Objectives: To observe the efficacy of acupuncture for reducing the south to reinforce the north on executive function, sleep structure and sleep quality in patients with chronic insomnia disorder of heart-kidney disharmony.
Methods: A total of 100 patients with chronic insomnia disorder of heart-kidney disharmony were randomized into an acupuncture group (50 cases, 1 case dropped out) and a western medication group (50 cases, 2 cases dropped out). Acupuncture for reducing the south to reinforce the north was applied at Baihui (GV 20) and bilateral Shenmen (HT 7), Sanyinjiao (SP 6), Shenmai (BL 62), Zhaohai (KI 6), Xinshu (BL 15), Shenshu (BL 23) in the acupuncture group, once a day, 5 days a week. Lorazepam tablet was given orally in the western medication group, 0.5-1 mg a time, once a day. Both groups were treated for 4 weeks. The Stroop color-word test (SCWT) indexes (the time consuming and the correct number of card A, B, C and the Stroop interference effect [SIE]), sleep structure indexes (total sleep time [TST], sleep latency [SL], wake after sleep onset [WASO], sleep efficiency [SE], non-rapid eye movement period 1 [N1], non-rapid eye movement period 2 [N2], non-rapid eye movement period 3 [N3], rapid eye movement period [REM]) and Pittsburgh sleep quality index (PSQI) score were observed before and after treatment in the two groups.
Results: After treatment, the time consuming of card B and C, the time consuming and the correct number of SIE, SL, WASO, N1, N2, as well as the sub-item scores and total score of PSQI were decreased (P<0.05, P<0.01), the correct number of card A, B and C, TST, SE, N3 and REM were increased (P<0.01) compared with those before treatment in the acupuncture group; the time consuming of card C and SIE, the correct number of card A and SIE, TST, SE, REM were increased (P<0.05, P<0.01), SL, WASO, N1, as well as the sub-item scores of sleep quality, sleep latency, sleep duration, sleep efficiency, daytime function and total score of PSQI were decreased (P<0.01) compared with those before treatment in the western medication group. After treatment, in the acupuncture group, the time consuming of card C, the time consuming and the correct number of SIE, N1, N2, as well as the sub-item scores of sleep quality, sleep dysfunction, daytime function and total score of PSQI were lower than those in the western medication group (P<0.01), the correct number of card B and C, N3, REM were higher than those in the western medication group (P<0.01).
Conclusions: Acupuncture for reducing the south to reinforce the north can improve the executive function of patients with chronic insomnia disorder of heart-kidney disharmony, adjust the sleep structure, and improve the night sleep quality and daytime body function.
目的: 观察泻南补北法针刺对心肾不交型慢性失眠障碍患者执行功能、睡眠结构及睡眠质量的影响。方法: 将100例心肾不交型慢性失眠障碍患者随机分为针刺组（50例，脱落1例）和西药组（50例，脱落2例）。针刺组施泻南补北法针刺（穴取百会及双侧神门、三阴交、申脉、照海、心俞、肾俞，每日1次，每周5 d），西药组予口服劳拉西泮片（每次0.5~1 mg，每日1次），两组均治疗4周。分别于治疗前后观察两组患者Stroop色词测验（SCWT）指标［卡片A、B、C耗时数和正确数，Stroop干扰量（SIE）耗时数和正确数］、睡眠结构指标［总睡眠时间（TST）、睡眠潜伏期（SL）、入睡后清醒时间（WASO）、睡眠效率（SE）、非快速眼球运动1期（N1）、非快速眼球运动2期（N2）、非快速眼球运动3期（N3）、快速眼球运动期（REM）］及匹兹堡睡眠质量指数（PSQI）评分。结果: 治疗后，针刺组卡片B耗时数、卡片C耗时数、SIE耗时数、SIE正确数、SL、WASO、N1、N2、PSQI各项评分及总分较治疗前减少（P<0.05，P<0.01），卡片A正确数、卡片B正确数、卡片C正确数、TST、SE、N3、REM较治疗前增加（P<0.01）；西药组卡片C耗时数、SIE耗时数、卡片A正确数、SIE正确数、TST、SE、REM较治疗前增加（P<0.05，P<0.01），SL、WASO、N1较治疗前减少（P<0.01），PSQI睡眠质量、入睡时间、睡眠时间、睡眠效率、日间功能评分及总分较治疗前减少（P<0.01）。治疗后，针刺组卡片C耗时数、SIE耗时数、SIE正确数、N1、N2低于西药组（P<0.01），PSQI睡眠质量、睡眠障碍、日间功能评分及总分低于西药组（P<0.01），卡片B正确数、卡片C正确数、N3、REM高于西药组（P<0.01）。结论: 泻南补北法针刺可改善心肾不交型慢性失眠障碍患者的执行功能，调节其睡眠结构，并提高其夜间睡眠质量、日间机体功能。.
Keywords: acupuncture; chronic insomnia disorder; executive function; heart-kidney disharmony; lorazepam; randomized controlled trial (RCT); reducing the south to reinforce the north; sleep structure.