| BackgroundInsomnia is currently a common disease with a high morbidity which has been increasing year by year.Because of the drug resistance and adverse reactive of medicine,acupuncture plays a key role with better therapeutic effect and less side effect as a alternative therapy. Quite many acupuncture clinical researches of treatment for insomnia studied on methods of manipulating and acupoints selecting.Though 3 randomized controlled trails conformably display that effect of acupuncture for insomnia in afternoon is better than morning,there is none of studies on acupuncture for it in the evening.However,some clinical researchers find that taking sleep-waking cycle and day-night rhythm into considerations to improve clinical effect.In order to explore whether acupuncture in the evening has better effects on treatment of insomnia or not,I design a clinical trial of acupuncture for insomnia with regulating suihai between patients accepting acupuncture in evening and morning.Then I analysis and discuss the relationship between intervention time and clinical effect of acupuncture for insomnia.ObjectiveTo compare therapeutic effects between patients of insomnia accepting acupuncture in evening and morning.MethodsDesigning prospective,randomized,controlled trail.All the cases were from endocrine department,cardiology department and acupuncture department of Guang'anmen Hospital.60 cases that fit inclusive criteria and not in the exclusive criteria were randomized into evening group and morning group,30 cases in each group.They were treated with electroacupuncture(EA) regulating suihai in the evening(8-9pm) and in the morning(8-11pm) respectively.Selection of points:Baihui(GV 20),Shenting(GV 24),Shangyingtang,Touwei(S 8),Shenmen(HT 7),Sanyinjiao(SP 6).Acupoints on head were punctured sub-periosteum 0.5 cun deep.EA(2Hz～100Hz,1～3mA)was applied to "Baihui" and "Shenting" for 20min, once a day,5 times a course of treatment,stopped on Saturday and Sunday,2 weeks continuously.In the course of the treatment,patients were encouraged not to take sleep-assistant unless necessary.PSQI(Pinsburgh Sleep Quality Index) score,sleep rate, daytime sleep time,and frequency of taking hypnotics were applied for evaluating therapeutic effect of pre-treatment,1st week-end and 2nd week-end after treatment in two groups successively.In addition,daytime sleep time and sleep rate were observed in 1st day,adverse reactive was recorded at any moment.Results①60 cases were taken part in randomization,2 cases dropped because of aggravation of other diseases,1 case each group.Adverse reaction of acupuncture result in 2 cases dropping from their groups,1 case each group.The dropping cases were included in ITT principle analysis.②The PSQI score and sleep rate got improved in both evening and morning group,they were 9.93±5.22 scores,70.83±21.77%and 13.07±4.22 scores,56.57±19.83%respectively after 2 weeks.Melioration of the two indexes of evening group was better than that of morning group with a significantly difference(P＜0.05),Besides,evening group significantly increased sleep rate in 1st day(P＜0.01) with instant efficacy.Hypnotics taken was significantly decreased from 3.23±3.22 times/week before treatment to 1.53±2.50 times/week in the 2nd week-end after treatment in the evening group(P＜0.01 ),and no changes in the morning group(P≥0.05 ). Daytime sleep time has no changes in the two groups(p＞0.05).ConclusionElectroacupuncture in evening can significantly improve PSQI score and sleep rate,decrease hypnotics taken,with instant efficacy,better than electroacupuncture in morning... |
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