, by assessing the change of value of the Pittsburgh Sleep Quality Index (PSQI), clinical TCM symptoms accumulate points and the score of Epworth Sleepiness Scale (ESS).5. To observe and compare the change of actigraphy data between two groups.Results:1. The curative effect comparison:After treatment, the clinical recovery rate and the total effective rate of both groups were different. After the whole treatment, the clinical recovery rate in the treatment group was 48.7%; the curing rate was 25.8%; the improvement rate was 19.4%. The treatment group’s total effective rate was 93.6%. While in the control group, the clinical recovery rate was 16.7%; the curing rate was 30.0%; the improvement rate was 33.3%. The control group’s total effective rate was 80%. Therefore, both the clinical recovery rate and the total effective rate in the treatment group were higher than those in the control group.2. The variation of the scale:After the whole treatment, PSQI scores, TCM symptoms accumulate scores and ESS have significantly decreased (P<0.01). The level of deductions of values in the treatment group is higher than the control group (P<0.01). For treatment group, most of the sleeping factors and TCM symptom accumulate points have significantly decreased (P<0.01), while in control group, just part of them have decreased.3. Actigraphy data comparison:After the whole treatment, compare with pre-treatment and the control group, there are significant changes in some factors in treatment group. The time to fall into sleep and times of awakens have decreased (P<0.01) and the sleeping efficiency has increased (P<0.01).Conelusion:1. Compare with the routine control group, there are greater improvements in the treatment group of the following factors: improvement of difficulties of sleeping onset, easy to wake, early waking, dreams, short sleeping time and daytime fatigue, waist and knee pain. Proven that "connecting and regulating Ren-Du Meridian" acupuncture therapy can improve elderly insomnia more comprehensively and the symptoms that arose.2. The overall clinical curative effect in treatment elderly insomnia of "connecting and regulating Ren-Du Meridian" acupuncture therapy is much better than conventional acupuncture therapy. The long term curative effect for elderly insomnia of "connecting and regulating Ren-Du Meridian" acupuncture therapy is more stable and reliable, which is clinically worthy to promote.3. Introduction of actigraphy instrument in the clinical research of insomnia, can reduce research funding, easy to carry, to use and to operate, can increase patients’compliance, which is clinically worthy to promote and apply in scientific research. |
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