Clinical Nursing Intervention of Moxibustion on Abdominal Distension Symptoms in Heart Failure (Heart and Kidney Yang Deficiency and Blood Stasis Blocking Collaterals Syndrome)

Objective:To investigate the clinical nursing intervention effect of moxibustion on abdominal distension symptoms in heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome).Methods:62 patients with heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome)admitted to our hospital from February 2023 to February 2024 were selected and divided into the observation group(n=31)and the control group(n=31)by using the random numerical table method.The control group adopted conventional nursing interventions,and the observation group received the nursing program of the control group with the addition of moxibustion nursing interventions.The nursing effectiveness,quality of life scores,and nursing satisfaction were compared between the two groups.Results:The nursing effectiveness of the observation group was significantly higher than the control group(P<0.05);the quality of life score of the observation group was significantly higher than the control group(P<0.05);the nursing satisfaction of the observation group was significantly higher than that of the control group(P<0.05).Conclusion:The use of moxibustion nursing intervention in patients with heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome)can effectively relieve the symptoms of abdominal distension,improve patients'quality of life,and increase nursing satisfaction,which has promotion and application values.

A Chinese Multi-Specialty Delphi Consensus to Optimize RAASi Usage and Hyperkalaemia Management in Patients with Chronic Kidney Disease and Heart Failure

Objective Variations are present in common clinical practices regarding best practice in managing hyperkalaemia(HK),there is therefore a need to establish a multi-specialty approach to optimal renin angiotension-aldosterone system inhibitors(RAASi)usage and HK management in patients with chronic kidney disease(CKD)&heart failure(HF).This study aimed to establish a multi-speciality approach to the optimal use of RAASi and the management of HK in patients with CKD and HF.Methods A steering expert group of cardiology and nephrology experts across China were convened to discuss challenges to HK management through a nominal group technique.The group then created a list of 41 statements for a consensus questionnaire,which was distributed for a further survey in extended panel group of cardiologists and nephrologists across China.Consensus was assessed using a modified Delphi technique,with agreement defined as"strong"(≥75%and<90%)and"very strong"(≥90%).The steering group,data collection,and analysis were aided by an independent facilitator.Results A total of 150 responses from 21 provinces across China were recruited in the survey.Respondents were comprised of an even split(n=75,50%)between cardiologists and nephrologists.All 41 statements achieved the 75%consensus agreement threshold,of which 27 statements attained very strong consensus(≥90%agreement)and 14 attained strong consensus(agreement between 75%and 90%).Conclusion Based on the agreement levels from respondents,the steering group agreed a set of recommendations intended to improve patient outcomes in the use of RAASi therapy and HK management in China.

Prognostic impact of atrial fibrillation on clinical outcomes of acute coronary syndromes,heart failure and chronic kidney disease

Atrial fibrillation(AF) is the most common type of sustained arrhythmia,which is now on course to reach epidemic proportions in the elderly population. AF is a commonly encountered comorbidity in patients with cardiac and major non-cardiac diseases. Morbidity and mortality associated with AF makes it a major healthcare burden. The objective of our article is to determine the prognostic impact of AF on acute coronary syndromes,heart failure and chronic kidney disease. Multiple studies have been conducted to determine if AF has an independent role in the overall mortality of such patients. Our review suggests that AF has an independent adverse prognostic impact on the clinical outcomes of acute coronary syndromes,heart failure and chronic kidney disease.

Prognostic Factors in Cardiorenal Syndrome Type 1: Retrospective Observational and Analytical Study

Introduction: Type 1 cardiorenal syndrome (CRS 1) is characterized by acute impairment of cardiac function leading to acute renal dysfunction. CRS1 is present in 25% of patients admitted for heart failure. The objective of our study is to analyze the epidemiological, clinical, therapeutic profile and the risk and prognostic factors of these patients. Materials and Methods: We identified 120 patients with cardiorenal syndrome (CRS) over a one-year period to determine the prevalence and risk factors for developing CRS 1. We analyzed the clinical, biological, and evolutionary profiles of patients with CRS 1 and determined the risk factors for the occurrence of acute kidney injury (AKI) as well as the mortality factors in these patients. Résultats: The average age of our patients with CRS1 is 58 ± 9 years, with a sex ratio of 1.4. The average eGFR of our patients is 35 ± 6.5 ml/min/1.73m2. Diabetes was found in 17% of our patients and hypertension in 14%. The etiology of cardiac impairment is predominantly acute coronary syndrome (ACS), followed by rhythm disorders. Renally, all our patients have acute kidney injury (AKI), with 86% having functional acute renal failure and 14% having acute tubular necrosis. Therapeutically, 50% of our patients are on diuretics, 42% receive beta-blocker treatment, and RAAS blockers are used in 29% of cases. Renal replacement therapy (RRT) sessions were required in 13.8% of cases. In univariate analysis, male gender, tachyarrhythmia, and hypertension are associated with the early onset of acute kidney injury (AKI). The use of diuretics, anemia, and low left ventricular ejection fraction (LVEF) are linked to a higher risk of developing CRS 1 (p = 0.021, p = 0.037, p = 0.010 respectively). In multivariate analysis, advanced age is significantly associated with increased mortality risk in CRS 1 patients (p = 0.030), while beta-blocker use is considered a protective factor (p = 0.014). Conclusion: Our study identifies several key factors associated with outcomes in type 1 CRS. Male gender, tachyarrhythmia, and hypertension are linked to early-onset AKI. The use of diuretics and the presence of anemia increase the risk of developing CRS1. Advanced age is significantly associated with higher mortality rates. Conversely, the use of beta-blockers appears to be protective in this patient population. .

Range of adiposity and cardiorenal syndrome

Obesity and obesity-related co-morbidities,diabetes mellitus,and hypertension are among the fastest-growing risk factors of heart failure and kidney disease worldwide.Obesity,which is not a unitary concept,or a static process,ranges from alterations in distribution to the amount of adiposity.Visceral adiposity,which includes intraabdominal visceral fat mass and ectopic fat deposition such as hepatic,cardiac,or renal,was robustly associated with a greater risk for cardiorenal morbidity than subcutaneous adiposity.In addition,morbid obesity has also demonstrated a negative effect on cardiac and renal functioning.The mechanisms by which adipose tissue is linked with the cardiorenal syndrome(CRS)are hemodynamic and mechanical changes,as well neurohumoral pathways such as insulin resistance,endothelial dysfunction,nitric oxide bioavailability,renin-angiotensin-aldosterone,oxidative stress,sympathetic nervous systems,natriuretic peptides,adipokines and inflammation.Adiposity and other associated co-morbidities induce adverse cardiac remodeling and interstitial fibrosis.Heart failure with preserved ejection fraction has been associated with obesity-related functional and structural abnormalities.Obesity might also impair kidney function through hyperfiltration,increased glomerular capillary wall tension,and podocyte dysfunction,which leads to tubulointerstitial fibrosis and loss of nephrons and,finally,chronic kidney disease.The development of new treatments with renal and cardiac effects in the context of type 2 diabetes,which improves mortality outcome,has highlighted the importance of CRS and its prevalence.Increased body fat triggers cellular,neurohumoral and metabolic pathways,which create a phenotype of the CRS with specific cellular and biochemical biomarkers.Obesity has become a single cardiorenal umbrella or type of cardiorenal metabolic syndrome.This review article provides a clinical overview of the available data on the relationship between a range of adiposity and CRS,the support for obesity as a single cardiorenal umbrella,and the most relevant studies on the recent therapeutic approaches.

Role of imaging in the evaluation of renal dysfunction in heart failure patients

Heart failure and kidney disease share common pathophysiological pathways which can lead to mutual dysfunction,known as cardiorenal syndrome.In heart failure patients,renal impairment is related to hemodynamic and nonhemodynamic factors.Both decreased renal blood flow and renal venous congestion due to heart failure could lead to impaired renal function.Kidney disease and worsening renal function are independently associated with poor prognosis in heart failure patients,both in acute and chronic clinical settings.The aim of this review is to assess the role of renal imaging modalities in the evaluation and management of heart failure patients.Renal imaging techniques could complete laboratory data,as estimated glomerular filtration rate,exploring different pathophysiological factors involved in kidney disease and adding valuable information about renal structure and function.In particular,Doppler examination of arterial and venous hemodynamics is a feasible and non invasive technique,which has proven to be a reliable method for prognostic stratification in patients with cardiorenal syndrome.The renal resistance index,a measure related to renal hemodynamics,can be calculated from the Doppler evaluation of arterial flow.Moreover,the analysis of Doppler venous flow patterns can integrate information from the arterial study and evaluate renal congestion.Other imaging modalities are promising,but still confined to research purposes.

Autonomic neurocardiogenic syndrome is stonewalled by the universal definition of myocardial infarction

Myocardial infarction(MI)is defined as myocardial cell death due to prolonged myocardial ischemia.Clinically,troponin rise and/or fall have become the“defining feature of MI”according to the universal definition of MI(UD-MI).Takotsubo syndrome(TS)and TS-related disease conditions also cause troponin elevation with typical rise and/or fall pattern but through a mechanism other than coronary ischemia.By strict application of the clinical diagnostic criteria for type-1 MI,type-2 MI,type-3 MI,and MI with non-obstructive coronary arteries according to the UD-MI including the fourth one published recently,TS and most of the 26 other causes of troponin elevation mentioned in the fourth UD-MI may erroneously be classified as MI.The existing evidence argues for the case that TS by itself is not a MI.Hyper-activation of the autonomic-sympathetic nervous system including local cardiac sympathetic hyper-activation and disruption with nor-epinephrine churn and spillover is the most probable cause of TS.This autonomic neuro-cardiogenic(ANCA)mechanism results in myocardial“cramp”(stunning),the severity and duration of which depend on the degree of the sympathetic-hyperactivation and nor-epinephrine spillover.The myocardial cramp may squeeze the cytosolic free troponin pools causing mild to moderate troponin elevation in TS and TS-related disease conditions.This ANCA syndrome,which has hitherto been enveloped by the UD-MI over more than one decade,may occur in acute,recurrent,and chronic forms.In this critical review,the controversies of UD-MI,evidence for ANCA syndrome,and a hypothetical mechanism for the troponin elevation in ANCA syndrome are provided.

Evidence based review of management of cardiorenal syndrome type 1

Cardiorenal syndrome(CRS)type 1 is the development of acute kidney injury in patients with acute decompensated heart failure.CRS often results in prolonged hospitalization,a higher rate of rehospitalization,high morbidity,and high mortality.The pathophysiology of CRS is complex and involves hemodynamic changes,neurohormonal activation,hypothalamic-pituitary stress reaction,inflammation,and infection.However,there is limited evidence or guideline in managing CRS type 1,and the established therapeutic strategies mainly target the symptomatic relief of heart failure.This review will discuss the strategies in the management of CRS type 1.Six clinical studies have been included in this review that include different treatment strategies such as nesiritide,dopamine,levosimendan,tolvaptan,dobutamine,and ultrafiltration.Treatment strategies for CRS type 1 are derived based on the current literature.Early recognition and treatment of CRS can improve the outcomes of the patients significantly.

宫颈高危型人乳头瘤病毒感染的中医证候特征研究

【目的】探究宫颈高危型人乳头瘤病毒(HR-HPV)感染者中医证候特征,为临床辨证论治提供参考。【方法】收集2020年9月至2022年10月于天津中医药大学第二附属医院妇科就诊行HPV检测确诊为宫颈HR-HPV感染者进行中医证候调查,总结其病位、病性特点及证型分布。【结果】宫颈HR-HPV感染者的临床特征主要以阴道分泌物异常为主,占63.40%。病位证素为胞宫、脾、肝、肾、经络、胃、心神、心,其中以胞宫、脾、肝最多见,分别占67.00%、58.80%和55.80%。病性证素为湿、热、气滞、血瘀、气虚、阳虚、阴虚、痰、寒,其中以湿、热、气滞、血瘀最多见,分别占66.40%、56.60%、36.00%和31.80%。各年龄段病位证素均以胞宫为主,病性证素均以湿、热为主。双病位证素以胞宫-脾最常见,三病位证素以胞宫-脾-肝最常见。双病性证素以湿-热最常见,三病性证素以湿-热-血瘀最常见。根据聚类分析结果,结合临床实际,发现宫颈HR-HPV感染者的主要证型分布为湿热瘀阻、肝郁气滞、心肾不交、脾胃阳虚。【结论】宫颈HR-HPV感染者的中医病位证素主要在胞宫,兼脾、肝、肾多脏腑合病;病性证素以湿、热为主,呈现虚实错杂的特点;中医证型主要是湿热瘀阻、肝郁气滞、心肾不交、脾胃阳虚。

缺铁性贫血孕妇的中医体质分布及影响因素研究

【目的】分析缺铁性贫血(iron deficiency anemia,IDA)孕妇的中医体质分布规律及相关影响因素,为中医药防治妊娠期IDA提供指导方案。【方法】纳入109例符合条件的妊娠期IDA患者,收集孕妇的一般资料、中医体质鉴别结果和相关实验室指标,包括血清铁蛋白(Fer)、血红蛋白(Hb)及平均红细胞体积(MCV)。对IDA孕妇的中医体质分布规律及相关影响因素、妊娠结局进行统计分析。【结果】(1)109例IDA孕妇中医体质以偏颇质为主,有60例(55.05%),各体质分布人数和比例从高到低依次为:平和质49例(44.95%)>湿热质13例(11.93%)>阳虚质12例(11.01%)>阴虚质11例(10.09%)>气虚质10例(9.17%)>气郁质9例(8.26%)>血瘀质3例(2.75%)>痰湿质2例(1.83%)。(2)不同体质类型IDA孕妇的Hb和MCV水平比较,差异均无统计学意义(P>0.05),但湿热质IDA孕妇的Fer水平显著高于平和质(P<0.01),湿热质IDA孕妇发生羊水混浊的概率显著高于平和质及其他偏颇体质(P<0.05)。【结论】湿热质是IDA孕妇最常见的偏颇体质,其次是阳虚质、阴虚质和气虚质,湿热质可能是IDA孕妇的易感体质,此体质类型IDA孕妇的Fer水平显著高于平和质,而其发生羊水混浊的概率显著高于平和质及其他偏颇体质。

海南省特发性性早熟女童中医证型分布特点研究

【目的】探讨海南省特发性性早熟(idiopathic central precocious puberty,ICPP)女童的中医证型分布特点。【方法】回顾性选取海南省妇女儿童医学中心于2019年1月至2021年12月收治的216例ICPP女童为研究对象,对其中医证候进行频数统计和分级评分,并按阴虚火旺证、气血亏虚证和心肾不交证三大中医证型,探讨其中医证型分布特点。【结果】(1)发病年龄方面,216例ICPP女童的发病年龄在4~10岁之间,平均发病年龄为(7.15±1.06)岁,其中满7岁且不满8岁阶段的ICPP女童发病率最高,为49.54%。(2)中医证型方面,三大证型中,阴虚火旺证的占比最高(147例,占68.06%),其次是气血亏虚证(41例,占18.98%)及心肾不交证(28例,占12.96%)。(3)中医证候方面,临床常见证候(频率>25.0%)按出现频率由高到低依次为:怕热盗汗、手足心热、乳房胀痛、性情急躁、脉细数、大便干结、咽干口燥、潮热、多食肥甘、舌红少苔、抑郁、精神乏力、颧红、失眠多梦、舌红苔黄和口苦口干等16种。(4)各证型的年龄分布方面:阴虚火旺证和气血亏虚证均多见于满7岁且不满8岁年龄段的ICPP女童(占58.50%和51.22%),心肾不交证多见于满8岁且不满9岁年龄段的ICPP女童(占89.29%)。【结论】阴虚火旺证是海南省ICPP女童占比最高的中医证型。研究性早熟女童的中医证型分布,有助于性早熟女童的早期临床症状观察以及疾病的早期诊断,从而为ICPP女童的临床辨证用药提供线索和依据。

绝经前后诸证心肾病机探析

绝经前后诸证 ,现称为“围绝经期综合征” ,即“更年期综合征”。西医以激素替代治疗 ,因存在许多禁忌症 ,故期待采用中医药防治本病 ,已成为医学界关注的热点。我们经 2 0年来对本病流行病学、心理学、生理病理及其治疗的临床研究 ,认为心肾病机在其发生中占有重要的地位 。

天王补心丹合交泰丸加减治疗围绝经期高血压伴失眠的临床研究

【目的】评价天王补心丹合交泰丸加减治疗围绝经期高血压伴失眠(心肾不交型)的临床疗效。【方法】将60例围绝经期高血压伴失眠(心肾不交型)患者随机分为对照组和观察组,每组各30例。对照组给予西医常规治疗,观察组在对照组基础上给予天王补心丹合交泰丸加减治疗,疗程为4周。观察2组患者治疗前后24 h动态血压、匹兹堡睡眠质量指数(PSQI)评分、更年期综合征自我评定量表Kupperman评分和性激素指标的变化情况,比较2组患者的睡眠疗效、中医证候疗效、不良反应和症状反复发生率。【结果】(1)研究过程中,观察组和对照组各有1例患者脱落,最终各纳入29例。(2)治疗4周后,观察组的睡眠疗效和中医证候疗效的总有效率分别为86.21%(25/29)和89.66%(26/29),对照组分别为75.86%(22/29)和72.41%(21/29),观察组的睡眠疗效和中医证候疗效均优于对照组(P<0.05)。(3)治疗后,2组患者的24 h动态血压(收缩压和舒张压)及PSQI评分均较治疗前明显改善(P<0.01),且观察组对PSQI评分的改善作用明显优于对照组(P<0.05);而2组24 h动态血压差值比较,差异均无统计学意义(P>0.05)。(4)治疗后,2组患者的Kupperman积分均较治疗前明显降低(P<0.01),且观察组对Kupperman积分的降低作用明显优于对照组(P<0.05)。(5)治疗后,2组患者血清卵泡刺激素(FSH)、黄体生成素(LH)水平均较治疗前明显降低(P<0.01),血清雌二醇(E2)水平均较治疗前明显升高(P<0.01),且观察组对血清FSH水平的降低作用及对血清E2水平的升高作用均明显优于对照组(P<0.05)。(6)观察组的不良反应发生率为17.24%(5/29),明显低于对照组的44.82%(13/29),差异有统计学意义(P<0.05)。(7)观察组的症状反复发生率为10.34%(3/29),低于对照组的31.03%(9/29),但差异无统计学意义(P>0.05)。【结论】天王补心丹合交泰丸加减治疗围绝经期高血压伴失眠(心肾不交型)患者疗效确切,可显著改善患者临床症状、体征和激素水平,减少不良反应,具有较高的安全性。

自拟安神方对心肾不交证失眠大鼠的作用研究

目的 从下丘脑-垂体-肾上腺轴(hypothalamic pituitary adrenal axis, HPA)功能及神经递质含量变化探讨自拟安神方(简称安神方)对心肾不交证失眠大鼠的作用。方法 复合因素刺激及腹腔注射DL-4-氯苯基丙氨酸(para-chlorophenylalanine, PCPA)制备心肾不交证失眠大鼠模型,造模成功后随机分为模型组,安神方高、中、低剂量组及阳性对照组,另设正常组每组各10只,分别灌胃相应药物2周。戊巴比妥钠翻正实验观察造模情况,旷场实验观察大鼠的紧张和焦虑情绪,Elisa法检测大鼠血清促肾上腺皮质激素(adrenocorticotropic hormone, ACTH)、促肾上腺皮质激素释放激素(corticotropin-releasing hormone, CRH)、皮质醇(cortisol, CORT)的含量,高效液相色谱-电化学法检测大鼠下丘脑中多巴胺(dopamine, DA)和5-羟色胺(5-hydroxytryptamine, 5-HT)的含量。结果 造模后模型组大鼠体质量下降(P<0.05),睡眠潜伏期延长(P<0.01),睡眠持续时间显著减少(P<0.01),说明心肾不交证失眠模型复制成功。给药后安神方3剂量组大鼠2周体质量增量升高(P<0.05),直立次数减少(P<0.05),睡眠持续时间均显著延长(P<0.01),CRH含量降低(P<0.05),安神方低、中剂量组总活动距离减少(P<0.05);安神方中、高剂量组大鼠睡眠潜伏期均显著缩短(P<0.01),DA含量均降低(P<0.05);安神方低剂量组5-HT含量升高(P<0.05)。结论 自拟安神方能显著改善心肾不交证大鼠的失眠症状,推测其机制可能与抑制HPA轴兴奋、降低下丘脑DA的含量、同时升高5-HT的含量有关。

耳穴贴压治疗心肾不交型女性更年期综合征临床疗效观察

目的:观察耳穴贴压治疗心肾不交型女性更年期综合征临床疗效。方法:将69例女性更年期综合征患者按照随机数字表法分为单纯汤药组35例和耳穴贴压组34例。单纯汤药组采用黄连阿胶汤治疗,耳穴贴压组在汤药组的基础上予耳穴贴压治疗,治疗12周,观察两组患者治疗前后中医症状评分、血清性激素水平(FSH、LH、E2)及中医症状改善临床疗效。结果:与治疗前相比,两组中医症状评分及性激素水平比较差异均有统计学意义(P<0.05);且耳穴贴压组与单纯汤药组相比,在改善更年期主症、次症方面有明显优势,治疗后中医症状评分、性激素水平比较差异均有统计学意义(P<0.05)。两组中医证候疗效比较(秩和检验),其中有效、显效比较差异均有统计学意义(P<0.05),耳穴贴压组的中医证候改善总有效率94.12%略高于单纯汤药组的88.57%,但比较差异无统计学意义(P>0.05)。结论:耳穴贴压治疗能明显改善心肾不交型女性更年期综合征患者临床症状及调节体内性激素水平,且耳穴贴压法操作简单、安全易行,值得临床推广。

王德明教授论心肾不交与肠易激综合征

王德明教授深受江苏特色孟河医派及清·陈士铎理论熏陶。大多数学者认为肠易激综合征的发病机制以肝郁和脾虚为主,王教授认为"肝郁脾虚"只是肠易激综合征的外在表象,其内在本质实为"心肾不交"。临床治疗主张交通心肾、调和肝脾。王教授以"心肾不交"为理论基础,总结出了经验方"肠康方",治疗肠易激综合征标本兼顾,交通心肾,补脾泻肝,解郁散结而收功。

中医综合疗法治疗老年性痴呆43例

目的:观察中医综合疗法治疗老年性痴呆的临床疗效。方法:将86例老年性痴呆患者随机分为对照组和研究组,每组各43例。对照组采用西医常规治疗,研究组采用中医综合疗法进行治疗,观察两组患者的临床疗效及治疗前后CDR积分、MMSE积分。结果:研究组有效率为95.35%,对照组有效率83.72%,两组有效率比较,差异具有统计学意义(P<0.05)。两组患者治疗后CDR积分及MMSE积分明显低于治疗前,且研究组优于对照组,差异均有统计学意义(P<0.05)。研究组患者不良反应的发生率明显低于对照组,差异具有统计学意义(P<0.05)。结论:中医综合疗法治疗老年性痴呆疗效确切,安全性好,且不良反应少。

Therapeutic efficacy observation on auricular point sticking therapy for cardiac syndrome X in women

Objective:To observe the clinical effect of auricular point sticking therapy for cardiac syndrome X(CSX)in women.Methods:A total of 64 patients were randomized into two groups by the random number table,with 32 cases in each group.Patients in the control group received conventional treatment for angina,while patients in the treatment group received auricular point sticking therapy on the basis of conventional treatment.After 8 weeks of treatment,the levels of serum estradiol(E2),nitric oxide(NO)and endothelium-1(ET-1)were compared to evaluate the therapeutic effect.Results:After 8 weeks of treatment,the total effective rate and markedly effective rate in the treatment group were significantly higher than those in the control group,and the between-group comparisons showed statistical significance(both P<0.05).After treatment,the scores of chest pain and tightness in the control group dropped significantly,and the intra-group comparisons showed statistical significance(both P<0.05);the scores of chest pain and tightness,palpitations,weakness and shortness of breath in the treatment group dropped significantly,and the intra-group comparisons showed statistical significance(all P<0.05);there were significant inter-group differences in the scores of chest pain and tightness.After treatment,the intra-group comparisons of E2,NO and ET-1 contents in the control group showed no statistical significance(all P>0.05),while the E2,NO and ET-1 contents in the treatment group changed significantly after treatment and were significantly different from those in the control group(all P<0.05).Conclusion:Auricular point sticking on the basis of conventional treatment was effective for CSX in women,and is worth clinical application.

Clinical Observation on Application of Jiao Tai Pill on Shenque （CV 8） in Treating Insomnia

Objective： To observe the clinical efficacy of application of Jiao Tai Pill on acupoint Shenque （CV 8） in the treatment of insomnia. Methods： A total of 152 subjects were randomized in visit sequence into two groups： a treatment group in which 76 cases were treated by application of Jiao Tai Pill on point Shenque （CV 8） and a control group in which 76 cases were treated by oral administration of Jiao Tai Pill, both with a course of four weeks. Pittsburgh Sleep Quality Index （PSQI） was used to evaluate the clinical efficacy respectively before treatment, at one-week, two-week and four-week treatment, and one week, two weeks and four weeks after treatment. Results： After four-week treatment, the sleep quality had improved in both groups, with no statistical difference between the two groups; there was no side-effect and the sleep quality kept improving thereafter. Conclusion： Application of Jiao Tai Pill on point Shenque （CV 8） and oral administration of Jiao Tai Pill both have positive effects on insomnia and no apparent withdrawal reaction after treatment.