Insomnia Treatment
I. Overview
Insomnia is a sleep disorder caused by sleep interruption or sleep time reduction, so that the quality and quantity of sleep can not meet the physiological needs of individuals, coupled with the impact of the mindset held on sleep, resulting in daytime sleepiness, depression and a series of neuropsychiatric symptoms. Most foreign epidemiological findings show that every year about 33% of people, there have been sleep disorders, 17% of serious insomnia, insomnia seriously affects people’s life and work and physical and mental health. Modern medicine, neurosis, menopause syndrome, concussion sequelae and hypertension, liver disease, hyperthyroidism, anemia, cerebral arteriosclerosis, chronic poisoning, early schizophrenia patients, insomnia as the main manifestation of this category of evidence. Sleep is an indispensable process for human beings. 1/3 of a person’s life is spent in sleep, and sleep is second only to breathing and heartbeat in importance to human beings. Sleep has many functions, including restoring concentration, promoting growth, as well as consolidating memory and relieving tension.
II. Treatment methods
(A) Identification and treatment
(2) Ear acupuncture therapy
(C) water acupuncture therapy
Acupuncture points: Baihui, Shenting, Yintang, Annmian, Neiguan, Shenmen, Sanyinjiao, Taichong. For yin deficiency and fire, add Taixi and Fengchi; for heart and spleen deficiency, add Foot Sanli and Hand Sanli; for liver depression and fire, add Xingma and Fengchi; for phlegm-heat internal disturbance, add Fenglong, Zhonggu and Hegu; for heart and gall bladder deficiency, add Padua and Foot Sanli. Basic manipulation: The above main points and supporting points should be used according to the identification of the deficiency of the organism and the strength and weakness of the qi and blood. The needles should be left in place for 25-30 minutes.
The following acupoints are used for the symptoms
1, headache, dizziness: Fengchi, Sun.
2, forgetfulness: Dazhi, Taixi.
3, tinnitus: cataract, ear door.
4, palpitations: Tanzhong, Tongli.
5, loss of appetite: zhongbei, sansili.
6, menstrual disorders, seminal emission: Guan Yuan, Qi Hai.
Body: reuse of the Governor’s meridian points, the Governor’s meridian links the three Yang meridians of the hands and feet, is the summit of the body’s Yang meridians, “general supervision of the Yang”, has the role of regulating the Yang energy of the whole body. It is the main point of the Governor’s Vessel and enters the brain, so the Governor’s Vessel leads to the marrow and is responsible for brain diseases. It is important to use the Baihui and Shenting of the Directing Vessel, and the Yin Tang on the Circulation Line to unblock the Qi of the Directing Vessel and calm the brain. In the treatment, we should start from the whole body, regulate the qi and blood of the internal organs, and transport yin and yang. At the same time, according to the identification of the body’s deficiency, the strength and weakness of the qi and blood, the use of different manipulation techniques to complement the deficiency and diarrhea in order to achieve different effects of the needle. For example, the Baihui point according to the identification of deficiency and reality, the use of Ying with, Xu and speed, lifting and inserting, twisting and other manipulation techniques to achieve different effects of raising Yang and benefitting Qi, resting wind and Yang, calming and tranquilizing the mind, in order to achieve the purpose of balancing Yin and Yang.
Chinese medicine: for liver stagnation and fire, use gentian diarrhea liver soup with Zhu Hu Shen, dragon bone, oyster, Yu Jin and Xiang Shen. For internal disturbance of phlegm and heat, use Warm Bile Tang with Huang Lian, Shanzha, Shen Qu and Lycopodium. For Yin deficiency and fire, use Huang Lian A Gou Tang and Zhu Sha An Shen Jiu with addition and subtraction. For deficiency of both heart and spleen, add and subtract Gui Spleen Tang. For deficiency of heart and gallbladder qi, add or subtract An Shen Ding Zhi Jiu.
Ear acupuncture therapy
Prescription: Subcortical, Heart, Shen Men, Endocrine, Kidney, Spleen, Sympathetic.
Operation method: use subcortical, heart and Shen Men as the main acupuncture points, and add 1-2 more acupuncture points according to different types of evidence. The heart and kidney do not intersect plus the kidney; heart and spleen deficiency plus the spleen; liver depression and fire plus the liver, endocrine, etc. Mostly using the buried needle or pill method, the patient is instructed to twist and press once a day for 3-5 minutes before nap time and half an hour before sleep at night, so that the ear point area is slightly distended.
Water injection therapy
Prescription: Annmian, foot Sanli heart Yu, spleen Yu, stomach Yu.
Drug selection: 2 ml of raw vein injection or Danshen injection.
Operation method: Take 2 acupuncture points each time and inject 0.3-0.5 ml of the drug solution into each point. Daily or every other day. 7-10 for 1 course of treatment.
Auxiliary treatment
1, half to one hour before bedtime, mild moxibustion Yongquan point or Baihui point 15-20 minutes.
2, self-massage: forehead, solar plexus 30 times each, Fengchi point, foot Chungquan 50 times each.
3, before going to bed line 40 ℃ -42 ℃ warm water bath for 10-15 minutes, friction rinse of the half-body bath is also beneficial.
4, appropriate participation in physical labor and physical exercise, especially tai chi, walking and other activities have a certain preventive and therapeutic effect, but do not exercise before bedtime.
5, a reasonable system of rest, less brain power in the evening, each person can be based on their own experience and habits, to find the best brain time and suitable rest time, so that life is regular.
6, should be light and nutritious, avoid spicy, tobacco and alcohol and other stimulating effects, a glass of milk before bedtime can also make people sleepy.
The mechanism of action of acupuncture for this disease
Insomnia is due to overexcitement or excitement, the cerebral cortex is in a state of abnormal excitement for a long time, and the impulses generated by the sleep center are inhibited in the cortex, leading to the occurrence of insomnia. The treatment of insomnia by acupuncture may be related to the fact that acupuncture has a two-way benign regulatory effect on the cerebral cortex. Acupuncture can inhibit the excitatory state of the cortex and improve the function of the cortex by inhibiting the spontaneous discharge of the cortex through acupuncture, thus playing a therapeutic role. The benign adjustment of the body’s nerve a body fluid by acupuncture, which improves the nerve conduction function, may also be one of the reasons for the treatment of insomnia by acupuncture.
Press
1. Choose more points of the heart, kidney, spleen, liver and gallbladder meridians. Too many acupoints should not be taken (8-10 acupoints).
2. The treatment is based on deficiency as a tonic and reality as a diarrhea.
3, acupuncture manipulation should be slower, or use warm needles, or moxibustion, can also obtain good results.
4, appropriate long stay needles, some patients are often in the process of stay needles produced drowsiness.
5, treatment should pay as much attention as possible to choose the timing of acupuncture, generally in the afternoon or evening acupuncture can improve the effectiveness.
6, some patients who have been ill for a long time is difficult to get results quickly, if necessary, can extend the course of treatment, from daily acupuncture to every other day or 2-3 times a week, adhere to the treatment of several courses, can make the disease gradually to heal.
Drug treatment
1, the use of sleeping pills should follow the following basic principles.
(1) Apply the minimum effective dose.
(2) intermittent medication (2-4 times a week).
(3) short-term use (generally not more than 3-4 weeks).
(4) Gradual discontinuation of the drug.
(5) Prevention of relapse after discontinuation of medication. Medication should vary according to the patient’s condition and the classification of the duration of the disease.
(2) Short-term insomnia should be treated psychologically by relieving the tension, giving advice and training on mental relaxation, guiding the patient to arrange reasonable sleep; avoiding daytime naps, not drinking caffeinated beverages and taking a walk before bedtime will be beneficial. If sleeping pills (benzodiazepines) are used, give the smallest effective dose and do not exceed 3 weeks; do not take one drug at a time, alternate the dose to avoid drug resistance and drug accumulation poisoning; or intermittently use the drug; if you sleep well for 1-3 nights, then reduce the dosage and maintain it for 1-2 days. Avoid long-term use of drugs, sleeping pills for a long time can produce addiction, once the drug is suddenly stopped, withdrawal symptoms can occur.
3, insomnia patients, such as mental disorders must be given appropriate antipsychotic medication, drug addiction should be detoxification and rehabilitation treatment, pain caused by the analgesic.
4.Patients with melancholic disorder have short sleep time, restless sleep, often wake up after falling asleep and irritable, need to treat melancholic disorder, and hypnotic drugs are not appropriate.
5.The elderly are less resistant to sleeping pills and the dose should be reduced.