Objective: To compare the effect of acupuncture based on syndrome differentiation and estazolam in the treatment of chronic insomnia and its influence on cognitive function.
Methods: A total of 90 patients with chronic insomnia were randomly divided into an acupuncture group and a medication group, 45 cases in each group. The acupuncture group was treated with acupuncture at Sishencong (EX-HN 1) and bilateral Shenmen (HT 7), Sanyinjiao (SP 6) combined with compatibility of acupoints based on syndrome differentiation, once a day for 6 d and then rest for 1 d, for a total of 4 weeks. The medication group was treated with oral estazolam tablets before bedtime, 1 tablet each time, for a total of 4 weeks. Before and after treatment, the scores of Pittsburgh sleep quality index (PSQI), mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA) and auditory verbal memory test (AVMT) of the two groups were compared, and the effects were evaluated.
Results: After treatment, the PSQI sub-item scores and total scores of the two groups were lower than those before treatment ( P<0.05 ), and above scores in the acupuncture group were lower than those in the medication group ( P<0.05 ); the scores of MMSE, MoCA and AVMT in the two groups were higher than those before treatment ( P<0.05 ), and the scores in the acupuncture group were higher than those in the medication group ( P<0.05 ). The total effective rate of the acupuncture group was 80.0% (36/45), which was higher than 53.3% (24/45) in the medication group (P<0.05).
Conclusion: Syndrome differentiation acupuncture can improve the sleep quality and cognitive function of patients with chronic insomnia, and the curative effect is better than that of estazolam.
目的：比较辨证针刺与艾司唑仑治疗慢性失眠的临床疗效及对认知功能的影响。方法：将90例慢性失眠患者随机分为针刺组和药物组，各45例。针刺组采用辨证针刺治疗，穴取四神聪及双侧神门、三阴交，并结合辨证配穴，每日治疗1次，连续治疗6 d后休息1 d，共治疗4周；药物组采用睡前口服艾司唑仑片治疗，每次1片，共治疗4周。比较两组患者治疗前后匹兹堡睡眠质量指数（PSQI）、简易精神状态检查量表（MMSE）、蒙特利尔认知评估量表（MoCA）及听觉词语记忆测验（AVMT）评分，并评定临床疗效。结果：治疗后，两组患者PSQI各项评分及总分均较治疗前降低（P<0.05），且针刺组低于药物组（P<0.05）；两组患者MMSE、MoCA评分及AVMT各项评分均较治疗前升高（P<0.05），且针刺组高于药物组（P<0.05）。针刺组总有效率为80.0%（36/45），高于药物组的53.3%（24/45，P<0.05）。结论：辨证针刺可改善慢性失眠患者的睡眠质量和认知功能，疗效优于艾司唑仑。.
Keywords: acupuncture; chronic insomnia; estazolam; randomized controlled trial (RCT); syndrome differentiation.