Skip to main content
SpringerLink
Log in

Clinical observation of acupuncture plus repetitive transcranial magnetic stimulation in the treatment of post-stroke insomnia

针刺加重复经颅磁刺激治疗脑卒中后失眠的临床观察

  • Clinical Study
  • Published:
Journal of Acupuncture and Tuina Science Aims and scope Submit manuscript

Abstract

Objective

To evaluate the clinical efficacy of the Governor Vessel-unblocking and mind-regulating acupuncture method plus repetitive transcranial magnetic stimulation (rTMS) in the treatment of post-stroke insomnia.

Methods

A total of 72 patients with post-stroke insomnia were randomly divided into 2 groups, with 36 cases in each group. The control group received rTMS treatment with a frequency of 1 Hz and a motion threshold value of 90%. The observation group received acupuncture with Governor Vessel-unblocking and mind-regulating method based on the rTMS treatment of the control group. The points were Baihui (GV 20), Shenting (GV 24), Yintang (GV 29), Fengfu (GV 16), Sishencong (EX-HN 1), Shenmen (HT 7), Sanyinjiao (SP 6), Shenmai (BL 62) and Zhaohai (KI 6). The treatment was performed once a day for 5 d a week followed by 2 d of rest for 4 weeks. The improvements of Pittsburgh sleep quality index (PSQI), self-rating anxiety scale (SAS) and self-rating depression scale (SDS) scores were observed after treatment, and the clinical efficacy was compared between the two groups.

Results

After 4 weeks of treatment, the PSQI, SAS, and SDS scores of the two groups were all reduced, and the intra-group differences were statistically significant (all P<0.001). After treatment, the three scores in the observation group were all lower than those in the control group, and the differences between the two groups were statistically significant (P<0.05, P<0.05, P<0.001). There was a statistically significant difference between the observation group and the control group comparing the clinical efficacy (P<0.05).

Conclusion

The therapeutic effect of the Governor Vessel-unblocking and mind-regulating acupuncture method plus rTMS in treating post-stroke insomnia is better than rTMS alone, and it can better improve the anxiety and depression of patients.

摘要

目的

评价“通督调神法”针刺加重复经颅磁刺激(rTMS)治疗脑卒中后失眠的临床疗效。

方法

将72例 脑卒中后失眠患者随机分为2组, 每组36例。对照组采用频率1 Hz、运动阈值90%的rTMS治疗, 观察组在对照组 rTMS治疗基础上加“通督调神法”针刺治疗。穴位取百会、神庭、印堂、风府、四神聪、神门、三阴交、申脉 和照海。每日治疗1次, 每周治疗5 d后休息2 d, 共治疗4周。观察两组治疗后匹兹堡睡眠质量指数(PSQI)、焦虑自 测量表(SAS)和抑郁自测量表(SDS)评分改善情况, 并进行两组临床疗效比较。

结果

治疗4周后, 两组PSQI、SAS及 SDS评分均降低, 组内差异均有统计学意义(均P<0.001); 观察组治疗后三项评分均低于对照组, 组间差异均有统 计学意义(P<0.05, P<0.05, P<0.001)。观察组和对照组临床疗效差异有统计学意义(P<0.05)。

结论

“通督调神 法”针刺加rTMS治疗脑卒中后失眠疗效优于单独rTMS治疗, 且能更好地改善患者焦虑、抑郁情绪。

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Zhang XL, Guan QB. Investigation of insomnia in patients with stroke. Zhonghua Shenjingke Zazhi, 2005, 38(5): 324–325.

    Google Scholar 

  2. Leppävuori A, Pohjasvaara T, Vataja R, Kaste M, Erkinjuntti T. Insomnia in ischemic stroke patients. Cerebrovasc Dis, 2002, 14(2): 90–97.

    Article  Google Scholar 

  3. Schuiling WJ, Rinkel GJ, Walchenbach R, de Weerd AW. Disorders of sleep and wake in patients after subarachnoid hemorrhage. Stroke, 2005, 36(3): 578–582.

    Article  Google Scholar 

  4. Su L, Lu Z. Interpretation of Chinese guideline for insomnia disorder diagnosis and its treatment in 2017. Shijie Linchuang Yaowu, 2018, 39(4): 217–222.

    Google Scholar 

  5. Liu S, Zhang B. Interpretation of ‘guidelines for the diagnosis and treatment of insomnia disorder in China’. Zhongguo Xiandai Shenjing Jibing Zazhi, 2017, 17(9): 633–638.

    Google Scholar 

  6. Tang L, You F, Ma C Y. Clinical research of post-stroke insomnia treated with low-frequency electric stimulation at acupoints in the patients. Zhongguo Zhen Jiu, 2014, 34(8): 747–750.

    PubMed  Google Scholar 

  7. Lang XB, Tan X. The effect of Governor Vesselunblocking and mind-regulating acupuncture method on sleep quality and nerve function in patients with poststroke sleep disorder. Hebei Zhongyiyao Xuebao, 2018, 33(3): 46–49.

    Google Scholar 

  8. Chen P, Chen ZK, Li MF, Zou WK, Wang JH. Clinical study of repeated transcranial magnetic stimulation for post-stroke insomnia. Hubei Yiyao Xueyuan Xuebao, 2018, 37(3): 262–264.

    Google Scholar 

  9. Wu J, Jia JP. Neurology. 3rd Edition. Beijing: People's Medical Publishing House, 2015.

    Google Scholar 

  10. Wu MH, Wang XY. Traditional Chinese Internal Medicine. 3rd Edition. Beijing: China Press of Traditional Chinese Medicine, 2012.

    Google Scholar 

  11. Zhang T. Chinese stroke rehabilitation guide (2011 full version). Zhongguo Kangfu Lilun Yu Shijian, 2012, 18(4): 301–318.

    Google Scholar 

  12. Ministry of Health of the People’s Republic of China. Guiding Principles for Clinical Study of New Chinese Medicines. Beijing: People’s Medical Publishing House, 1993: 186–188.

    Google Scholar 

  13. Wang DY, Jiang YY, Song J, He L. A survey of acupuncture and moxibustion treatment of post-stroke insomnia. Liaoning Zhongyi Zazhi, 2018, 45(12): 2674–2676.

    Google Scholar 

  14. Palomäki H, Berg A, Meririnne E, Kaste M, Lönnqvist R, Lehtihalmes M, Lönnqvist J. Complaints of poststroke insomnia and its treatment with mianserin. Cerebrovasc Dis, 2002, 15(1-2): 56–62.

    Article  Google Scholar 

  15. Jiang AJ, Pei ZB. Locus of acute stroke and dyssomnia. Zhongguo Linchuang Kangfu, 2005, 9(20): 80–81.

    Google Scholar 

  16. Tang L, Ma CY, You F, Ding L. Impacts of the low-frequency electric stimulation at the acupoints on the content of plasma 5-HT and NE in the patients with post-stroke insomnia. Zhongguo Zhen Jiu, 2015, 35(8): 763–767.

    PubMed  Google Scholar 

  17. Deng JH, Wen Y, Lin W. Study on the change of serum cytokines and neurotransmitters expression of patients with stroke complicated with sleep disorders. Shijie Shuimian Yixue Zazhi, 2019, 6(3): 269–271.

    Google Scholar 

  18. Ren Y, Chen HD. A research overview of treating insomnia by acupuncture. Zhongyi Linchuang Yanjiu, 2011, 3(16): 52–53.

    Google Scholar 

  19. Liu ZH, Wang SJ. Effects of acupuncture on the expression of the clock gene and amino acid neurotransmitters in the brain of rats with insomnia. Zhongguo Laonianxue Zazhi, 2015, 35(21): 6067–6069.

    CAS  Google Scholar 

  20. Huang J, Li RQ, Wu ML, Liu RC, Feng XD. Effects of electroacupuncture at Shenting (GV 24) and Baihui (GV 20) acupoints on learning and memory ability of rats with ischemia-reperfusion and expression of autophagy-related proteins. Zhonghua Zhongyiyao Xuekan, 2019, 37(4): 838–841, 1041.

    Google Scholar 

  21. Tan LH, Li KG, Wu YY, Lan Y, Guo MW, Zhu WL, Zhang LF, Zhao YF, Li XH, Ren XX. Effect of electroacupuncture at Yintang (GV 29) and Tianshu (ST 25) on the ethology and the expression of TRPV 1 receptor in colon of irritable bowel syndrome rats. Zhen Ci Yan Jiu, 2017, 42(2): 136–140, 167.

    PubMed  Google Scholar 

  22. Zhao J Y, Liu Y, Xi SH, Xu NG. Clinical application regularity of Fengfu (GV 16) acupoint: research on ancient Chinese medical literature. Zhen Ci Yan Jiu, 2015, 40(2): 170–173.

    PubMed  Google Scholar 

  23. Song J, Wang DY, He L, Zhang R, Dong X. Research progress of Sishencong (EX-HN 1). Zhenjiu Linchuang Zazhi, 2018, 34(2): 82–84.

    Google Scholar 

  24. Qiao LN, Gao QL, Tan LH, Shi YN, Jiang YS, Yang JJ, Yang YS. Electroacupuncture of multiple acupoints is significantly superior to that of single acupoint in improving sleep by regulating serum sleep-promoting and awakening-promoting factors in insomnia rats. Zhen Ci Yan Jiu, 2018, 43(10): 651–656.

    PubMed  Google Scholar 

  25. Zhu YH, Yang CH, He LX, Qiao L, Cheng CS. Effect of electroacupuncture at Shenmen (HT 7) and Sanyinjiao (SP 6) on energy metabolism in the paraventricular nucleus of the hypothalamus of insomnia rats. Zhen Ci Yan Jiu, 2019, 44(3): 170–175.

    PubMed  Google Scholar 

  26. Liu YF, Ma XM, Yan B, Yang Y, Huang XX, Yu HB. Therapeutic observation of acupuncture plus moxibustion at Baihui (GV 20) for post-stroke insomnia. Shanghai Zhenjiu Zazhi, 2016, 35(3): 270–272.

    CAS  Google Scholar 

  27. Zhou YL, Ye XF. Experimental study on the effects of acupuncture at different acupoints on the contents of cytokines IL-1 and TNF-α in the brain of rats with insomnia model. Zhongguo Zhongyi Jichu Yixue Zazhi, 2012, 18(4): 419–420.

    CAS  Google Scholar 

  28. Liu J. Effects of Acupuncture in Heel Vessels on the Circadian Rhythm and the Content of 5-HT, NE and IL-1β in Rats with Insomnia. Chengdu: Master Thesis of Chengdu University of Traditional Chinese Medicine, 2015.

    Google Scholar 

  29. Magavi LR, Reti IM, Vasa RA. A review of repetitive transcranial magnetic stimulation for adolescents with treatment-resistant depression. Int Rev Psychiatry, 2017, 29(2): 79–88.

    Article  Google Scholar 

  30. Vucurovic K, Emeriau S, Coulon JM, Peruzzi P, Litré CF, Kaladjian A. Functional brain neuroimaging-guided repetitive transcranial magnetic stimulation in neuro-developmental disorders: the case of a schizencephaly-related spastic dystonia. J Neurol Sci, 2017, 378: 167–169.

    Article  Google Scholar 

  31. Wu QW, Zhu YH, Liu P, Zhang YQ, Kou J, Wei Q. The effect of Shenmen (HT 7) and Sanyinjiao (SP 6) on insomnia from the prospective of sleep mechanism. Shizhen Guoyi Guoyao, 2014, 25(2): 402–403.

    CAS  Google Scholar 

  32. Chen WL. Application and effectiveness of repetitive transcranial magnetic stimulation (rTMS) in the treatment of anxiety with insomnia. Zhongguo Shiyong Yiyao, 2018, 13(7): 64–65.

    Google Scholar 

  33. Chen JL. The Clinical Study of 1 Hz Repetitive Transcranial Magnetic Stimulation (rTMS) on the Treatment of Insomnia. Lanzhou: Master Thesis of Lanzhou University, 2016.

    Google Scholar 

Download references

Acknowledgments

This work was supported by Mental Disorders Department Construction Project of Key Specialty During the 12th Five-year Plan Period of the State Administration of Traditional Chinese Medicine [国家中医药管理局 “十二五” 重点专科神志病科建设项目, No. (2012)2]; Provincial Key Specialty (Disease) Construction Project of Traditional Chinese Medicine During the 13th Five-year Plan Period of Anhui Province [安徽省“十三五”省级中 医重点专科(病)建设项目, No. (2017)567].

Author information

Authors and Affiliations

  1. Anhui University of Chinese Medicine, Hefei, 230031, China

    Wei Zhang  (张伟) (master degree candidate of grade 2017, resident physician), Kun-qin Ma  (马坤琴), Mei-lin Gui  (桂美琳) & Yin-feng Lu  (卢尹凤)

  2. The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, 230031, China

    Hong-bo Xiao  (肖洪波) (professor, chief physician), Rui-quan Chen  (陈瑞全) & Zong-jun Zhu  (朱宗俊)

  3. The Second Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, 230061, China

    Pei-fang Li  (李佩芳)

Authors
  1. Wei Zhang  (张伟)
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kun-qin Ma  (马坤琴)
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hong-bo Xiao  (肖洪波)
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Pei-fang Li  (李佩芳)
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mei-lin Gui  (桂美琳)
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yin-feng Lu  (卢尹凤)
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Rui-quan Chen  (陈瑞全)
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Zong-jun Zhu  (朱宗俊)
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hong-bo Xiao  (肖洪波).

Additional information

Conflict of Interest The authors declare that there is no conflict of interest.

Statement of Informed Consent Informed consent was obtained from all individual participants.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhang, W., Ma, Kq., Xiao, Hb. et al. Clinical observation of acupuncture plus repetitive transcranial magnetic stimulation in the treatment of post-stroke insomnia. J. Acupunct. Tuina. Sci. 18, 122–128 (2020). https://doi.org/10.1007/s11726-020-1166-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11726-020-1166-z

Keywords

关键词

中图分类号

文献标志码

Search

Navigation