Objective: To observe the clinical efficacy of Bushen Anshen acupuncture (acupuncture for tonifying kidney and calming spirit ) in treating perimenopausal insomnia (PMI) of kidney-yin deficiency.
Methods: A total of 72 patients with PMI of kidney-yin deficiency were randomized into an observation group (36 cases, 1 case dropped off) and a control group (36 cases, 1 case dropped off). Acupuncture was applied at Baihui (GV 20) and bilateral Shenshu (BL 23), Taixi (KI 3), Anmian (Extra) in the observation group, while sham acupuncture of shallow needling at non-acupoints was applied in the control group. The treatment was required once every other day, 3 times a week for 10 times in the two groups. Before and after treatment, Pittsburgh sleep quality index (PSQI) was used to evaluate the subjective sleep quality, and polysomnography (PSG) was used to monitor the objective sleep quality in the two groups.
Results: After treatment, the scores of sleep quality, sleep latency, sleep duration, sleep efficiency, hypnotic, daytime dysfunction and total score of PSQI were decreased compared with those before treatment in the observation group (P<0.01), the scores of sleep duration, sleep efficiency and total score of PSQI were decreased compared with those before treatment in the control group (P<0.05); the scores of sleep quality, sleep latency, sleep efficiency, hypnotic and total score of PSQI in the observation group were lower than those in the control group (P<0.05). After treatment, the sleep time was prolonged, the sleep efficiency was improved, the sleep latency and the awake time after falling asleep were shortened, the arousal awake index was reduced (P<0.01) when PSG indexes were monitored, and the percentage of non-rapid eye movement sleep period 1 (N1%) was decreased while the percentage of non-rapid eye movement sleep period 3 (N3%) was increased (P<0.05) compared with those before treatment in the observation group; there was no statistical difference in the PSG indexes compared with those before treatment in the control group (P>0.05). After treatment, compared with the control group, the sleep time was prolonged, the sleep efficiency was improved, the sleep latency and the awake time after falling asleep were shortened, the arousal awake index and N1% were decreased in the observation group (P<0.01).
Conclusion: Bushen Anshen acupuncture can effectively improve the subjective and objective sleep quality in PMI patients of kidney-yin deficiency.
目的：观察“补肾安神”法针刺治疗肾阴虚型围绝经期失眠（PMI）的临床疗效。方法：将72例肾阴虚型PMI患者随机分为观察组（36例，脱落1例）和对照组（36例，脱落1例）。观察组予针刺百会及双侧肾俞、太溪、安眠；对照组予非穴浅刺假针刺。两组均隔日1次，每周3次，共治疗10次。治疗前后采用匹兹堡睡眠质量指数（PSQI）评价患者主观睡眠质量，采用多导睡眠图（PSG）监测患者客观睡眠质量。结果：与治疗前比较，治疗后观察组患者PSQI睡眠质量、入睡时间、睡眠时间、睡眠效率、催眠药物、日间功能评分及总分降低（P<0.01），对照组患者PSQI睡眠时间、睡眠效率评分及总分降低（P<0.05）。治疗后，观察组患者PSQI睡眠质量、入睡时间、睡眠效率、催眠药物评分及总分均低于对照组（P<0.05）。与治疗前比较，治疗后观察组患者PSG睡眠时间延长、睡眠效率提高、入睡潜伏期及入睡后清醒时间缩短、微觉醒指数降低（P<0.01），非快速眼动（NREM）睡眠第1期百分比（N1%）降低、NREM睡眠第3期百分比（N3%）增加（P<0.05）；对照组PSG各项指标与治疗前比较差异无统计学意义（P>0.05）。治疗后，观察组PSG睡眠时间长于对照组、睡眠效率高于对照组、入睡潜伏期及入睡后清醒时间短于对照组、微觉醒指数及N1%低于对照组（P<0.01）。结论：“补肾安神”法针刺可有效改善肾阴虚型PMI患者主观和客观睡眠质量。.
Keywords: Bushen Anshen; Pittsburgh sleep quality index (PSQI); acupuncture; perimenopausal insomnia; polysomnography.