头部透穴法治疗失眠症随机对照观察

目的：观察头部透穴疗法治疗失眠症的临床疗效并探讨其作用机制。方法：将71例失眠患者随机分为头部透穴组（36例）和常规针刺组（35例）。头部透穴组取神庭透前神聪、左右头临泣透左右神聪、后神聪透强间；常规针刺组取百会、印堂、四神聪、内关等穴。治疗30天后，分别对2组疗效、治疗前后匹兹堡睡眠质量指数量表（PSQI）积分和血浆5-羟色胺（5-HT）含量进行对比观察。结果：头部透穴组总有效率为91．7％，优于常规针刺组的77．1％（P〈0．05）。头部透穴组对PSQI中睡眠质量、入睡时间以及总积分的改善均优于常规针刺组（P〈0．05）。头部透穴组能明显提高血浆5-HT含量，与常规针刺组相比，差异有显著性意义（P〈0．05）。结论：头部透穴治疗失眠症的疗效优于常规针刺，其作用机制与调节5-HT代谢有关。

Randomized controlled observation on head point-through-point therapy for treatment of insomnia

OBJECTIVE: To observe the therapeutic effect of head point-through-point therapy on insomnia and to probe the mechanism. METHODS: Seventy-one cases of insomnia were randomly divided into a head penetration needling group (n=36) and a routine acupuncture group (n=35). In the head penetration needling group, Shenting (GV 24)-through-anterior Shencong (EX-HN 1), bilateral Toulinqi (GB 15)-through-bilateral Shencong (EX-HN 1), posterior Shencong-through-Qiangjian (GV 18) were selected; and in the routine acupuncture group, Baihui (CV 20), Yintang (EX-HN 3), Sishencong (EX-HN 1), Neiguan (PC 6), etc. were selected. After treatment of 30 days, their therapeutic effects, cumulative scores of Pittsburgh Sleep Quality Index (PSQI) and plasma serotonin contents before and after treatment were compared. Results The total effective rate of 91.7% in the head penetration needling group was better than 77.1% in the routine acupuncture group (P < 0.05), and the improvement of sleep quality, falling asleep time and the total cumulative score of PSQI in the head penetration needling group was superior to that in the routine acupuncture group (P < 0.05), and plasma serotonin was significantly increased in the head penetration needling group with a significant difference as compared with that in the routine acupuncture group (P < 0.05). CONCLUSION: The therapeutic effect of head penetration needling is better than that of the routine acupuncture, and the mechanism is related with regulation of serotonin metabolism.