Clinical Observation On Treatment Of Perimenopausal Insomnia(Syndrome Of Disharmony Between Heart And Kidney) With Back-shu Points And Front-mu Points Combination

Objective:The purpose of this study was to observe the clinical efficacy of back-shu points and front-mu points combination as the method of acupoint selection in the treatment of female perimenopausal insomnia(syndrome of disharmony between heart and kidney),and set the conventional acupuncture method as the control group to evaluate the difference in the efficacy of the two treatment methods in the treatment of female perimenopausal insomnia(syndrome of disharmony between heart and kidney).In order to provide a more effective therapy for the treatment of female perimenopausal insomnia in the future.Methods:The subjects of this study were all perimenopausal patients with insomnia who visited the acupuncture department of Hubei Hospital of Traditional Chinese Medicine from October 2018 to September 2020,and 67 patients who met the inclusion criteria were screened out.The patients were divided into two groups by random number method: the backshu points and front-mu points combination treatment group(34 cases)and the conventional acupuncture treatment group(33 cases).There were 32 cases in the Back-shu points and front-mu points combination treatment group and 30 cases in the conventional acupuncture treatment group were finally included in the statistical analysis.The treatment group with back-shu points and front-mu points combination is based on the principle of back-shu points and front-mu points combination,with Xinshu(BL15),Shenshu(BL16),Ganshu(BL18),Pishu(BL20),Juque(RN14),Jingmen(GB25),Zhangmen(LR13),and Qimen(LA14)as the main points,and Shenmai(BL62),Zhaohai(KI6),Shenmen(HT7),Sanyinjiao(SP6),Anmian as the matching points.During the treatment,the patients were first placed in the supine position,and the needle was retained for 20 minutes after deqi,after needle removal,the patients were then placed in the prone position and the needle was also retained for 20 minutes after deqi.The patients were treated once every other day,three times a week,every 4 weeks as a course of treatment,for a total of two courses.The conventional acupuncture treatment group was treated with Shenmai(BL62),Zhaohai(KI6),Shenmen(HT7),Sanyinjiao(SP6),Anmian,Baihui(DU20)and Sishencong(EXHN1)as the main acupoints,and Xinshu(BL15)and Shenshu(BL16)as the matching acupoints.During the treatment,the patient was in the prone position,and the needle was kept for 30 minutes after de qi.The treatment period was the same as that of the Back-shu points and front-mu points combination treatment group.Pittsburgh sleep quality index(PSQI)score,modified Kupperman score,and MenopauseSpecific Quality of Life questionnaire(MENQOL)score before and after treatment were observed and recorded in 2 groups,and the difference of efficacy between 2 groups was analyzed by statistical methods.Results:(1)Comparison of clinical efficacy: there were 32 patients in the back-shu points and front-mu points combination group,after the treatment,3 were cured,14 were markedly effective,11 were effective,and 4 were ineffective,with a total effective rate of 87.50%;A total of 30 patients were in the conventional acupuncture treatment group,0 case was cured,3 cases were markedly effective,19 cases were effective,and 8 cases were ineffective.The total effective rate was 73.33%.After rank sum test,P<0.01,indicating that there is a significant difference in clinical efficacy between the two groups,which is statistically significant.(2)Comparison of Pittsburgh Sleep Quality Index(PSQI)scores: After treatment,the PSQI scores of the two groups were decreased compared with those before treatment,P < 0.05,indicating that both treatment methods could reduce the PSQI scores of the patients.When comparing the two groups after treatment,the clinical efficacy of the back-shu points and front-mu points combination treatment group was better than that of the conventional acupuncture treatment group,no matter from the total scores of PSQI or from the categories of sleep quality,sleep time,and daytime function,etc.(P< 0.05).(3)Comparison of modified Kupperman scores: After treatment,the modified Kupperman scores decreased in both groups(P < 0.05),indicating that both treatment methods could reduce the modified Kupperman score.There was significant difference between the two groups(P < 0.05).(4)Comparison of Menopause-Specific Quality of Life questionnaire(MENQOL)scores: After treatment,the MENQOL scores of both the back-shu points and front-mu points combination treatment group and the conventional treatment group were lower than those before treatment(P < 0.05),indicating that both treatment methods can reduce the MENQOL scores of patients.When comparing between groups,the data of the two groups were statistically significant(P < 0.05).Conclusion:(1)Both Back-shu points and front-mu points combination and conventional acupuncture method can effectively treat female perimenopausal insomnia,but the Back-shu points and front-mu points combination has better clinical efficacy and can better improve the insomnia symptoms of patients.(2)Back-shu points and front-mu points combination was superior to conventional acupuncture method in reducing PSQI scores,modified Kupperman scores,and MENQOL scores of patients.(3)Back-shu points and front-mu points combination can effectively treat perimenopausal insomnia,which is worthy of promotion in clinical practice.