Humans ; Estazolam ; Chromatography, High Pressure Liquid

OBJECTIVE: To observe the differences in the sleep quality and the effects on insomnia severity between 's three-promotion needling method and the oral administration of estazolam. METHODS: A total of 70 patients of subacute insomnia were randomized into a three-promotion needling group and a medication group, 35 cases in each one. In the three-promotion needling group, the mild promotion technique with the filiform needle, the warm promotion technique with the fire needle and the strong promotion technique with the three-edged needle were adopted in combination. The acupuncture with the filiform needle was used at Baihui (GV 20), Sishencong (EX-HN1), Shenting (GV 24), Shenmen (HT 7), etc, The treatment was given 3 times a week, once every 2 days. The pricking technique with fire needle was applied to Ganshu (BL 18), Xinshu (BL 15), Feishu (BL 13), Pishu (BL 20), Shenshu (BL 23) and Geshu (BL 17), once every 3 days, twice a week. The bleeding technique with the three-edged needle was used at the ear apex, once every 2 days, 3 times a week. In the medication group, the estazolam tablets were taken orally before sleep, 1mg once every 2 days. The treatment was given consecutively for 4 weeks in the two groups. Separately, before treatment, in 2-week treatment and in 4-week treatment as well as in 1-month follow-up after treatment, the Pittsburgh sleep quality index (PSQI) and the insomnia severity index (ISI) scores were recorded in the patients of the two groups. The clinical effects were evaluated in the two groups. RESULTS: In 2 weeks and 4 weeks of treatment, as well as in the follow-up, PSQI scores and ISI scores were all reduced obviously as compared with those before treatment in the two groups (all <0.05). In the three-promotion needling group, the PSQI score at each time point was reduced much more obviously as compared with the medication group (all <0.05). In the follow-up, the ISI score in the three-promotion needling group was lower than the medication group (<0.05). The total effective rates were 97.2% (34/35) and 91.4% (32/35) at the end of treatment and in the follow-up respectively in the three-promotion needling group, higher than 85.7% (30/35) and 71.4% (25/35) in the medication group (both <0.05). CONCLUSION 's three-promotion needling method much more effectively improves the sleep quality and reduces insomnia severity in the patients of subacute insomnia. This therapy presents the satisfactory short-term and long-term effects.
Acupuncture Points ; Acupuncture Therapy ; Estazolam ; Humans ; Sleep Initiation and Maintenance Disorders ; therapy ; Treatment Outcome

OBJECTIVE: To compare the effect of acupuncture based on syndrome differentiation and estazolam in the treatment of chronic insomnia and its influence on cognitive function. METHODS: A total of 90 patients with chronic insomnia were randomly divided into an acupuncture group and a medication group, 45 cases in each group. The acupuncture group was treated with acupuncture at Sishencong (EX-HN 1) and bilateral Shenmen (HT 7), Sanyinjiao (SP 6) combined with compatibility of acupoints based on syndrome differentiation, once a day for 6 d and then rest for 1 d, for a total of 4 weeks. The medication group was treated with oral estazolam tablets before bedtime, 1 tablet each time, for a total of 4 weeks. Before and after treatment, the scores of Pittsburgh sleep quality index (PSQI), mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA) and auditory verbal memory test (AVMT) of the two groups were compared, and the effects were evaluated. RESULTS: After treatment, the PSQI sub-item scores and total scores of the two groups were lower than those before treatment ( P<0.05 ), and above scores in the acupuncture group were lower than those in the medication group ( P<0.05 ); the scores of MMSE, MoCA and AVMT in the two groups were higher than those before treatment ( P<0.05 ), and the scores in the acupuncture group were higher than those in the medication group ( P<0.05 ). The total effective rate of the acupuncture group was 80.0% (36/45), which was higher than 53.3% (24/45) in the medication group (P<0.05). CONCLUSION Syndrome differentiation acupuncture can improve the sleep quality and cognitive function of patients with chronic insomnia, and the curative effect is better than that of estazolam.
Humans ; Sleep Initiation and Maintenance Disorders/therapy* ; Estazolam ; Acupuncture Therapy ; Cognition ; Acupuncture Points ; Syndrome

OBJECTIVETo compare the clinical efficacy differences between "governor vessel method of acupuncture" combined with estazolam and estazolam alone for insomnia.

METHODSSeventy patients of insomnia were randomly divided into an observation group and a control group, 35 cases in each one. The patients in the control group were treated with oral administration of estazolam, 2 mg each time; the estazolam was taken 30 min before sleeping. The patients in the observation group were treated with "governor vessel method of acupuncture" combined with estazolam; the positive reaction points along governor vessel and Baihui (GV 20) were selected as the main points. The acupuncture was given for 30 min per treatment, once every two days. Both groups were treated for four weeks. Pittsburgh sleep quality index (PSQI) and polysomnography (PSG) were observed before and after treatment. Clinical efficacy was assessed between the two groups and adverse reactions were recorded.

RESULTSThe total effective rate was 94.3% (33/35) in the observation group, which had no significant difference with 82.9% (29/35) in the control group (>0.05). The cured and markedly effective rate was 71.4% (25/35) in the observation group, which was superior to 42.9% (15/35) in the control group (<0.05). Each item score and total score of PSQI were decreased obviously after treatment in the observation group (all <0.05), while the score of sleep latency, sleep duration and sleep efficiency as well as total score of PSQI were decreased obviously after treatment in the control group (all <0.05). The scores of sleep duration, sleep disturbance and day dysfunction due to sleepiness as well as total score of PSQI in the observation group were lower than that in the control group (all <0.05). After treatment, the PSG-related parameters of total sleeping duration, sleeping latency, sleeping arousal and sleeping efficiency were improved significantly in the observation group (all <0.05); the total sleeping duration, sleeping arousal and sleeping efficiency were also improved in the control group (all <0.05). The total sleeping duration, sleeping latency, sleeping arousal and sleeping efficiency in the observation group were superior to those in the control group (all <0.05). 4 adverse reactions in the observation group and 3 adverse reactions in the control group were observed.

CONCLUSION"Governor vessel method of acupuncture" combined with estazolam could significantly improve insomnia, which are superior to estazolam alone.

Acupuncture Therapy ; Combined Modality Therapy ; Estazolam ; therapeutic use ; Humans ; Sleep ; Sleep Initiation and Maintenance Disorders ; therapy ; Treatment Outcome

OBJECTIVE: To compare the therapeutic effect of acupuncture, conventional acupuncture and oral estazolam tablet on refractory insomnia. METHODS: A total of 180 patients with refractory insomnia were randomized into a acupuncture group, a conventional acupuncture group and a medication group, 60 cases in each group. In the acupuncture group, acupuncture was applied at Baihui (GV 20), Waiguan (TE 5), Neiguan (PC 6), Weishu (BL 21), Zhongwan (CV 12) and Taixi (KI 3); in the conventional acupuncture group, conventional acupuncture was applied at Baihui (GV 20), Shenmen (HT 7), Sanyinjiao (SP 6), Zhaohai (KI 6), Shenmai (BL 62) and Anmian (Extra). Supplementary acupoints were added according to different patterns in the two acupuncture groups, and the treatment was given once a day, 7 times as one course and 4 courses were required. In the medication groups, estazolam was taken orally 1 h before sleep, 1 mg each time, once a day for 4 weeks. The Pittsburgh sleep quality index (PSQI) score was observed before and after treatment and the therapeutic effect was evaluated in the 3 groups. RESULTS: The total effective rates in the acupuncture group and the conventional acupuncture group were 90.0% (54/60) and 83.3% (50/60), which were superior to 30.0% (18/60) in the medication group (both <0.05). Compared before treatment, the PSQI scores were significantly reduced in the two acupuncture groups (all <0.05), the sleep efficiency and the total score of PSQI were reduced in the medication group (both <0.05). After treatment, the changes of sleep latency, sleep efficiency, sleep disorder, daytime function and total score of PSQI in the acupuncture group were significantly larger than those in the conventional acupuncture group (all <0.05). The changes of PSQI scores in the acupuncture group were significantly larger than the medication group (all <0.05). The changes of sleep quality, sleep latency, sleep time, sleep disorder, daytime function and total score of PSQI in the conventional acupuncture group were significantly larger than the medication group (all <0.05). CONCLUSION The therapeutic effect of acupuncture on refractory insomnia is superior to estazolam and conventional acupuncture.
Acupuncture Points ; Acupuncture Therapy ; methods ; Estazolam ; therapeutic use ; Humans ; Sleep ; Sleep Initiation and Maintenance Disorders ; therapy ; Treatment Outcome

AIMTo investigate the fragmentation behavior of triazolobenzodiazepines and to develop a specific, sensitive and rapid LC/MSn assay for simultaneous determination of estazolam, alprazolam and triazolam in human urine.

METHODSAfter oral administration of a single 4 mg dose of the drugs to each of three healthy volunteers, urine samples were purified by solid-phase extraction, and then injected into an ODS column (150 mm x 4.6 mm) with a mobile phase of methanol-water (8:2) for LC/MSn analysis. The structures of estazolam, alprazolam and triazolam in human urine were identified by direct comparison of the observed mass spectra and the chromatographic retention time with those of the reference substance. The mass spectrometer (Finnigan LCQ) was operated in positive mode and in two scan modes including SIM and full scan MS/MS mode. The obtained mass spectra was analyzed assisted with the software Mass Frontier 1.0 for their fragmentation pathways.

RESULTSThe full scan MS/MS spectra of each compound gave characteristic fragment ions of [M + H - N2]+ and [M + H - Cl]+. The detection limit was below 0.5 ng.mL-1 for estazolam, alprazolam and triazolam in human urine.

CONCLUSIONThe method is useful in forensic and clinical toxicology in which unequivocal identification of eatazolam, alprazolam and triazolam is desired.

Alprazolam ; urine ; Anti-Anxiety Agents ; urine ; Chromatography, Liquid ; Estazolam ; urine ; Humans ; Male ; Spectrometry, Mass, Electrospray Ionization ; Triazolam ; urine

OBJECTIVE: To compare the effect on chronic insomnia disorder (CID) and influences on episodic memory and sleep structure between acupuncture and estazolam tablets. METHODS: A total of 140 CID patients were randomized into a meridian-point group (46 cases, 1 case dropped off), a non-meridian-and-non-acupoint group (47 cases, 2 cases dropped off) and a medication group (47 cases, 2 cases dropped off). In the meridian-point group, Baihui (GV 20), Shenmen (HT 7), Sanyinjiao (SP 6), Zhaohai (KI 6) and Shenmai (BL 62) were selected and the routine acupuncture was applied. In the non-meridian-and-non-acupoint group, the needling technique was same as the meridian-point group. Acupuncture was given once daily for 4 weeks in the above two groups. In the medication group, estazolam tablets were administered orally, taken 1 to 2 mg per night, consecutively for 4 weeks. Before and after treatment, the changes in the following indexes were observed in each group, i.e. the score of insomnia severity index (ISI), the score of auditory verbal memory test (AVMT) and the relevant indexes of sleep structure [total sleep time (TST), sleep onset latency (SOL), wake after sleep onset (WASO), sleep efficiency (SE) and the percentage of non rapid eye movement phase 1, 2 and 3 (N1, N2 and N3) and rapid eye movement time (REM) in TST]. RESULTS: After treatment, ISI scores were reduced in the meridian-point group and the medication group (<0.01), the score in the meridian-point group was lower than the medication group and the non-meridian-and-non- acupoint group respectively (<0.01) and that in the medication group was lower than the non-meridian-and-non-acupoint group (<0.01). After treatment, the score of each of immediate recall, short-term delayed recall, long-term delayed recall and delayed recognition of AVMT was increased in the meridian-point group and the medication group respectively (<0.01, <0.05) and the score of each item of AVMT in the meridian-point group was higher than the medication group and the non-meridian-and-non-acupoint group respectively (<0.01, <0.05). The scores of immediate memory and delayed recognition in the medication group were higher than the non-meridian-and-non-acupoint group respectively (<0.01). After treatment, SOL, WASO and N1% were all reduced (<0.01) and TST, SE, N3% and REM% were all increased (<0.01, <0.05) in the meridian-point group and the medication group, N2% in the meridian-point group was reduced (<0.01). After treatment, N1% and N2% in the meridian-point group were lower than the medication group (<0.01) and N3% and REM% were higher than the medication group (<0.01). After treatment, TST, SE and N3% in the meridian-point group and the medication group were all higher than the non-meridian-and-non-acupoint group respectively (<0.01, <0.05) and SOL, WASO and N1% were lower than the non-meridian-and-non-acupoint group respectively (<0.01). REM% in the meridian-point group was also higher than the non-meridion-and-non-acupoint group (<0.01), and N2% in the meridian-point group was also lower than the non-meridian-and-non-acupoint group (<0.01). CONCLUSION Compared with estazolam, acupuncture much better improves sleep quality and episodic memory in patients with chronic insomnia disorder, which is possibly related to the regulation of sleep structure of patients in treatment with acupuncture.
Acupuncture Points ; Acupuncture Therapy ; Estazolam ; therapeutic use ; Humans ; Memory, Episodic ; Sleep ; Sleep Initiation and Maintenance Disorders ; therapy ; Treatment Outcome

Acupuncture Points ; Acupuncture Therapy ; Estazolam ; Humans ; Sleep Initiation and Maintenance Disorders/drug therapy* ; Treatment Outcome ; gamma-Aminobutyric Acid

OBJECTIVETo compare the safety and efficacy of midazolam and estazolam in hypertensive patients with chronic insomnia.

METHODSIn this multicentre, open labeled, randomized clinical trial, 217 adult (18 - 75 years) hypertensive patients (BP range 140 mm Hg or= 3 times/week for more than 1 month) were randomly divided into midazolam (7.5 - 15 mg before sleep, n = 113) or estazolam group (1 - 2 mg before sleep, n = 104). Patients took medication according to own need. Sleep diary should be completed within 15 minutes after getting up next morning. Follow-up analysis was performed in patients completed 8 sleep diaries or received midazolam or estazolam for 1 month. Patients' sleep diaries were evaluated, blood pressure and heart rate before and after therapy were measured and adverse events were recorded.

RESULTS(1) Blood pressure was equipotent reduced after both treatments (-11.8/7.3 mm Hg for midazolam group, and -9.1/5.6 mm Hg for estazolam group, all P < 0.05 vs. before treatment). (2) The total sleep score was also significantly decreased in both groups after medication (P < 0.01) and midazolam was significantly superior to estazolam in shortening sleep latency, reducing awakening frequency, improving objective sleep evaluation and decreasing daytime sleepiness, but there were no differences in dream frequency and total sleep time. (3) The adverse reactions such as dizziness, headache and nausea was similar in midazolam (3%) and estazolam group (7%, P > 0.05).

CONCLUSIONSIt is safe to take midazolam or estazolam for hypertensive patients with chronic insomnia and both drugs reduced blood pressure. Midazolam is superior to estazolam in shortening sleep latency, reducing awakening frequency, improving objective sleep evaluation and decreasing daytime sleepiness.

Aged ; Estazolam ; therapeutic use ; Female ; Humans ; Hypertension ; complications ; Hypnotics and Sedatives ; therapeutic use ; Male ; Midazolam ; therapeutic use ; Middle Aged ; Sleep Initiation and Maintenance Disorders ; drug therapy ; etiology

Adult ; Aged ; Anti-Anxiety Agents ; therapeutic use ; Estazolam ; therapeutic use ; Female ; Humans ; Magnetic Field Therapy ; Male ; Middle Aged ; Sleep Initiation and Maintenance Disorders ; therapy