Objective: To observe the effects of acupuncture at "umbilical four-acupoints" on chronic insomnia and its comorbid symptoms.
Methods: A total of 120 patients with chronic insomnia were randomly divided into an observation group (60 cases, 8 cases dropped off) and a control group (60 cases, 5 cases dropped off). The patients in the observation group were treated with acupuncture at regular acupoints (Baihui [GV 20] and bilateral Shenmen [HT 7], Neiguan [PC 6], Anmian [Extra]) and "umbilical four-acupoints", while the patients in the control group were treated with acupuncture at regular acupoints. Acupuncture was given once a day, 6 times a week, for a total of 3 weeks in the two groups. The Pittsburgh sleep quality index (PSQI), insomnia severity index (ISI) scores were observed before treatment, after treatment and in follow-up of one month after treatment completion; the Beck anxiety inventory (BAI), Beck depression inventory (BDI), fatigue severity scale (FSS), and Epworth sleepiness scale (ESS) scores were observed before and after treatment; the sleep parameters of polysomnography (PSG), including sleep latency (SL), awake-up time (AT), sleep efficiency (SE) and total sleep time (TST), were observed before and after treatment using polysomnography monitor in the two groups.
Results: Compared with those before treatment, the PSQI and ISI scores in both groups were reduced after treatment and in follow-up (P<0.05), and the PSQI and ISI scores in the observation group were lower than those in the control group after treatment and in follow-up (P<0.05). Compared with those before treatment, the BAI, BDI, FSS and ESS scores in both groups were reduced after treatment (P<0.05), and the BAI, BDI, FSS and ESS scores in the observation group were lower than those in the control group after treatment (P<0.05). Compared with those before treatment, the SL and AT in both groups were reduced after treatment (P<0.05), while SE and TST were increased after treatment (P<0.05); after treatment, the SL and AT in the observation group were lower than those in the control group (P<0.05), while SE and TST in the observation group were higher than those in the control group (P<0.05).
Conclusion: On the basis of regular acupoint selection, acupuncture at "umbilical four-acupoints" could improve sleep quality, alleviate the severity of insomnia, and improve the comorbid symptoms i.e. anxiety, depression, fatigue and lethargy in patients with chronic insomnia.
目的：观察针刺“脐四边穴”对慢性失眠及其并发症的影响。方法：将120例慢性失眠患者随机分为观察组（60例，脱落8例）和对照组（60例，脱落5例）。观察组在常规取穴（百会及双侧神门、内关、安眠）的基础上配合“脐四边穴”进行针刺治疗，对照组仅取常规穴位针刺治疗，均每日1次，一周6次，共治疗3周。观察两组患者治疗前后及治疗后1个月随访时匹兹堡睡眠质量指数（PSQI）和失眠严重程度指数（ISI）评分，治疗前后Beck焦虑量表（BAI）、Beck抑郁量表（BDI）、疲劳严重度量表（FSS）、Epworth嗜睡量表（ESS）评分，并应用多导睡眠记录仪观察两组患者治疗前后多导睡眠图（PSG）睡眠参数[睡眠潜伏期（SL）、觉醒时间（AT）、睡眠效率（SE）、实际总睡眠时间（TST）]。结果：两组患者治疗后及随访时，PSQI和ISI评分均较治疗前降低（P<0.05），且观察组低于对照组（P<0.05）。治疗后，两组患者BAI、BDI、FSS和ESS评分均较治疗前降低（P<0.05），且观察组低于对照组（P<0.05）。治疗后两组患者SL、AT较治疗前降低（P<0.05），SE、TST较治疗前升高（P<0.05）；观察组SL、AT低于对照组（P<0.05），SE、TST高于对照组（P<0.05）。结论：在常规取穴基础上，针刺“脐四边穴”可提高慢性失眠患者睡眠质量，减轻失眠严重程度，改善并发的焦虑、抑郁、疲劳和嗜睡症状。.
Keywords: acupuncture; chronic insomnia; comorbid symptoms; umbilical four-acupoints.