Meta-analysis of randomized controlled trials of acupuncture in the treatment of menopausal insomnia

Objective:We aimed to investigate the safety and efficacy of acupuncture in the treatment of climacteric insomnia compared with western medicine through a comprehensive metaanalysis.Methods:Literature retrieval,research selection and data extraction were done independently and in duplicate.Effect-size estimates are expressed as risk ratio(RR)and 95%confidence interval(CI).Results:Summary data from 27 articles,involving a total of 2349 menopausal women,were meta-analyzed.The overall analysis showed that the clinical cure rate(RR=1.85,95%CI:1.57~2.18,P<0.001)of acupuncture was 1.85 times higher than western medicine,and the markedly effective rate was 1.3 times higher than that of westernmedicine(RR=1.30,95%CI:1.09~1.54,P=0.003).In terms of Pittsburgh Sleep quality Index((PSQI)),simple acupuncture is superior to western medicine in sleep quality,falling asleep time,sleep time,sleep efficiency and daytime dysfunction.In the evaluation of adverse reactions,the incidence of adverse events in the acupuncture-related therapy group(3.5%)was lower than that in the western medicine group(12.5%).Conclusion:The results of metaanalysis show that the clinical efficacy of acupuncture in the treatment of climacteric insomnia is better than that of western medicine which has better efficacy and safety.The acupuncture therapy is suitable for clinical.

SOOJI CHIM (Koryo hand acupuncture) for perimenopausal insomnia:Evidence from actigraphy and serum hormone testing

Objective:This study is conducted to determine the effects of SOOJI CHIM(Koryo hand acupuncture,KHA)therapy on sleep structures and perimenopause symptoms among insomniacs.Methods:Totally 49 participants who met the inclusion criteria were enrolled in a two-arm randomized,placebo controlled,patients-blind trial,with 24 cases allocated to a real-KHA group and 25 cases allocated to a sham-KHA group.Patients in each group received corresponding treatment every other day,three times a week for total eight weeks.Both actigraphy and testing of serum hormones level reflected by biological markers such as follicle-stimulating hormone(FSH),luteinizing hormone(LH)and estradiol(E2)were performed at pre-and post-treatment.Additionally,the scores of Pittsburgh sleep quality index(PSQI)was used for assessing the subjective sleep experience of insomniacs.Meanwhile,adverse effects were monitored and recorded.Results:After eight-week treatment,the global scores of PSQI declined significantly(P<0.05)in the realKHA group but not in the sham-KHA group(P>0.05).According to the outcomes of actigraphy,a striking increase was observed in both sleep efficiency(SE)and total sleep time(TST)in the real-KHA group(both P<0.05)but not in the sham-KHA group(P>0.05).However,no significant changes of sleep awakenings(SA)in both groups was found after treatment(both P>0.05).Meanwhile,FSH and LH in the real-KHA group decreased markedly after intervention(both P<0.05)while those indicators only slightly changed in the sham-KHA group(P>0.05).The fluctuation of E2 levels were not significant in both groups(both P>0.05).No serious adverse event was reported in either real-or sham-KHA group.Conclusion:KHA may be a potential alternative therapy for improving perimenopausal insomnia via down regulating the levels of FSH and LH.