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Evaluation of Clinical Efficacy of Combined Use of Acupuncture and Medicine in Treating Sleep Disorder in Patients with Anxiety Disorder

2021-07-21 06:09XiangpuLIUJingpingMUXinhuaYUShunZENGNannanLIUXiaohuZHU
Medicinal Plant 2021年3期

Xiangpu LIU, Jingping MU, Xinhua YU, Shun ZENG, Nannan LIU, Xiaohu ZHU*

1. Orthopedic Rehabilitation Ward 3, Shiyan Taihe Hospital (Affiliated Hospital of Hubei University of Medicine), Shiyan 442000, China; 2. Sleep Disorder Center, Shiyan Taihe Hospital (Affiliated Hospital of Hubei University of Medicine), Shiyan 442000, China

Abstract [Objectives] To evaluate the clinical efficacy of combined acupuncture and medicine in the treatment of sleep disorders in patients with anxiety disorders. [Methods] A total of 300 anxiety patients with sleep disorders were randomly selected and divided into a research group and a control group, with 150 cases in each group. The control group was administered with western medicine, and the research group was treated with acupuncture and medicine to compare their clinical treatment effects. [Results] The total effective rate of treatment in the research group was significantly higher than that in the control group; after treatment, both the PSQI and SAS scores of the two groups were significantly reduced, and the reduction degree of the research group was higher than that of the control group, the difference was statistically significant (P<0.05). [Conclusions] Combined use of acupuncture and medicine to treat sleep disorders in patients with anxiety disorders has better curative effect and fewer adverse reactions, so it has high clinical application value.

Key words Combined use of acupuncture and medicine, Anxiety disorder, Sleep disorder

1 Introduction

With the rapid social progress and constant acceleration of life pace, people’s life and working pressure is gradually increasing. As a result, people’s mental state remains in a high pressure state, and both the physical and mental state could not be effectively adjusted. In consequence, the number of people suffering from mental illness is getting larger and larger. Sleep disorder is the most common clinical manifestation of a sub-health state and it greatly influences the quality of work and life. What is worse, most patients with sleep disorder are accompanied by symptoms such as anxiety, long-term palliative and neglect of regular treatment of sleep disorders, resulting in increasingly serious anxiety, and in severe cases, it may even lead to depression, thereby increasing the risk of suicide[1]. Clinically, in order to quickly improve the sleep quality of patients, psychotropic drugs with strong sedative effects are often used. However, due to the difference between the clinical level of physicians and the degree of understanding of the disease, the treatment effect is significantly different. And long-term use of such drugs may cause severe adverse reactions in patients. Extensive studies have shown that the combined use of acupuncture and medicine for the treatment of sleep disorders in patients with anxiety has good effects and broad prospects. In view of this, we conducted a randomized controlled study on 300 anxiety patients with sleep disorders admitted to the Department of Acupuncture and Moxibustion in Shiyan Taihe Hospital, to explore the clinical effects of combined use of acupuncture and medicine.

2 Data and methods

2.1 General dataWe selected a total of 300 anxiety patients with sleep disorders admitted to the Affiliated Hospital of Hubei University of Medicine during July 1, 2019 and July 1, 2020. We randomly divided them into a research group and a control group, with 150 cases in each group. In the research group, there were 79 males and 71 females; they were 40-60 years old, and the average was (50.65±5.90) years old; the disease course was 2-12 months, and the average course was (6.91±3.13) months; in the control group, there were 65 males and 95 females; they were 35-72 years old, and the average was (55.43±10.57) years old; the disease course was 3-24 months, and the average course was (13.11±6.02) months. There was no statistical significance in the difference between the two groups of patients (P>0.05), so they were comparable.

2.2 MethodsThe patients in the control group were treated with trazodone hydrochloride tablets, orally, once a day, 25 mg each time, taking before going to bed; moderate and severe patients once a day, 50 mg each time, 7 d as a course of treatment, 3 consecutive courses of treatment. The research group patients were treated with combined acupuncture and medicines. Acupoint selection: selected Baihui, Yintang, Anmian, Sanyinjiao, Sishencong, Zhaohai, Shenmen, Taichong, and Shenmai as the main acupoints, and added or subtract acupoints according to different syndrome types; added Danshu and Xinshu for those with deficiency of heart and gallbladder qi; for syndrome of qi depression transforming into fire, added Pishu and Xinshu; for hyperactivity of fire due to yin deficiency, added Fuliu and Taixi; for syndrome of phlegm-heat harassing the interior, added Yinlingquan and Fenglong acupoints. Adopted (0.25×25) mm-(0.30×40) mm Huatuo brand filiform needles, and used the even hand method for acupuncture and moxibustion; retained needles for 20-30 min. One course of treatment lasted 5 d, and patients were treated for 3 consecutive courses. Traditional Chinese Medicine Therapy: the prescriptions were as follows: 30 g of Suanzaoren (Ziziphi Spinosae Semen), 10 g of Dangshen (Codonopsis Radix), 10 g of Danggui (Angelicae Sinensis Radix), 10 g of Xuanshen (Scrophulariae Radix), 10 g of Danshen (Salviae Miltiorrhizae Radix Et Rhizoma), 15 g of Fuling (Poria), 30 g of Niuxi (Achyranthis Bidentatae Radix), 15 g of Yuanzhirou (Polygalae Radix), 30 g of Shengdihuang (RehmaniaglutinosaLibosch), 10 g of Wuweizi (Schisandrae Chinensis Fructus), and 6 g of Jiegeng (Platycodonis Radix), 10 g of Shishao (Paeoniae Radix Rubra), and 10 g of Chuanxiong (Chuanxiong Rhizoma), taking after decocting in water, one time daily. One course of treatment lasted 7 d, and patients were treated for 3 consecutive courses.

2.3 Observation indicatorsWe compared the treatment effects of the two groups, and evaluated the improvement of sleep disorders and anxiety disorders in the two groups before and after treatment. Efficacy evaluation criteria: cured: sleep time ≥ 5 h, deep sleep and mental state is good after being awake; markedly effective: sleep time extended ≥ 3 h, sleep significantly improved and sleep deepened; effective: sleep disorder alleviated, and sleep time extended, but ≤ 3 h; ineffective: failure to take effect. The total effective rate is the sum of the effective raste, the markedly effective rate, and the cured rate. We used the Pittsburgh Sleep Quality Index (PSQI) to evaluate the sleep disorders of patients, and used the Self-Rating Anxiety Scale (SAS) to evaluate the patient’s anxiety state. The higher the score, the more serious the patient’s sleep disorder and anxiety state.

2.4 Statistical methodThe data analysis was carried out with the aid of SPSS 19.0 statistical software. The measurement data were expressed as (mean±standard deviation), tested byttest; the count data was expressed as a rate and tested by chi-square (χ2) test.P<0.005 means statistically significant difference.

3 Results and analysis

3.1 Comparison of treatment effects between the two groups

The total effective rate of treatment in the research group was 96.67%, which was significantly higher than 82.50% in the control group. The difference was statistically significant (χ2=23.214,P<0.05), as shown in Table 1.

Table 1 Comparison of treatment effects between the two groups (n=60)

3.2 Improvement of sleep disorders before and after treatment in the two groupsAfter the treatment, the PSQI scores of the two groups were significantly reduced, and the reduction degree of the research group was higher than that of the control group, the difference was statistically significant (P<0.05), as shown in Table 2.

Table 2 Comparison of sleep disorders between the two groups of patients before and after treatment points, n=150)

3.3 Depression and anxiety state of the two groups before and after treatmentAfter the treatment, the SAS scores of the two groups were significantly reduced, and the reduction degree of the research group was higher than that of the control group, the difference was statistically significant (P<0.05), as shown in Table 3.

Table 3 Comparison of sleep disorders between the two groups of patients before and after treatment points, n=150)

4 Discussion

Sleep disorder mainly refers to the disorder of sleep on-set and sleep maintenance. It causes the patient’s sleep quality and/or time to be unsatisfactory, and then affects a subjective experience of patients’ social functions. Sleep disorder is a neurological disease[2]. It is mainly characterized by difficulty falling asleep, awakening easily, more dreams, early awakening, light sleep, and low energy after waking up. The vast majority of patients with sleep disorders are accompanied by varying degrees of anxiety and other mental symptoms, and these symptoms can occur at the same time as sleep disorder, which seriously affects the quality of life and work efficiency of patients, and reduces the efficiency of their mental activities[3]. Clinically, doctors often use psychotropic drugs such as anti-anxiety, sedation, and hypnosis. Although they have certain therapeutic effects, they have relatively large adverse reactions, which can easily lead to emotional instability, fatigue, lethargy, and forgetfulness. The recurrence rate is high after stopping the drug, and long-term drug use is prone to drug resistance or dependence[4].

According to the Traditional Chinese medicine theory, sleep disorders belong to the categories of "insomnia" and "inability to sleep"[5]. Its cause is mainly emotional disorders, and its disease location involves important organs such as the heart, liver, spleen, stomach, and kidneys. The main pathogenesis of the disease is that the defense does not enter the nutrient, the yang does not connect with the yin, and the yin and yang are imbalanced. In the TCM theory, the anxiety syndrome belongs to the scope of emotional disease. Emotional disorder may lead to disorder of qi mechanism, disorder of internal organ functions, and aggravate the yin and yang imbalance. Anxiety and insomnia have a reciprocal causation relationship. They have the same reasons, belong to the different manifestation of different development stages of the same pathogenesis, and they can be mutually changed[6]. The treatment should focus on balancing yin and yang, coordinating internal organs, and unblocking qi and blood[7].

As a treatment method commonly used in traditional Chinese medicine clinical practice, acupuncture has the effects of reconciling yin and yang, dredging the meridians, strengthening the body and eliminating evil, the operation is green and environmentally friendly, simple, fast onset, and few adverse reactions, so it is easy for patients to accept[8]. In this study, the research group patients were mainly treated with acupuncture and medicine, and the control group patients were treated with trazodone hydrochloride tablets. The results showed that the total effective rate of treatment in the research group was higher than that in the control group. After treatment, the PSQI and SAS scores of the research group were lower than those before and after treatment, and the difference was statistically significant. These proved that the combined use of acupuncture and medicine can effectively improve the sleep quality of patients, relieve their anxiety and other symptoms, and the therapeutic effect is significantly better than that of western medicines. The reasons are as follows: the acupoints selected in the study can invigorate the brain, soothe the nerves, regulate qi and blood, invigorate the brain and improve the mind, regulate qi and soften the liver. The matching of acupoints can effectively improve the patient’s sleep quality, relieve their anxiety symptoms, and achieve the purpose of treating both symptoms and root causes[9]. In addition, the traditional Chinese medicine prescriptions selected in this study have the effects of invigorating qi and promoting blood flow, replenishing qi and nourishing spleen, clearing yang and alleviating diarrhea, and moving qi to soothe the chest. In summary, the combined use of all medicines can give full play to the effects of regulating qi and blood, tonifying the heart and calming the nerves, nourishing yin and clearing away heat. The combined use of acupuncture and traditional Chinese medicine can further enhance the therapeutic effect, the adverse reactions are few and the safety is high[10].