Wang Jianping, Wang Jianbing, Wang Lichao, Zhang Yiming
Zhongguo Zhen Jiu. 2015 Jun;35(6):544-8.
To compare the efficacy difference in the treatment of senile insomnia among western, medication, acupuncture and the integrated therapy of acupuncture and western medication.
Ninety-eight patients of senile insomnia were randomized into a western medication group (30 cases), an acupuncture group (35 cases) and an integrated acupuncture and medication group (35 cases). In the western medication group, estazolam 1mg was prescribed, taken 30 min before going to bed, oryzanol 20 mg, oral administration, three times a day, for 4 weeks totally. In the acupuncture group, the simple acupuncture therapy was applied at Shenmen (HT 7), Sanyinjiao (SP 6), Anmian (Extra), Baihui (GV 20) and Sishencong (EX-HN 1), as well as the supplementary points selected according to the differentiation. The acupuncture treatment was given once a day, 5 treatments a week, for 4 weeks totally. In the integrated acupuncture and medication group, the western medication was combined with acupuncture. The dosage and usage of western medication were same as those in the western medication group; and acupoints in acupuncture treatment were same as those in the acupuncture group. The treatment lasted for 4 weeks in the three groups. Pittsburgh sleep quality index (PSQI) and clinical efficacy were observed before treatment, after 4 weeks' treatment and in 4 weeks after discontinuity of treatment in the three groups.
Four weeks after treatment, the clinical curative rates were 3. 3% (1/30), 21. 2% (7/33) and 25. 7% (9/35) in the western medication group, the acupuncture group and the integrated acupuncture and medicines group separately. The total effective rates were 70. 0%(21/30), 93. 9%(31/33) and 97. 1%(34/35) in the three groups separately. The curative rates and the total effective rates in the integrated acupuncture and medication group and the acupuncture group were higher than those in the western medication group separately (all, P<0. 01). PSQI scores after 4 Weeks' treatment were all improved as compared with those before treatment in the three groups (all P<0. 05). PSQI score in either the integrated acupuncture and medication group or the acupuncture group was lower than that in the western medication group, indicating the significant difference (both P< 0. 05). Four weeks after discontinuity of treatment, the efficacy was stable in the acupuncture group and the integrated acupuncture and medication group. PSQI score did not change as compared with that in the 4th week of treatment. The score in the western medication group ran back, close to that before treatment (P>0. 05). During the treatment, a few patients had dry mouth in the western medication group. The adverse reactions were not discovered in the other two groups.
The integrated therapy of acupuncture and medication achieves the quick efficacy on senile insomnia and rapidly relieves the symptoms, with quite high clinical curative rate and total effective rate obtained. The long-term efficacy is better than that of western medication. The integrated therapy is the first option among the three therapeutic programs.
比较西药、针刺及针药结合治疗老年失眠症的疗效差异。
将98例老年失眠症患者随机分为西药组（30例）、针刺组（35例）和针药结合组（35例）。西药组给予艾司唑仑1mg，睡前30分钟服用，谷维素20mg，口服，每日3次，共治疗4周。针刺组采用单纯针刺疗法，取神门（HT7）、三阴交（SP6）、安眠（奇穴）、百会（GV20）、四神聪（EX-HN1），并根据辨证选取配穴。针刺治疗每日1次，每周5次，共治疗4周。针药结合组采用西药与针刺相结合的方法。西药的剂量和用法与西药组相同；针刺治疗的穴位与针刺组相同。三组治疗均持续4周。观察三组治疗前、治疗4周后及停药4周后的匹兹堡睡眠质量指数（PSQI）及临床疗效。
治疗4周后，西药组、针刺组和针药结合组的临床治愈率分别为3.3%（1/30）、21.2%（7/33）和25.7%（9/35）。三组的总有效率分别为70.0%（21/30）、93.9%（31/33）和97.1%（34/35）。针药结合组和针刺组的治愈率和总有效率分别高于西药组（均P<0.01）。三组治疗4周后的PSQI评分均较治疗前有所改善（均P<0.05）。针药结合组和针刺组的PSQI评分均低于西药组，差异有统计学意义（均P<0.05）。停药4周后，针刺组和针药结合组疗效稳定。PSQI评分与治疗第4周时相比无变化。西药组评分回升，接近治疗前水平（P>0.05）。治疗期间，西药组少数患者出现口干。其他两组未发现不良反应。
针药结合治疗老年失眠症起效快，症状缓解迅速，临床治愈率和总有效率较高。远期疗效优于西药。针药结合疗法是三种治疗方案中的首选。
