Against the backdrop of global aging, the onset age of ischemic stroke is getting younger and the prevalence is increasing, with insomnia as one of its complications.

To examine the clinical, interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) responses to needling posterior neck meridian sinews nodes and herbal ointment externally applied to Yongquan acupoint in patients with post-ischemic stroke insomnia.

A total of 80 outpatients and inpatients with post-ischemic stroke insomnia were recruited from the First Affiliated Hospital of Guangdong Pharmaceutical University from May 2020 to May 2021, and equally divided into a Chinese medicine group (treated using needling posterior neck meridian sinews nodes and herbal ointment externally applied to Yongquan acupoint) and a Western medicine group (treated using estazolam) by complete randomization. Both groups were treated for two treatment cycles (10 times of treatment as one cycle) . Comparisons of intergroup differences were made in terms of the total score and domain scores (subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleep medication, and daytime dysfunction) of Pittsburgh Sleep Quality Index (PSQI) , Athens Insomnia Scale (AIS) score, and serum IL-6 and TNF-α levels at baseline, and the end of the first and second cycles of treatment, as well as overall efficacy.

All patients were included for analysis except for three dropouts (one was treated with Chinese medicine and the other two with Western medicine) . The type and duration of treatment had significant interaction effects, and main effects on mean total score of PSQI and mean score of each of its domains as well as mean AIS score (P<0.05) . After the end of the first or second treatment cycle, the mean total score and domain scores of PSQI as well as mean AIS score in both groups were lower than before treatment(P<0.05). After the end of the second treatment cycle, the mean total score and domain scores of PSQI as well as mean AIS score in both groups were lower than the end of the first treatment cycle (P<0.05) . After the end of the first or second treatment cycle, the mean total score and domain scores of PSQI as well as mean AIS score in Chinese medicine group were lower than those in Western medicine group (P<0.05) . The type and duration of treatment produced significant interaction effects, and main effects on mean levels of serum IL-6 and TNF-α (P<0.05) . After the end of the second treatment cycle, the mean levels of serum IL-6 and TNF-α in both groups were lower than the end of the first treatment cycle (P<0.05) . After the end of the first or second treatment cycle, the mean levels of serum IL-6 and TNF-α in Chinese medicine group were lower than those in Western medicine group (P<0.05) . The overall clinical efficacy of Chinese medicine group was better than that of Western medicine group (Z=2.234, P<0.05) .

Compared to estazolam, needling posterior neck meridian sinews nodes in combination with herbal ointment externally applied to Yongquan acupoint achieved more significantly improved sleep quality and reduced serum IL-6 and TNF-α levels as well as higher overall efficacy in post-ischemic stroke insomnia patients.