Objective To compare the clinical effect of manual acupuncture and moxibustion therapies in the treatment of perimenopausal insomnia(PMI).Methods A total of 60 outpatients with PMI were randomly and equally divided into an acupuncture group(29 cases)and a moxibustion group(28 cases).Acupoints Zhongwan(CV12)

Xiawan(CV10)

Qihai(CV6)and Guanyuan(CV4)were employed in these two groups.For acupuncture group

filiform needles were inserted slowly into these acupoints and twirled mildly for a while

and then retained for 30 min.When moxibustion performed

the ignited moxa-cone was applied to the same 4 acupoints

with 7 cones for each acupoint.The treatment was conducted once daily for 10 consecutive days

suspended for 2 days

then another 10 days' treatment followed. The Pittsburgh Sleep Quality Index(PSQI)scale(7 items:subjective sleep quality

sleep latency

duration of sleep

habitual sleep efficiency

sleep disturbance

use of sleeping medications

and daytime dysfunction

0-3 points per item

0-21 points in total)was used to evaluate the patient's sleep quality.The clinical therapeutic effect was also assessed according to the sleep rate(=sleep duration/total duration from spin-in to wake-up×100%).The contents of serum follicular stimulating hormone(FSH)

estradiol(E2)and luteinizing hormone(LH)were detected using radioimmunoassay.Results After treatment

the total score of PSQI and the score of each item were all significantly reduced in the two groups relevant to their own pre-treatment(P<0.01).The scores of sleep latency

sleep disturbance and daytime dysfunction were comparable between the two groups(P>0.05)

but the total score

and scores of sleep quality

sleep duration

sleep efficiency

and use of sleeping medication were significantly lower in the moxibustion group than in the acupuncture group(P<0.05).Of the 29 and 28 cases in the acupuncture and moxibustion groups

6(20.69%)and 11(39.29%)were cured

7(24.14%)and 9(32.14%)experienced marked improvement

9(31.03%)and 5(17.86%)were effective

and 7(24.14%)and 3(10.71%)ineffective

with the total effective rate being 75.86% and 89.29%

respectively.The therapeutic effect of moxibustion was obviously superior to that of acupuncture treatment(P<0.05).After the treatment

the levels of serum FSH and LH were significantly decreased(P<0.01)

and that of E2 was significantly increased in both groups(P<0.01).The levels of FSH and E2 in the moxibustion group were obviously improved than those of the acupuncture group(P<0.05).Conclusion Both acupuncture and moxibustion can relieve the sleep quality of patients with PMI

which may be associated with their effect in regulating serum hormone levels.The therapeutic effect of moxibustion is superior to that of acupuncture.