Objective

2

To observe the clinical effect and safety of the warm acupuncture of Mongolian medicine in treatment of insomnia in the elderly

and to explore its underlying brain-gut peptide mechanism.

Methods

2

Sixty elderly patients with insomnia were randomly divided into a warm acupuncture group and a western medication group

30 cases in each group. In the warm acupuncture group

the warm acupuncture of Mongolian medicine was operated at Dinghuixue (at the center of the vertex

the crossing site of the anterior midline and the line connected the upper edges of two ear apexes)

Heyixue (at the depression of the spinous process of the 7th cervical vertebra) or Xinxue (at the depression of the spinous process of the 6th thoracic vertebra) in each treatment. Only one of the above points was selected and stimulated for 20 min one treatment and the three points were used alternatively. The treatment was given once every day or every other day

3 times a week

and for a total of 3 weeks. In the western medication group

estazolam tablets were administered orally

once a day

1 mg before bedtime

consecutively for 3 weeks. Before and after treatment

as well as in 1-month follow-up visit after the treatment completion

the scores of the Pittsburgh sleep quality index (PSQI) and the insomnia severity index (ISI) were observed in the two groups. The serum brain-related peptide markers (substance P [SP]

neuropeptide Y [NPY]

5-hydroxytryptamine 1A [5-HT1A] and 5-hydroxytryptamine 2A [5-HT2A]) were measured before and after treatment

and the clinical efficacy and safety was evaluated in the two groups.

Results

2

After treatment and in follow-up

the scores of sleep quality

sleep latency

sleep duration

sleep efficiency

sleep disturbance and daytime dysfunction

as well as the total scores of PSQI

and ISI scores were all reduced in the two groups (

P

<

0.05

P

<

0.01); and the scores in the warm acupuncture group were lower than those of the western medication group (

P

<

0.05

P

<

0.01). After treatment

the levels of serum SP and 5-HT2A were decreased (

P

<

0.01) and the levels of serum NPY and 5-HT1A were increased (

P

<

0.01) when compared with those before treatment in the two groups. The levels of serum SP and 5-HT2A in the warm acupuncture group were lower than those of the western medication group (

P

<

0.05)

and the levels of serum NPY and 5-HT1A were higher than those of the western medication group (

P

<

0.05). After treatment

the total effective rate was 93.3% (28/30) in the warm acupuncture group

which was higher than 83.3% (25/30) of the western medication group (

P

<

0.05). No serious adverse reactions were found in the two groups.

Conclusion

2

Warm acupuncture of Mongolian medicine can effectively improve the sleep quality of the elderly patients with insomnia

and its mechanism may be related to the regulation of the levels of serum SP

NPY

5-HT1A and 5-HT2A.