The Clinical And Experimental Research On The Treatment Of Insomnia By "Needling By Regulating Yin Yang And Five Viscera"

Aim of researchInsomnia is one of the most common diseases about sleep-disorder somnipathy. It receives high attention in the medical circles because of the high incidence rate of the disease. Insomnia is called "Bu mei" or "Bu de mian" etc in TCM. Many ancient medical literature and modern clinical report show that the acupuncture and moxibustion has certain effect on the treatment of insomnia but ignore synthesis regulation about the rhythm of sleeping-waking in the day and night;They only emphasize on the research of Yin and Yang or Yin and Wei or mind to declare the pathogenesis of insomnia but ignore the internal relationship of them which exist in the progress of the morbidity . So the research about the treatment of insomnia by the acupuncture and moxibustion should be made some breakthrough on the pathogenesis ,needling and the selection of point.Through many clinical observation and theory research , we think that the main pathogenesis of insomnia is the disorder of Yin and Yang and the disharmony of human' s Yin and Yang rhythm in the day and night. While the dysfunction of five organs which can' t hold their own vitality is the main pathology foundation . Insomnia is the sign which tell the disharmony of the Yin and Yang rhythm in the day and night and the dysfunction of five organs which can' t hold their own vitality. It not only show the patient' s sleeping quality which is called "Ye bu mian" during the night, but also reflect the patient' s status of the function which is called "Zhou bu jing" during the daytime. So as to give the clinical judgment to the insomnia, we should synthesize the combination between the patient' s sleeping quality during the night and thestatus of function during the daytime."Needling by regulating Yin Yang and five viscera" which is created according to the whole recognition of the pathogenesis in TCM and the standard selection of points , and the manipulation with measure belongs to the acupuncture' s way which can regulate the rhythm of human' s sleeping-waking . "Needling by regulating Yin Yang and five viscera" has two functions that it can not only regulate the rhythm of Yin and Yang , but also make five viscera restore their vitality.Regulation of Yin and Yang means regulating the rhythm of Yin and Yang. Dazui point, Shenmai point and Guangyuan point, Zhaohai point are selected and needle manipulation is used to reinforce the Yang while reduce the Yin or "reinforce the Yin while reducing the Yang" according to the time when the patient visits which can regulate the rhythm of Yin and Yang by times. When the patient visits before noon, we use twisting reinforcing method at Dazui and Shenmai points while twisting reducing method at Guanyuan and Zhaohai points (invigorating Yang and reducing Yin). When the patient visits post meridiem, we use twisting reducing method at Dazui and Shenmai points while twisting reinforcing method at Guanyuan and Zhaohai points (invigorating Yin and reducing Yang).Regulation of five viscera means regulating the function of storing the vitality . Five back shu points (Feisu points Xinsu point, Gansu point, Pisu point, Shensu point and Gesu point are selected to regulate the dysfunction of five organs , harmonize the Qi and Blood, make the five vitality stored each .Through systematic clinical observation about "Needling by regulating Yin Yang and five viscera" , Our topic try to declare the function and the clinical effect of this method which treat the insomnia by regulating the rhythm of Yin and Yang in the day and night , making five organs store five vitality;Through the experiment of "Needling by regulating Yin Yang and five viscera" on the animals which regulate the mouse' s sleeping and affect the quantity of the monoamines neurotransmitter in the rat' s hypothalamus , we probe the pathogenesis of "Needling by regulating Yin Yang and five viscera" used in treating insomnia;We hope this topic can supply the new researching way and treating method at insomnia.Method of research1.116 insomnia cases are selected and arranged in "Needling by regulating Yin Yang and five viscera" group and traditional needling group. A few tables such as Epworth' s weary schedule>Self~anxiety scheduleCSASXSelf-depression schedule, PSQK TCM symptom schedule )are made to compare the effect before and after the treatment or interclass so as to know the situation of sleeping at night and status during the daytime .2.TCD is used to detect the change of LVA> RVA, VBA, Vp, Vd, Vm> and the blood flow rate of vertebra-basilar arterial before and after the treatment.3.Studying the patient' s clinical therapeutic effect according to the standard clinical judgment after the treatment and 6 months' follow-up visit is needed.4.The experimental research is progressed to get the contradistinction about the regulation of the sleep between "Needling by regulating Yin Yang and five viscera" and melatonin .which is used to calculate the sleep time and sub threshold hypnosis dosage affected by pentogen Na.5.The insomnia rat' exemplars which get PCPA are chosen to receive "Needling by regulating Yin Yang and five viscera" and the change of monoamine neurotransmitter in the rat' hypothalamus is observed to know the mechanism of action of neurotransmitter .Result of research1.Invigorating yang and reducing yin is used in "Needling by regulating Yin Yang and five viscera" to help yang come out of yin and educe the exciting function extensively when the yang has gotten its tide so as to improve the insomnia patient' s "Zhou bu jing" status and the living quality during the daytime.2.1nvigorating yin and reducing yang is used in "Needling by regulating Yin Yang and five viscera" to help yang go inside yin and educe the restraining function extensively when the yin has gotten its tide so as to improve the insomnia patient' s "Ye bu mei" status and the sleeping quality during the night.3.After the treatment by "Needling by regulating Yin Yang and five viscera" , the TCM symptom integral obviously improved (P<0. 05 , P<0. 01)4. " Needling by regulating Yin Yang and five viscera" can expandvertebra-basilaris arteriae , improve cerebral arteries' blood-supply and is helpful for sleeping.5.Through clinical observation and treatment , there are50. 85% cure rate, 22.03% marked effect rate, 18.64% effect rate, 8.48% no effect rate and all effect rate gets 91. 52% in "Needling by regulating Yin Yang and five viscera" group. 67.80% insomnia patient has the clinical effect at 1 to 10 days. While in traditional needling group , there are 31. 57% cure rate, 28. 07% marked effect rate, 15.79% effect rate, 24.57% no effect and all effect rate gets 75. 43%. 42.11% insomnia patient has the clinical effect at 1 to 10 days. The statistics result show that the clinical effect of "Needling by regulating Yin Yang and five viscera" group is obviously better than the traditional needling group (P<0. 01)6.Each 30 cases is selected at random and arranged in "Needling by regulating Yin Yang and five viscera" group and traditional needling group. After 1 month and 6 months follow visit .there are 72.37% sleep rate which happen in the "Needling by regulating Yin Yang and five viscera" group within 1 month and 71.67% sleep rate after 6 months. There is no difference between them in statistic (P>0.05), and it shows the long-term clinical effect of "Needling by regulating Yin Yang and five viscera" is steady. While there are 62. 11% sleep rate which happen in the "traditional needling" group within 1 month and 50.21% sleep rate after 6 months. There is obvious difference between them in statistic (P<0. 01), and it shows the long-term clinical effect of "traditional needling" group isn' t good.7.Can prolong the hypnosis time and add the number of the sleep rat duo to pentogen Na. It has the same function of melatonin, so "Needling by regulating Yin Yang and five viscera" has the function of hypnosis.8.The content NE in the hypothalamus of the insomnia rat of the exemplar control group steps up, which has obvious difference with black group (P<0. 01);The content NE in hypothalamus of needling therapy group steps down, which has obvious difference with exemplar control group (P<0. 01);It shows that needling therapy group can depress the increasement of content NE in cerebral ganglion of rat which gets the insomnia by PCPA.9-The contents 5-HT and the metabolites of 5-HIAA in the brain of the insomnia rat of the exemplar control group both degrade and has obvious difference with blank group (P<0.05) , which shows PCPA can degrade thecomposition and metabolism of the content 5-HT in the rat' s brain. While "Needling by regulating Yin Yang and five viscera" group can increase the content 5-HT and 5-HIAA which are low in the insomnia rat, which has the significance difference with exemplar control group (P<0. 01).Conclusion of researchl."Needling by regulating Yin Yang and five viscera" not only can improve the sleep quality of the insomnia patient at night , but also improve the status of the function during the daytime. So it improves the living quality of the insomnia patent in the day and night. "Needling by regulating Yin Yang and five viscera" can regulate the rhythm of Yin and Yang during the day and night, at the same time it can adjust the disorder function of five organs. So it can harmonize the Qi and Blood and make five vitality be stored and cure the insomnia essentially.2.The clinical effect of "Needling by regulating Yin Yang and five viscera" is better than "traditional needling" group and its effect in the near and long term future is reliability . It is easy for the clinic to generalize.3.The mechanism of action of "Needling by regulating Yin Yang and five viscera" is that it can degrade the content NE in the hypothalamus and increase the content 5-HT and 5-HIAA in the hypothalamus.