| Purpose:In this study,we compared the therapeutic effect of Du-moxibustion combined with western medicine estazolam and estazolam alone in the treatment of insomnia with heart and kidney disjunction,and explored the possible mechanism of Du-moxibustion in the treatment of insomnia with heart and kidney disjunction based on the changes of serum cortisol(CORT)content in the two groups.method:Seventy-four patients with insomnia of heart and kidney disjunction type who met the inclusion criteria were randomly divided into control group(Eszolam group)and treatment group(Du Moxibustion combined with Eszolam group)with a ratio of 1:1.There were 37 patients in each group.During the test,one patient fell out of each group,and 72 patients were finally included.Both groups received sleep hygiene education.The patients in the control group took 1 mg of estazolam tablets orally before going to bed,and the patients in the treatment group were treated with Du moxibustion on the basis of the control group.In this study,the Du moxibustion therapy is to evenly spread the Du moxibustion powder made of Jiaotai pills on the Du meridian,then spread the mulberry paper and place the moxibustion box.The moxibustion box is covered with ginger powder about 3cm thick,and finally put moxa wool along the Du meridian and ignite the moxibustion.The treatment is performed once every 3 days,twice a week,and the single time is about 60 min.Both groups were treated for 2 weeks/1 course of treatment for 2 consecutive courses.By observing the scores and total scores of Pittsburgh sleep quality index(PSQI),the score of the insomnia severity index(ISI)and the total clinical effective rate of the two groups of patients after treatment,we compared the clinical efficacy and adverse reactions of the two groups,comprehensively evaluated the clinical efficacy and safety of Du moxibustion combined with estazolam,and detected the serum CORT level,To explore the possible mechanism Of Du-moxibustion therapy.result:1.Comparison of baseline data: There was no significant difference in gender,age and course of disease between the two groups(P>0.05),which was comparable.2.Comparison of Pittsburgh Sleep Quality Scale: PSQI scores of patients in the two groups were performed before and after treatment,and there was no significant difference before treatment(P>0.05),which was comparable.Intra-group comparison showed that there were significant differences between the scores of each factor and the total score of the two groups after treatment and before treatment(P<0.05),suggesting that both treatment methods were effective.Compared with the control group,the treatment group was superior to the control group in terms of sleep quality,sleep time,daytime dysfunction factor and total score of PSQI,with a statistically significant difference(P<0.05),indicating that the combination therapy was superior to the single oral estazolam in terms of improving sleep quality,prolonging sleep time and improving daytime function.There was no significant difference between the two groups in terms of sleep time,sleep disorders and sleep efficiency factors(P>0.05),indicating that the two groups had the same effect in improving the sleep.3.Comparison of insomnia severity index scale: ISI scores of patients in the two groups before and after treatment showed no significant difference(P>0.05),which was comparable.Intra-group comparison showed that the ISI score of the two groups after treatment was significantly different from that before treatment(P<0.05),and the treatment was effective.Compared with the control group,the improvement of ISI total score in the treatment group was better than that in the control group,and the difference was statistically significant(P<0.05),indicating that the combination therapy could better improve the patients’ sleep status,quality of life and negative emotions.4.Comparison of serum cortisol level: The serum CORT level was measured before and after treatment in the two groups,and there was no difference between the two groups before treatment(P>0.05),which was comparable.After treatment,the CORT level in both groups was lower than that before(P<0.05),but the combination of Du moxibustion and estazolam treatment could lower the CORT level more than estazolam treatment,the difference was statistically significant(P<0.05),indicating that Du moxibustion may play a role in treating insomnia by regulating the function of HPA axis.5.Comparison of the total clinical efficacy: the total clinical efficacy of the Du-moxibustion combined with estazolam group(94.4%)was higher than that of the estazolam group(83.3%),with a statistically significant difference(P<0.05).6.Safety evaluation: During the test,1 case of mild adverse reaction occurred in the control group,which was dizziness and relieved by itself,while no adverse reaction occurred in the treatment group.Conclusion:1.Du-moxibustion combined with estazolam therapy can significantly improve the sleep quality,prolong sleep time,improve daytime function,improve bad mood,and further improve the clinical efficiency of patients with insomnia with heart and kidney disjunction.2.Du-moxibustion combined with estazolam may play a role in improving sleep and daytime energy deficiency by regulating the HPA axis function,reducing the serum CORT level,improving the body’s hyperawakefulness.3.Moxibustion therapy is safe. |
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