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Objective: To observe the acupoint compatibility effect of Shenmen (HT7) and Sanyinjiao (SP6) in improving daytime fatigue and sleepiness of insomnia, and its mechanism in regulating hypothalamic-pituitary-adrenal (HPA) axis and suprachiasmatic nucleus-pineal gland-melatonin (SCN-PG-MT) system.
Methods: Ninety patients with insomnia were randomly divided into Shenmen (HT7), Sanyinjiao (SP6) and Shenmen (HT7)-Sanyinjiao (SP6) (Shenmen (HT7) plus Sanyinjiao (SP6)) groups, with 30 cases in each group. Electroacupuncture (EA,5 Hz/25 Hz) was applied to Shenmen (HT7), Sanyinjiao (SP6) or HT7-Sanyinjiao (SP6) in each group for 30 min. The Electroacupuncture treatment was conducted once daily, 5 days a week for 2 weeks. Before and after treatment, the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) were observed, separately. The contents of serum adrenocorticotrophic hormone (ACTH), cortisol (CS) and melatonin (MT) were detected by ELISA.
Results: Compared with before treatment, the sleep quality, sleep time, sleep efficiency, sleep disturbance, daytime dysfunction scores and total score of PSQI in the three groups after treatment were decreased (P<0.05), the time to fall asleep score of PSQI and total score of ESS were decreased in the Sanyinjiao (SP6) and Shenmen (HT7)-SP6 groups (P<0.05). After treatment, the sleep quality, time to fall asleep, sleep efficiency, daytime dysfunction scores, total score of PSQI and total score of ESS in the Shenmen (HT7)-Sanyinjiao (SP6) group were lower than those in the Shenmen (HT7) group (P<0.05), the sleep quality, sleep efficiency and total score of PSQI in the Sanyinjiao (SP6) group were lower than those in the Shenmen (HT7) group (P<0.05).
Compared with before treatment, the serum ACTH and CS levels in the three groups were decreased (P<0.05), and the serum MT levels in the Sanyinjiao (SP6) and Shenmen (HT7)-Sanyinjiao (SP6) groups were increased (P<0.05). After treatment, the ACTH and CS levels in the Shenmen (HT7)-Sanyinjiao (SP6) group were lower than those in the Shenmen (HT7) group (P<0.05), and the serum MT levels in the Sanyinjiao (SP6) and Shenmen (HT7)-Sanyinjiao (SP6) groups were higher than that in the Shenmen (HT7) group (P<0.05).
Conclusion: The compatibility of Shenmen (HT7) and Sanyinjiao (SP6) has a synergism effect on the improvement of night sleep quality and daytime fatigue and sleepiness of insomnia patients, the mechanism may be related with its function in down-regulating the serum ACTH and CS levels and increasing the serum MT content. Sanyinjiao (SP6) has a better effect than Shenmen (HT7), and plays a major role in acupoint compatibility.
Reference: https://pubmed.ncbi.nlm.nih.gov/35880281/