Discussion On The Acupoint Selection Of Primary Insomnia Based On Randomized Controlled Trial

Objects:To summarize the application characteristics and the law of meridians and acupoints in the treatment of insomnia for acupuncture by the analysis of Randomized Controlled Trials (RCT) in modern literature, which may provide the selected meridians and acupoints reference for clinical treatment of insomnia.Method:This study uses a computer and manual method to retrieve the specified database for the literature about acupuncture treatment of insomnia performing RCTs. The author have searched the clinical literature from China National Knowledge Infrastructure (CNKI), WANFANG Data (WANFANG), China Biology Medicine Disc (CBM), Chinese Scientific Journal Database (VIP), and PubMed Database, Cochrane Library and Springer Link Database. The search conditions of Chinese database were "(subject= insomnia and subject= acupuncture)" or "(subject= sleep disorder and subject= acupuncture)" or "(subject = insomnia and subject= needling)" or "(subject= sleep disorder and subject= needling)"; The search conditions of foreign language database were "(keyword= insomnia and keyword = acupuncture)" or "(keyword= insomnia and keyword= needling)" or "(keyword= sleep disorder and keyword= acupuncture)" or "(keyword = sleep disorder and keyword= needling)". The author collected the clinical literature from January 1994 to December 2015. Under the analysis of RCTs, the author summarized the application characteristics and the law of meridians acupoints in the treatment of insomnia for acupuncture.Results:This study included 245 RCTs, involving 21401 cases of primary insomnia. Through selecting, sorting and analyzing the literature, statistical results are as follows:1. The selection regularity of merdians and acupoints:(1) The top 15 frequently used acupoints in proper orders:Shenmen (164 times), Baihui (138 times), Sanyinjiao (128 times), Sishencong (108 times), Neiguan (97 times), Anmian (75 times), Zhaohai (57 times), Shenting (51 times), Shenmai (46 times), Zusanli (40 times), Yintang (40 times), Taichong (35 times), Xinshu (31 times), Taixi (30 times), Fengchi (25 times).(2) The highest frequency of acupoints’ meridians distribution:Governor vessl (189 times), Heart Meridian of Hand Shaoyin (164 times), Spleen Meridian of Foot Taiyin (128 times), Pericardium Meridian of Hand Jueyin (97 times), Kidney Meridian of Foot Shaoyin (87 times), Bladder Meridian of Foot Taiyang (76 times), Stomach Meridian of Foot Yangming (40 times), Liver Meridian of Foot Jueyin (35 times), Gallbladder Meridian of Foot Shaoyang (25 times).(3) The highest frequency of acupoints’distribution on the body surface:head (437 times), lower limbs (336 times), upper limbs (261 times), trunk (31 times).(4) The highest frequency of acupoints specific point belongs to:crossing points (445 times), five transport points (269 times), source points (229 times), confluence points of the eight vessels (200 times), connecting points (97 times), lower sea points of six bowels (40 times) and transport points point (31 times).(5) The frequency of acupoints during different periods of acupuncture treatment of insomnia:The highest frequency of acupoints to use ten years ago (1994-2005) top 5 in turn: Shenmen, Sanyinjiao, Baihui, Neiguan, Fengchi. Sishencong, Anmian, Yintang is in:No.7, No.12, No.16.The highest frequency of acupoints to use five years ago (2006-2010):Shenmen, Sanyinjiao, Baihui, Sishencong, Neiguan. The frequency of Sishencong, Anmian, Yintang are higher than they used to be. Anmian ranked No.6, Yintang ranked No.13.The highest frequency of acupoints to use in recent five years (2011-2015):Shenmen, Sanyinjiao, Baihui, Sishencong, Neiguan. This result is the same as the result about the top 5 frequently used acupoints for acupuncture treatment of insomnia nearly 20 years. Anmian ranked No.6, Yintang in No.8.2. The selection regularity of meridians and acupoints in the acupuncture treatment in different patterns of insomnia:(1) The highest frequency using acupoints to deficiency of Heart-Spleen syndrome in insomnia:Xinshu (68 times), Pinshu (68 times), Zusanli (33 times), Sanyinjiao (23 times), Yinlingquan (9 times). The high-frequency acupoints’meridian in this syndrome:Bladder Meridian of Foot Taiyang (5 times), Spleen Meridian of Foot Taiyin (4 times), Conception vessel (2 times), etc.(2) The highest frequency using acupoints to deficiency of Fire excess from Yin syndrome in insomnia:Taixi (74 times), Shenshu (38 times), Xinshu (35 times), Taichong (30 times), Daling (21 times). The high-frequency acupoints’meridian distribution in this syndrome:Kidney Meridian of Foot Shaoyin (7 times), Bladder Meridian of Foot Taiyang (5 times), Pericardium Meridian of Hand Jueyin (3 times), etc.(3) The highest frequency using acupoints for insomnia with syndrome of Heart deficiency and timidity:Danshu (41 times), Xinshu (39 times), Qiuxu (26 times), Daling (11 times), Yanglingquan (6 times). The high-frequency acupoints’meridian distribution in this syndrome:Bladder Meridian of Foot Taiyang (5 times), Gallbladder Meridian of Foot Shaoyang (4 times), Heart Meridian of Hand Shaoyin (2 times), etc.(4) The highest frequency using acupoints for insomnia with syndrome of internal disturbance of Phlegm-heat:Fenglong (47 times), Neiting (27 times), Zhongwan (16 times), Zusanli (9 times), Quchi (7 times). The high-frequency acupoints’meridian distribution in this syndrome:Stomach Meridian of Foot Yangming (5 times), Pericardium Meridian of Hand Jueyin (3 times), Triple Energizer Meridian of Hand Shaoyang (3 times), etc.(5) The highest frequency using acupoints to deficiency of depression the< liver transforming into fire syndrome in insomnia:Taichong (61 times), Xingjian (36 times), Ganshu (23 times), Fengchi (22 times), Xiaxi (16 times). The high-frequency acupoints’ meridian distribution in this syndrome:Gallbladder Meridian of Foot Shaoyang (6 times), Pericardium Meridian of Hand Jueyin (4 times), Liver Meridian of Foot Jueyin (3 times), etc.(6) The highest frequency using acupoints to syndrome of Incoordination between Spleen and Stomach in insomnia:Zusanli (24 times), Zhongwan (19 times), Weishu (12 times), Lidui (6 times), Neiguan (6 times). The high-frequency acupoints’meridian distribution in this syndrome:Stomach Meridian of Foot Yangming (5 times), Spleen Meridian of Foot Taiyin (4 times), Bladder Meridian of Foot Taiyang (3 times), etc.Conclusion:1. Acupuncture treatment of insomnia takes Governor vessel, Heart Meridian of Hand Shaoyin, Spleen Meridian of Foot Taiyin’s acupoints and meridians.2. Acupuncture treatment of insomnia often choose Shenmen, Sanyinjiao, Baihui, Sishencong, Neiguan, often take head acupoints. Deficiency of Heart-Spleen syndrome in insomnia often uses Xinshu, Pinshu, etc. Deficiency of Fire excess from Yin syndrome in insomnia often uses Taixi, Shenshu, etc. Deficiency of Heart deficiency and timidity syndrome in insomnia often use Danshu, Xinshu, etc. Deficiency of internal disturbance of Phlegm-heat syndrome in insomnia often uses Fenglong, Neiting, etc. Deficiency of depression the liver transforming into fire syndrome in insomnia often uses Taichong, Xingjian, etc. Syndrome of Incoordination between Spleen and Stomach in insomnia often uses Zusanli, Zhongwan.3. The basic methods of acupuncture treatment of insomnia remain relatively stable over the past two decades.