Effect Of Combined Tongren Tiaodu Acupuncture And Low-frequency Repetitive Transcranial Magnetic Stimulation On Primary Insomnia

Effectiveness of Acupuncture in Insomnia: A MetaanalysisObjective To systematically evaluate the effect of acupuncture in treating insomnia.Methods The Embase databases,Cochrane Library,Pubmed,Medline and Chinese databases,such as: CNKI,VIP and Wanfang were searched by computer.Randomized controlled trials of acupuncture and sham acupuncture,acupuncture and Chinese herb,acupuncture and Western medicine or acupuncture plus other therapies in the treatment of insomnia were searched from January 2008 to November 2018.We also handsearched the references of relevant studies to further identify relevant publications.The primary outcomes were total effective rate,total score of Pittsburgh sleep quality index(PSQI)and the score of Insomnia Severity Index(ISI).The Secondary outcomes were daytime function,sleep time,sleep efficiency,sleep quality,sleep disorders and sleep latency.After extracting the data and evaluating the quality of the included literature,the meta-analysis was carried out using Revman 5.3 software.Results A total of 29 studies including 2311 patients were included.Meta analysis showed that,compared with traditional Chinese medicine,western medicine,sham acupuncture and other therapies,acupuncture could significantly improve the total effective rate of insomnia clinical efficacy [OR =3.54,95% CI(2.68,4.67),P <0.00001],PSQI total score [MD =3.00,95% CI(2.32,3.68),P <0.00001],ISI[MD =5.71,95% CI(3.16,8.27),P <0.0001],daytime function [MD =0.78,95%CI(0.33,1.23),P =0.0006< 0.01],sleep time [MD =0.55,95% CI(-0.55,1.15),P<0.007],total sleep time [MD =1.92,95% CI(1.02,2.83),P <0.0001],sleep quality[MD = 0.59,95% CI(0.20,0.98),P = 0.003],sleep disorders [MD =0.76,95% CI(0.25,1.28),P = 0.004].But in terms of sleep efficiency,the difference between acupuncture and western medicine or sham acupuncture was significant,while there was no significant difference between acupuncture plus other therapies and other therapies [MD =0.14,95% CI(-0.08,0.36),P = 0.21.In improving sleep latency,there was no significant difference between acupuncture and western medicine or sham acupuncture [MD =6.31,95% CI(0.01,12.61),P = 0.05].Conclusion Acupuncture can effectively improve insomnia and provide a basis for clinical treatment of insomnia.Effect of Tongren Tiaodu Acupuncture on Primary Insomnia: a Double-blind Randomized Controlled TrailObjective To evaluate the efficacy and safety of Tongren Tiaodu acupuncture in treating primary insomnia.Methods This study was a single-center,double-blind and randomized controlled clinical trial.89 patients with primary insomnia were randomly divided into two groups:control group and experimental group.The control group was given ordinary acupuncture treatment,while the experimental group received Tongren Tiaodu acupuncture treatment.Both groups received therapy of 5 days per week for 4 weeks.Sleep quality was assessed by Pittsburgh Sleep Quality Index(PSQI);the severity of insomnia was assessed by Insomnia Severity Index(ISI);Sleep structure parameters were assessed by polysomnography(PSG),including total sleep time(TST),wake-time after sleep onset(WASO),sleep latency(SL)and sleep efficiency(SE%).All these parameters were assessed before and 4 weeks after treatment.Sleep log parameters,including TST,SL and WASO,were used to evaluate sleep patterns.At the end of each week,the parameters of sleep log were evaluated.Results Before treatment,there was no significant difference in the parameters of PSQI,ISI,polysomnography and sleep log between the two groups(P > 0.05).At the end of 4 weeks of treatment,the parameters of PSQI,ISI,polysomnography and sleep log of the two groups were significantly different from those before treatment(P < 0.05,P < 0.01).In the experimental group,PSQI,ISI,TST,SL,WASO,SE% and SL of polysomnography monitoring were obviously ameliorated contrasted to the control group(P < 0.05),while TST and WASO of sleep log monitoring had no significant difference compared with the control group(P > 0.05).At the end of two weeks of treatment,TST,SL and WASO of sleep log monitoring were compared with those before treatment.Statistical differences were found.At the end of the third and fourth weeks,the differences were stable.The total effective rate was 93.1% in the experimental group and 78.6% in the control group(P < 0.05).There were no serious adverse reactions in both groups.Conclusion Tongren Tiaodu Acupuncture is more effective than ordinary acupuncture in improving sleep quality,reducing insomnia degree,improving sleep structure and sleep pattern of patients with primary insomnia.Effect of Combined Tongren Tiaodu Acupuncture and Low-frequency Repetitive Transcranial Magnetic Stimulation on Primary Insomnia: a Double-blind Randomized Controlled TrailObjective To evaluate the effect of combined Tongren Tiaodu acupuncture and lowfrequency repetitive transcranial magnetic stimulation on primary insomnia.Methods 195 patients with primary insomnia were randomly divided into control group and experimental group in a randomized,double-blind and controlled trail.Two groups both received basic treatment.The experimental group was treated with combined Tongren Tiaodu acupuncture and low-frequency repetitive transcranial magnetic stimulation(r TMS),while the control group received combined Tongren Tiaodu acupuncture and sham r TMS.Participants in both groups received therapy of 5days per week for 4 weeks,followed up for 2 months.Pittsburgh Sleep Quality Index(PSQI),Insomnia Severity Index(ISI),Polysomnography(PSG)and Sleep Log were evaluated before treatment,4 weeks after treatment and 2 months of follow up.The parameters of sleep log were evaluated at the end of each week.Results Totally,192 patients completed the study(98 in experimental group and 94 in control group respectively).There was no significant difference in PSQI,ISI,parameters of polysomnography and sleep log between the two groups before treatment(P > 0.05).At the end of two weeks of treatment,the parameters of sleep log in the experimental group began to show statistical differences compared with those before treatment.After three weeks of treatment,the difference of the parameters of sleep log between the experimental group and the control group was obvious.At the end of 4 weeks of treatment,there were significant differences in PSQI,ISI,TST,SL,WASO,SE% of polysomnography and TST,SL,WASO of sleep log between the two groups before and after treatment(P < 0.05,P < 0.01).Compared with the control group,PSQI,ISI,TST,SL,WASO,SE% of polysomnography and TST,SL,WASO of sleep log all improved in the experimental group(P < 0.05,P < 0.01).At the end of the treatment,the total effective rates of the experimental group and the control group were 95% and 89.5%(P< 0.05)respectively.Following up after 2 months,the differences of PSQI,ISI,polysomnography and sleep log parameters between the experimental group and control group were obviously(P < 0.05).There were no serious adverse reactions in both groups.Conclusion Tongren Tiaodu acupuncture combined with r TMS can better improve the sleep quality,reduce the degree of insomnia,improve the sleep structure and sleep mode of patients with primary insomnia.It also has better long-term effect.