Objective: To compare the clinical effect of manual acupuncture and moxibustion therapies in the treatment of perimenopausal insomnia (PMI).
Methods: A total of 60 outpatients with PMI were randomly and equally divided into an acupuncture group (29 cases) and a moxibustion group (28 cases). Acupoints Zhongwan (CV12), Xiawan (CV10), Qihai (CV6) and Guanyuan (CV4) were employed in these two groups. For acupuncture group, filiform needles were inserted slowly into these acupoints and twirled mildly for a while, and then retained for 30 min. When moxibustion performed, the ignited moxa-cone was applied to the same 4 acupoints, with 7 cones for each acupoint. The treatment was conducted once daily for 10 consecutive days, suspended for 2 days, then another 10 days' treatment followed. The Pittsburgh Sleep Quality Index (PSQI) scale (7 items: subjective sleep quality, sleep latency, duration of sleep, habitual sleep efficiency, sleep disturbance, use of sleeping medications, and daytime dysfunction, 0－3 points per item, 0－21 points in total) was used to evaluate the patient's sleep quality. The clinical therapeutic effect was also assessed according to the sleep rate (＝sleep duration/total duration from spin-in to wake-up×100%). The contents of serum follicular stimulating hormone (FSH), estradiol (E2) and luteinizing hormone (LH) were detected using radioimmunoassay.
Results: After treatment, the total score of PSQI and the score of each item were all significantly reduced in the two groups relevant to their own pre-treatment (P<0.01). The scores of sleep latency, sleep disturbance and daytime dysfunction were comparable between the two groups (P>0.05), but the total score, and scores of sleep quality, sleep duration, sleep efficiency, and use of sleeping medication were significantly lower in the moxibustion group than in the acupuncture group (P<0.05). Of the 29 and 28 cases in the acupuncture and moxibustion groups, 6 (20.69%) and 11 (39.29%) were cured, 7 (24.14%) and 9 (32.14%) experienced marked improvement, 9(31.03%) and 5 (17.86%) were effective, and 7(24.14%) and 3 (10.71%) ineffective, with the total effective rate being 75.86% and 89.29%, respectively. The therapeutic effect of moxibustion was obviously superior to that of acupuncture treatment (P<0.05). After the treatment, the levels of serum FSH and LH were significantly decreased (P<0.01), and that of E2 was significantly increased in both groups (P<0.01). The levels of FSH and E2 in the moxibustion group were obviously improved than those of the acupuncture group (P<0.05).
Conclusion: Both acupuncture and moxibustion can relieve the sleep quality of patients with PMI, which may be associated with their effect in regulating serum hormone levels. The therapeutic effect of moxibustion is superior to that of acupuncture.
Keywords: Acupuncture; Moxibustion; Perimenopausal insomnia; Randomized controlled trial.