Based On Literature Research To Explore The Efficacy Of Cervicogenic Insomnia By T-type Release Of Occipital With Acupotomy

Objective: Based on data mining,this paper summarizes the common acupoints,meridian,location,specific acupoint attribute and the rules of acupoint compatibility in the treatment of cervicogenic insomnia,the clinical trial was carried out to verify the safety and effectiveness of T-type release of occipital with acupotomy in the treatment of cervicogenic insomnia,in order to provide a safe and effective new scheme for the clinical treatment of cervicogenic insomnia.Methods: 1.literature Research: to search the literatures published in CNKI,Wanfang,VIP and other databases from 2000 to 2019 on acupuncture treatment of cervicogenic insomnia,the key words were "cervical insomnia","cervical spondylosis combined with insomnia",the key words mentioned above were grouped and matched with the key words of "acupuncture","electroacupuncture","fire acupuncture","moxibustion","acupoint injection","acupoint catgut embedding" and "small needle knife",and screened them according to the inclusion and exclusion criteria,and established literature information database and acupoint information database,and sorted out the treatment schemes in the included literatures,descriptive statistics analysis,correlation analysis and cluster analysis were carried out,and summarized acupuncture treatment of cervicogenic insomnia acupoint optimization and compatibility rules.2.clinical research: In this study,72 patients who met the diagnostic criteria in the Department of traditional Chinese medicine of Shanxi Bethune hospital from December2018 to December 2020 were selected,and randomly divided into occipital acupotomy T-type release group(treatment group)and ordinary acupuncture group(control group),with 36 cases in each group.In the control group,the main points were Fengchi,Xinshu,Dazhui,Anmian,Jingbailao,Shenshu,Shenmen,Baihui and Fengfu,Patients were in prone position,with 75% alcohol routine disinfection,into the needle after the application of mild reinforcing-attenuating,keep the needle for about 30 minutes after getting the Qi,A course of treatment is 5 days per week,there were 4 courses of treatment totally.The treatment group was treated by T-type release of occipital with acupotomy,with 5 points on the horizontal line: The first point is external occipital protuberance;On the superior nuchal line,there are two points which are 2.5cm away from the posterior midline to both sides;and there are two points which are 5cm away from the posterior midline to both sides.There are six points in the vertical line,which are the apex of spinous process C2-C7.The patients was prone,head down,routine disinfection towel,local infiltration anesthesia with 1% lidocaine,each treatment point injected for 0.5ml.Patients get this treatment once a week for a course of treatment,and there were also 4 courses of treatment.Before and after the treatment,PSQI and NPQ were used to score,the level of 5-HT and GABA in the serum were detected,and the results were statistically analyzed to evaluate the efficacy and safety.Results: 1.literature Research: After screening and sorting,a total of 40 literatures were entered,involving 58 acupoints,with a total frequency of 349 times,covering 14 meridians.In the treatment of cervicogenic insomnia,acupuncture(40%)and acupuncture combined with massage(30%)were the most commonly used;the top eight acupoints in the treatment of cervicogenic insomnia were as follows: Fengchi(27),Jingjiaji(23),Xinshu(22),Dazhui(21),Anmian(18)and jingbailao(17);The top five high frequency acupoints were: Bladder Meridian of foot Taiyang(78),extra meridian(70),Du Meridian(58),gallbladder meridian of foot Shaoyang(37),stomach meridian of Foot Yangming(19);The high frequency acupoints were ranked as follows: head,neck and shoulder(179),waist and back(62),lower limbs(57),upper limbs(41),chest and abdomen(5);The top four high-frequency acupoints were intersection(111),Beishu(60),Wushu(38)and Bamai intersection(34);According to the order of support from high to low,the association analysis was as follows: jingbailao,Shenshu,Xinshu,jingbailao,Dazhui,Xinshu,Shenmen,Dazhui,jingbailao;Cluster analysis results: four cluster groups were obtained,which were divided into the first group: Xinshu,Shenshu,Jingbailao,Shenmen,Wangu,Zhaohai and Dazhui;The second type: Anmian,Shenting,Sanyinjiao,Zusanli,Sishencong,Jianjing,Baihui,Fengfu and Fengchi;The third type is Jingjiaji;The fourth type: Tianzhu.2.clinical research:(1)Analysis and comparison of general data: there was no significant statistical difference in gender,age,course of disease and other general information between the two groups before the treatment(P>0.05),which was comparable.(2)Analysis and comparison of PSQI and NPQ scores: Before treatment,there was no significant difference in PSQI and NPQ scores between the two groups(P>0.05)which was comparable;after the treatment,both of the two groups’ PSQI and NPQ scores were lower than those of the same group before treatment(P<0.05),indicating that common acupuncture and occipital acupotomy T-type release can improve the sleep quality and relieve the degree of neck pain of patients;the acupotomy group’ PSQI and NPQ score was lower than the acupuncture group’ score(P<0.05),indicating that the acupotomy group was better than the acupuncture group.(3)Analysis and comparison of 5-HT and GABA contents: before the treatment,there was no significant statistical difference in the content of 5-HT and GABA between the two groups(P>0.05),which was comparable;after the treatment,both of the two groups’ content of 5-HT and GABA were higher than those of the same group before treatment(P<0.05),indicating that both of the two groups can improve the content of 5-HT and GABA;the Acupotomy group’ 5-HT content was significantly higher than that in the acupuncture group(P<0.05),indicating that the Acupotomy group was better than the acupuncture group in improving the content of 5-HT.The Acupotomy group’ GABA content was slightly higher than that in the acupuncture group(P>0.05),indicating that there was no significant difference in promoting the content of GABA between the two groups.(4)Analysis and comparison of clinical efficacy:After the treatment,the total effective rate of the acupotomy group and the acupuncture group was 88.24% and 78.13% independently(P<0.05),which indicated that the clinical effect of acupotomy group was better than that of acupuncture group.Conclusion: 1.Acupuncture are the main intervention methods in the treatment of cervicogenic insomnia;The most frequently used acupoints were Fengchi,Jingjiaji,Xinshu,Dazhui,Anmian,jingbailao,Shenshu,Shenmen,Baihui and Fengfu.2.Both T-type release of occipital with acupotomy and ordinary acupuncture can effectively treat cervicogenic insomnia.3.The occipital acupotomy T-type release group was better than the ordinary acupuncture group in PSQI score,NPQ score,content of 5-HT and GABA in the serum and clinical treatment efficiency.