Effects of dexzopiclone and estazolam on neurotransmitters, nerve cytokines and stress states in patients with insomnia after stroke

Objective:To study the effects of dexzopiclone and estazolam on neurotransmitters, nerve cytokines and stress states in patients with insomnia after stroke.Methods: The patients with insomnia after stroke who were treated in Linyi Rongjun Hospital between March 2015 and October 2017 were chosen and randomly divided into dexzopiclone group and estazolam group. The levels of neurotransmitters, nerve cytokines and stress indexes in serum were measured before treatment as well as 14 days and 28 days after treatment.Results: Compared with those before treatment, serum Glu,γ-GABA, 5-HT, 5-HIAA, BDNF and NGF levels of both groups significantly increased whereas NE, TNF-α, IL-6, ATCH, Cor, CRP, SOD and GSH levels significantly decreased after treatment, and serum Glu,γ-GABA, 5-HT, 5-HIAA, BDNF and NGF levels of dexzopiclone group after treatment were higher than those of estazolam group whereas NE, TNF-α, IL-6, ATCH, Cor, CRP, SOD and GSH levels were lower than those of estazolam group.Conclusion:Dexzopiclone is more effective than estazolam to regulate the secretion of neurotransmitters and nerve cytokines and reduce the stress state in patients with insomnia after stroke.

Auricular acupressure as assistant in primary insomnia management: a randomized single-blind controlled clinical trial

Objective: To observe the efficacy and safety of dexzopiclone plus auricular acupressure in intervening primary insomnia. Methods: A total of 72 participants who met the in clusi on criteria were en rolled in a ran domized con trolled trial, with 36 cases allocated to a treatment group and 36 cases allocated to a control group. Both groups were given dexzopiclone as the routine treatment. Patients in the treatment group were given auricular acupressure with Wang Bu Liu Xing (Semen Vaccariae) seeds at the auricular acupoints related to sleep and emotion based on meridian theory, whereas for patients in the control group, the medical plasters with Wang Bu Liu Xing (Semen Vaccariae) seeds were only gently stuck to acupoints unrelated to sleep without stimulation. Patients in both groups were required to visit the hospital once a week for replacing the seeds and plasters. The course of intervention lasted for 8 weeks and the patients were followed up for another 4 weeks. Pittsburgh sleep quality index (PSQI) and Karolinska sleep diary (KSD) were used to evaluate the outcomes. Meanwhile, adverse effects were monitored and recorded. Results: In the enrolled 72 cases, 4 patients (one in the treatment group and three in the control group) reported thirst and a bitter taste, and one case in the control group reported nausea and vomiting. At last, 3 cases in the control group dropped out for adverse reactions, and 69 cases completed the clinical trial. After 8 weeks of treatment, the global scores of PSQI in both treatment and control groups decreased significantly compared with the baseline (both PvO.001). Furthermore, the global score of PSQI in the treatment group was lower than that in the control group (P<0.01). The global scores of PSQI in both groups at the follow-up were significantly different from the baseline (both PvO.001), but insignificantly different compared with the post-treatment results (both P>0.05). According to KSD, both treatment protocols could prolong the total sleep time, shorten sleep-onset latency, improve sleep efficacy and sleep quality significantly, and the changes in the treatment group were more significant. The total effective rate was 88.9% in the treatment group, higher than 81.8% in the control group, though the difference was statistically insignificant (P>0.05). Con elusion: Dexzopicl one plus auricular acupressure is effective and safe for pati ents with primary in somnia both in short and long terms, and it is more effective tha n mono therapy of dexzopicl one.