J. Acupunct. Tuina. Sci. 2010, 8 (1): 42-43 DOI: 10.

1007/s11726-010-0042-7

Special Topic Study

Clinical Observation on Suspended Moxibustion at Baihui (GV 20) for Insomnia

YANG Li-xia (), JU Yan-li () Guangzhou University of Traditional Chinese Medicine, Guangdong 510405, P. R. China

Key WordsPoints, Baihui (GV 20); Moxibustion; Insomnia CLC NumberR246.6 Document CodeB Insomnia is a common disease with frequently disturbed sleep which can strongly influence the patients daily life, work and studyso it should be treated as early as possible. A more effective and less harmful therapy was recently sought by the clinical researchers due to serious side-effects of drugs. The author treated insomnia with suspended moxibustion at Baihui (GV 20), the report is as follows. cases were male, 21 were female. There were no statistical differences in gender, age, state of the disease and disease duration between two groups after statistical analysis, and they were comparable.

2 Therapeutic Method
2.1 Treatment group Main points: Baihui (GV 20). Adjunct points: Sishencong (Ex-HN1), Taiyang (Ex-HN5), Fengchi (GB20), Neiguan (PC 6). Operation: Punctured the above points after routine sterilization and did the even reinforcingreducing manipulation after arrival of qi. At the same time, the moxibustion hander was placed on the superior of Baihui (GV 20), the moxa stick was ignited and put into the hander 2 cm approximately away from the point and required an obvious heat feeling. The distance between the moxa stick and the point was modulated to keep a persistent heat feeling. Each treatment took 30-60 min and was performed once daily, 5 times being one treatment course. Special attention was paid to the wire mesh under the hander to prevent the skin from burning; and the patient was asked to keep a good mood and to do appropriate exercise to improve their constitution. 2.2 Control group Patients in the control group were given Estazolam 1-2 mg/d before sleep, 5 days as a treatment course.

1 General Data
The sleep quality was classified in five degrees according to the sleep efficiency of WHO (sleep duration / total time between going to bed and getting up100%) Grade : Sleep efficiency is 70%-80%sleep well; Grade : Sleep efficiency is 60%-70%sleep with difficulty; Grade : Sleep efficiency is 50%-60% disturbed sleep; Grade : Sleep efficiency is 40%-50% moderate disturbed sleep; Grade : Sleep efficiency is 30%-40% seriously disturbed sleep. Seventy-five patients with primary insomnia in absence of organic diseases evaluated by Western medicine were divided into a treatment group and a control group randomly. Of the 40 patients in the treatment group, 18 cases were male, 22 were female; of the 35 patients in the control group, 14
AuthorYANG Li-xia (1981- ), female, master of medicine

42 Shanghai Research Institute of Acupuncture and Meridian and Springer-Verlag Berlin Heidelberg 2010

J. Acupunct. Tuina. Sci. 2010, 8 (1): 42-43

3 Therapeutic Effects
3.1 Therapeutic effects criteria The effects were evaluated according to the standard of WHO for sleep efficiency. Cured: Symptoms disappeared; the sleep efficiency is above 75%. Marked effective: Symptoms alleviated; the sleep efficiency is 65%-74%. Effective: Symptoms improved; the sleep efficiency is 55%-64%. Ineffective: Symptoms remained no change; the sleep efficiency is under 55%. 3.2 Therapeutic Results The effective rates were 90.0% and 80.0% in the treatment group and control group respectively after 2 courses of treatment. There was no significant difference of the total effective rate between the two groups (table 1, 2 =1.49P>0.05). However, side effects such as dry mouth, somnolence, dizziness and lassitude appeared in the control group and dependence on the drug occurred after a long-term using, Depression or irritability occurred if the drug was stopped suddenly. There were no side-effects in the treatment group.
Table 1. Comparison of effect between two groups (Cases) Groups n Cured 8 3 Total Marked Effective Ineffective effective effective rate (%) 16 13 12 12 4 7 90.0 80.0

Treatment 40 Control 35

4 Discussion
Chinese medicine holds that several factors may contribute to insomnia, while disorder of qi, blood, yin and yang of the Zang-fu organs are the main causes of the disease. Insufficiency of blood and disharmony of yin and yang are the chief mechanism. Baihui (GV 20) is a point on the Governor Vessel, located on the top of head, which is the meeting of all yang meridians. It correlates with the five Zang and six Fu organs[1]. The physiology and pathology of the brain is governed by the heart and reflected by the five Zang organs. The Governor Vessel spreads to the spinal cord, and collaterals situated between the heart and brain, thus closely relating to mental activity. The mechanism

of Baihui (GV 20) in treating insomnia is to harmonize the five Zang organs and reinforce the brain as well as tranquilize the mind. Moxibustion at Baihui (GV 20) could ascend yang qi, guide the blood up to nourish brain and marrow, which could reinforce the brain and tranquilize mind, regulate yin and yang thus alleviating insomnia[2,3]. Modern medicine considers insomnia to be related with the dysfunction of the cerebral cortex due to nerves and mental stress. There are rich nerves, blood vessels distributed on the surface of Baihui (GV 20) point, such as the trochlear nerve, greater occipital nerve, and frontal nerve branch. The deeper parts of the point are the cerebral cortical motor area and paracentral lobule, and around are the artery and venous networks accumulated from perimeter to the center. Moxibustion on this point could improve the blood circulation and elasticity of blood vessels, regulating the autonomic nervous system to strengthen the excitement of the related areas thus treating nervous system diseases. The recent research indicates that moxibustion possesses far-infrared and near-infrared energy, which could regulate the functional activities of each system and organ so as to regulate the function of the nervous system. Suspended moxibustion at Baihui (GV 20) overlapped the effect of both point and moxibustion to regulate the disorder and strengthen the resistance of the body. Even though there are no statistical differences between the effective rate of two groups, suspended moxibustion at Baihui (GV 20) is easily accepted by patients because it can markedly improve the general condition and without side-effect.

References
[1] LU Jin. Clinical Observations on Treatment of Insomnia by Acupuncture Method of Harmonizing Nutrient and Defense. Shanghai Journal of Acupuncture and Moxibustion, 2008, 27(2): 6-7. [2] WANG Jun. Professor SUN Shen-tians Clinical Experiences in Application of Baihui (GV 20). Shanghai Journal of Acupuncture and Moxibustion, 2009, 28(2): 67-68. [3] WANG Yu-ming, WU Hai-yan. Observation on Therapeutic Effect of Acupuncture plus Moxibustion for Insomnia. Journal of Acupuncture and Tuina Science, 2007, 5(5): 281-283. Translator: YANG Ling () Received Date: December 14, 2009

Shanghai Research Institute of Acupuncture and Meridian and Springer-Verlag Berlin Heidelberg 2010 43