Clinical observation of kidney-tonifying and mind-calming acupuncture therapy in the treatment of perimenopausal insomnia
Authors: Yang Wenjia , Yu Xintong , Zhao Na , Xie Chen , Li Jinjin , Gao Xiaolin , Fu Cong , Chen Yunfei 
Published: December 2023

Abstract
Objective
To observe the effects of kidney-tonifying and mind-calming acupuncture therapy on sleep, mood, sex hormone levels, and traditional Chinese medicine (TCM) symptoms in patients with perimenopausal insomnia (PMI).

Methods
A total of 90 patients with PMI were randomly divided into a treatment group and a control group, with 45 cases in each group. Patients in the treatment group were treated with acupuncture at Shenshu (BL23), Taixi (KI3), Baihui (GV20), and Anmian (Extra). The control group was treated with sham acupuncture. Both groups were treated 3 times a week for 4 weeks. Pittsburgh sleep quality index (PSQI) and insomnia severity index (ISI) were used to evaluate the sleep quality of the subjects before treatment, after treatment, and 1 month after treatment (follow-up). Beck depression inventory (BDI) and Beck anxiety inventory (BAI) were used to evaluate the depression and anxiety of the subjects before treatment, after treatment, and at 1-month follow-up. The TCM symptom scale was used to evaluate the TCM symptoms of the subjects before treatment, after treatment, and 1 month after treatment. Serum levels of estradiol (E2), follicle-stimulating hormone (FSH), and luteinizing hormone (LH) were measured before and after treatment.

Results
During the study, 2 cases dropped out of the treatment group, and no cases dropped out of the control group. The PSQI scores of the treatment group were significantly lower after treatment and at 1-month follow-up compared with those before treatment (P<0.05), and the difference was statistically significant compared with that of the control group (P<0.05). In the control group, the PSQI score was significantly lower after treatment compared with before treatment (P<0.05), and the difference was not statistically significant at 1-month follow-up compared with before treatment (P>0.05). Compared with the pre-treatment, the ISI, BDI, BAI, and TCM symptom scale scores of the treatment group were lower after treatment and at 1-month follow-up (P<0.05), and the differences with the control group at the same time point were statistically significant (P<0.05). The differences in ISI, BDI, BAI, and TCM symptom scale scores of the control group before treatment, after treatment, and at 1-month follow-up were not statistically significant (P>0.05). After treatment, the serum E2 level in the treatment group was significantly higher than that before treatment (P<0.05), and the difference with the control group was statistically significant (P<0.05). The difference in the serum E2 level before and after treatment in the control group was not statistically significant (P>0.05). The differences in the serum FSH and LH levels between before and after treatment were not statistically significant in either group of subjects (P>0.05).

Conclusion
Kidney-tonifying and mind-calming acupuncture therapy can improve sleep quality, relieve anxiety and depression, delay the decrease of serum E2 level, and improve related TCM symptoms in patients with PMI.