[Acupuncture combined with bamboo-based medicinal moxibustion for chronic insomnia complicated with mild depressive state: a randomized controlled trial].

Objective: To observe the clinical efficacy of acupuncture combined with bamboo-based medicinal moxibustion in the treatment of chronic insomnia complicated with mild depressive state.

Methods: A total of 60 patients with chronic insomnia complicated with mild depressive state were randomly divided into an observation group and a control group, 30 cases in each group. The control group was treated with acupuncture at bilateral Zhaohai (KI6), Shenmen (HT7), Sanyinjiao (SP6), Anmian (Extra) and Sishencong (EX-HN1), Baihui (GV20), etc. The observation group was treated with bamboo-based medicinal moxibustion based on the treatment in the control group, on the abdomen，Shenque (CV8), Guanyuan (CV4), Zhongwan (CV12) and bilateral Tianshu (ST25) were selected , on the back, the acupoints of governer vessel from Dazhui (GV14) to Yaoshu (GV2) were selected. Both groups were treated once every other day, 3 times a week for 4 weeks. The Pittsburgh sleep quality index (PSQI) score, Hamilton depression scale-17 (HAMD-17) score, insomnia severity index (ISI) score, fatigue assessment instrument (FAI) score before and after treatment and after 2 weeks of treatment completion (follow-up) were observed in the two groups, and the serum level of γ-aminobutyric acid (GABA) before and after treatment was detected in the two groups, and the clinical efficacy and safety were evaluated.

Results: After treatment and in the follow-up, the sub-item scores and total scores of PSQI in both groups were reduced compared with those before treatment (<0.001); except for the score of daytime dysfunction in the follow-up, the scores of sleep quality, sleep duration, daytime dysfunction, and total scores of PSQI in the observation group were lower than those in the control group (<0.05). After treatment and in the follow-up, the HAMD-17, ISI and FAI scores in both groups were reduced compared with those before treatment (<0.001); the scores in the observation group were lower than those in the control group (<0.05). After treatment，the serum levels of GABA in both groups were increased compared with those before treatment (<0.05); the level in the observation group was higher than that in the control group (<0.05). The total effective rate of treating chronic insomnia in the observation group was 96.7% (29/30), which was higher than 80.0% (24/30) in the control group (<0.05); and the total effective rate of improving mild depressive state was 93.3% (28/30), which was higher than 66.7% (20/30) in the control group (<0.001). During the treatment period, no serious adverse reactions occurred in both groups.

Conclusion: Acupuncture combined with bamboo-based medicinal moxibustion has definite efficacy in the treatment of chronic insomnia complicated with mild depressive state, and has synergistic efficacy in improving sleep quality, sleep duration, daytime dysfunction and depressive state, its action mechanism may be related to the increase of serum level of GABA.