Clinical Efficacy Of Acupuncture Combined With Transcranial Magnetic Stimulation In The Treatment Of Insomnia Due To Deficiency Of Both Heart And Splee

Purpose:To observe the effect of acupuncture combined with repetitive transcranial magnetic(rTMS)therapy on clinical symptoms,sleep quality and sleep time of insomnia with deficiency of both heart and spleen,so as to provide a new scheme for the treatment of insomnia with deficiency of both heart and spleen.Material and method:According to the inclusion criteria and exclusion criteria,90 patients with insomnia of deficiency of both heart and spleen were randomly divided into acupuncture group(n = 30),rTMS group(n = 30)and combined group(n = 30).Acupuncture group,rTMS group and combination group were all treated on the basis of basic treatment.Acupuncture group was treated with acupuncture,rTMS group was treated with low frequency rTMS,and combination group was treated with acupuncture and rTMS.The patients were treated once a day,five times a week for two weeks.Pittsburgh sleep quality index(PSQI),insomnia severity index(ISI),sleep diary and TCM syndrome scores were used as the observation indexes of this study.All patients need to be evaluated before and after treatment.Statistical software was used to analyze and compare the therapeutic effects of the three groups.Results:1.Completion of the trial: a total of 90 patients with insomnia due to deficiency of both heart and spleen were included in this study.78 patients completed the study,12 patients fell off,and the shedding rate was 13.33%.Among them,there were 5 cases in the acupuncture group and 25 patients completed the study,3 cases in the rTMS group and 27 cases in the combined group,and 4 cases in the combined group and 26 cases in the combined group.2.Basic situation: there was no significant difference in sex,age and course of disease among the three groups before treatment(P > 0.05).3.Pittsburgh Sleep quality Index(PSQI): there was no significant difference in PSQI index among the three groups before treatment,but the PSQI index in the three groups decreased significantly after treatment.The score in the combined group was significantly lower than that in the acupuncture group and the rTMS group.There was no statistical difference between the acupuncture group and the rTMS group.The analysis of all factors of PSQI in the combination group was better than that in the acupuncture group and the rTMS group.In terms of sleeping time,the rTMS group was better than the acupuncture group.In terms of sleep time and sleep disorders,the acupuncture group was better than the rTMS group.4.Insomnia severity index(ISI): there was no significant difference in ISI index among the three groups before treatment,but the ISI index in the three groups decreased significantly after treatment(P < 0.01).The score in the combined group was significantly lower than that in the acupuncture group and rTMS group,and there was no significant difference between the acupuncture group and the rTMS group.5.Sleep diary: there was no significant difference in total sleep time(TST),post-sleep awakening time(WASO)and sleep latency(SL)among the three groups before treatment.After treatment,the TST of the three groups was significantly higher than that before treatment,and the WASO and SL of the three groups were significantly lower than those before treatment.The combination group was superior to the acupuncture group and the rTMS group in improving TST and reducing SL,and the acupuncture group was better than the rTMS group in regulating TST.The rTMS group was superior to the acupuncture group in improving SL.The difference was statistically significant.6.TCM syndrome scores: there was no significant difference in TCM syndrome scores among the three groups before treatment.After treatment,the TCM syndrome scores of the three groups were significantly lower than those before treatment,and the scores of the combined group were significantly lower than those of the acupuncture group and rTMS.7.Evaluation of PSQI score reduction rate: the three groups can significantly reduce the PSQI score and improve the sleep quality of patients.The effective rate of acupuncture group was 64.00%.The effective rate of rTMS group was 62.97%,and that of combined group was 88.46%.The curative effect of combined group was the best in improving sleep quality,and there was no significant difference between acupuncture group and rTMS group.8.Evaluation of score reduction rate of TCM Syndromes: in improving the TCM syndrome of heart and spleen deficiency insomnia,the effective rate of acupuncture group is 80.00%.The effective rate of the combined group is 55.56%,and that of the combined group is 96.15%.The curative effect of the combined group is significantly better than that of the acupuncture group,and that of the acupuncture group is significantly better than that of the rTMS group.Conclusion:1.Acupuncture,rTMS and acupuncture combined with rTMS can significantly improve the sleep quality and clinical manifestations of patients with insomnia due to deficiency of both heart and spleen,and they are safe.2.In the treatment of insomnia,acupuncture therapy is superior to rTMS therapy in prolonging sleep time,alleviating sleep disorders and improving TCM symptoms of insomnia patients with deficiency of heart and spleen,while rTMS therapy is superior to acupuncture therapy in reducing sleep time and sleep latency of insomnia patients.3.Acupuncture combined with rTMS therapy can make up for the disadvantage of acupuncture alone in falling asleep time and sleep latency,and can also make up for the disadvantage of using rTMS therapy alone in sleep time,sleep disturbance,and improving TCM symptoms of insomnia patients with deficiency of both heart and spleen.At the same time,in reducing and increasing PSQI score,ISI score,sleep diary,TCM syndrome score,the curative effect of acupuncture combined with rTMS is significantly better than that of acupuncture and rTMS alone.