Clinical study of electroacupuncture in the treatment of insomnia with depressive disorder

Insomnia is a very common problem. Patients with insomnia-predominant depressive disorder are common in general hospitals and their physical and mental health is seriously affected. In previous studies, electroacupuncture achieved good efficacy in the treatment of depression. This thesis aims to further observe, from a clinical research perspective, the efficacy of electroacupuncture in patients with insomnia accompanied by depressive disorder, to compare electroacupuncture with trazodone (Meishuyu) in the treatment of this condition, and to explore the mechanism of action of electroacupuncture in insomnia. RESEARCH METHODS: 60 patients with non-organic insomnia with depressive disorder meeting the ICD-10 and CCMD-3 diagnostic criteria were randomly divided into two groups: 30 in the electroacupuncture group and 30 in the drug (trazodone) control group. The course of treatment was 4 weeks. Efficacy was compared with the Sleep Questionnaire (SQ), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Hamilton Depression Scale (HAMD), Clinical Global Impression (CGI) and the Asberg side-effect scale. The electroacupuncture group used an intelligent electroacupuncture device (Beijing Zhongke Medical Technology Company); after needle twirling and arrival of qi, the device was connected with the sleep waveform at an intensity tolerated by the patient. Baihui and Yintang were used on the head, adding Shenmen, Taichong and Zusanli for the liver depression and spleen deficiency type; Neiguan, Shenmen and Zusanli for the heart and spleen deficiency type; and Neiguan, Shenmen and Taixi for the heart-kidney non-interaction type. Filiform needles 0.30 mm in diameter and 50 mm long were inserted perpendicularly 25-40 mm and retained after arrival of qi. Treatment was given once a day, 45 minutes per session, 6 times a week with weekends off, for a 4-week course. The drug group took trazodone (Meishuyu) 50-150 mg every night before bedtime for 4 weeks. RESULTS: At the end of week 4, the reduction rate of the SQ score and the decrease of the SAS score were similar in the electroacupuncture and drug groups; the decrease of the HAMD anxiety/somatization factor score was significantly greater in the electroacupuncture group than in the drug group (P<0.05); in patients with depression masked by insomnia, the reduction rate of the HAMD score was significantly greater in the drug group than in the electroacupuncture group (P<0.05); the Asberg score was significantly lower in the electroacupuncture group than in the drug group; the CGI score was significantly higher in the electroacupuncture group than in the drug group (P<0.01). This suggests that electroacupuncture improves insomnia and subjective anxiety symptoms as much as trazodone (Meishuyu) (P>0.05) and improves anxiety/somatization more than trazodone (Meishuyu) (P<0.05), whereas trazodone (Meishuyu) is more effective for depression masked by insomnia; electroacupuncture has fewer side effects than trazodone (Meishuyu), and its overall clinical efficacy is better than that of trazodone (Meishuyu). CONCLUSION: Electroacupuncture has the same sedative-hypnotic and anxiolytic effects as trazodone (Meishuyu); the antidepressant effect of trazodone (Meishuyu) is stronger than that of electroacupuncture (using the sleep waveform); electroacupuncture has fewer side effects than trazodone (Meishuyu), and its overall clinical efficacy is better than that of trazodone (Meishuyu). This study shows that electroacupuncture is better than trazodone (Meishuyu) in improving neurotic insomnia with depressive disorder, whereas trazodone (Meishuyu) is more effective for depression masked by insomnia. Electroacupuncture with the sleep waveform combined with syndrome-differentiated point selection has a good effect in improving insomnia and relieving anxiety, better than trazodone (Meishuyu). It is suitable for neurotic insomnia with depressive disorder and many somatization complaints, and is especially worth promoting in general hospitals. Patients with depression masked by insomnia should receive systematic antidepressant treatment, and when electroacupuncture is used the depression waveform should be chosen instead.