[Tiaoshen acupuncture for primary insomnia: a pilot randomized controlled trial].

To observe the effects of Tiaoshen (regulating the spirit) acupuncture on cognitive function and sleep quality in patients with primary insomnia (PI).Sixty patients with PI were randomly divided into an observation group (30 cases, 2 cases dropped off) and a control group (30 cases, 2 cases dropped off, 1 case was excluded). The patients in the observation group were treated with acupuncture at Baihui (GV 20), Shenting (GV 24), Sishencong (EX-HN 1), and bilateral Benshen (GB 13), Shenmen (HT 7), Neiguan (PC 6), Sanyinjiao (SP 6). The patients in the control group were treated with shallow needling at non-effective points. Each treatment was provided for 30 min, once every other day, 3 treatments per week for 4 weeks. The Montreal cognitive assessment (MoCA), digit span test (DST), trail making test (TMT)-A, Pittsburgh sleep quality index (PSQI), and fatigue scale-14 (FS-14) were used to assess cognitive function and sleep quality before and after treatment, as well as in follow-up of 4-week after treatment completion. Correlation analysis was conducted between the differences in PSQI scores and differences in MoCA scores before and after treatment in the observation group.Compared with before treatment, the total score, visuospatial and executive function score and delayed memory score of MoCA as well as DST backward score were increased (P<0.01), while TMT-A time, PSQI and FS-14 scores were significantly reduced (P<0.01) after treatment and in follow-up in the observation group. Compared with before treatment, the PSQI score in the control group was reduced (P<0.01, P<0.05). After treatment and in follow-up, the observation group had significantly higher total score, visuospatial and executive function score, delayed memory score of MoCA, and DST backward score compared to the control group (P<0.05, P<0.01). In the observation group, the TMT-A time was significantly shorter than that in the control group (P<0.05, P<0.01), and the PSQI and FS-14 scores were significantly lower than those in the control group (P<0.01). In the observation group, there was a negative correlation between the difference in PSQI scores (post-treatment minus pre-treatment) and the difference in MoCA scores (post-treatment minus pre-treatment) (r=-0.481, P<0.01). A similar negative correlation was found between the difference in PSQI scores (follow-up minus pre-treatment) and the difference in MoCA scores (follow-up minus pre-treatment) (r=-0.282, P<0.05).Tiaoshen acupuncture could improve cognitive function, enhance sleep quality, and alleviate daytime fatigue in patients with PI. The improvement in cognitive function in patients with PI is correlated with the improvement in sleep quality.目的：观察调神法针刺对原发性失眠（PI）患者认知功能及睡眠质量的影响。方法：将60例PI患者随机分为观察组（30例，脱落2例）和对照组（30例，脱落2例，剔除1例）。观察组于百会、神庭、四神聪，双侧本神、神门、内关、三阴交行针刺治疗；对照组于非效穴行浅刺治疗。均每次30 min，隔日1次，每周治疗3次，连续治疗4周。于治疗前后及随访期（治疗结束后4周）采用蒙特利尔认知评估量表（MoCA）、数字广度测验（DST）、连线测验（TMT）-A、匹兹堡睡眠质量指数（PSQI）、疲劳量表-14（FS-14）评定两组患者认知功能及睡眠质量。对观察组PSQI评分和MoCA总分治疗前后差值进行相关性分析。结果：治疗后及随访期，观察组MoCA总分、视空间与执行功能评分、延迟回忆评分及DST-倒背评分较治疗前升高（P<0.01），TMT-A时间较治疗前缩短（P<0.01），PSQI、FS-14评分较治疗前降低（P<0.01）；对照组PSQI评分较治疗前降低（P<0.01，P<0.05）。治疗后及随访期，观察组MoCA总分、视空间与执行功能评分、延迟回忆评分及DST-倒背评分高于对照组（P<0.05，P<0.01），TMT-A时间短于对照组（P<0.05，P<0.01），PSQI、FS-14评分低于对照组（P<0.01）。观察组PSQI评分差值（治疗后–治疗前）与MoCA总分差值（治疗后–治疗前）呈负相关（r=–0.481，P<0.01）； PSQI评分差值（随访–治疗前）与MoCA总分差值（随访–治疗前）呈负相关（r=–0.282，P<0.05）。结论：调神法针刺可提高PI患者认知功能，改善睡眠质量，缓解日间疲劳，PI患者认知功能提高与睡眠质量改善相关。.