Acupuncture methods for insomnia caused by internal disturbance of phlegm-heat can be approached from aspects such as the selection of main acupoints, the combination of associated acupoints, acupuncture techniques, auxiliary treatments, and course planning. The following is a detailed introduction:

Selection of main acupoints

Shenmen: The original point of the Heart Meridian, it can regulate the heart qi and calm the mind. For insomnia caused by phlegm-heat disturbing the heart, it can play a role in clearing the heart and calming the mind.

Sanyinjiao: It is a point where the Spleen meridian meets the liver and kidney meridians. It can enhance the effect of strengthening the spleen and soothing the liver, and at the same time help regulate the body’s qi and blood, alleviating discomfort caused by internal disturbance of phlegm-heat.

Neiguan: An acupoint on the Pericardium Meridian, it can broaden the chest, regulate qi, harmonize the stomach and reduce upward movement, improve symptoms such as chest tightness and discomfort in the epigastrium caused by internal disturbance of phlegm-heat, and assist in calming the mind.

Fenglong: It is a key point for resolving phlegm. It is good at resolving phlegm turbidity and can effectively improve the pathological state of internal disturbance caused by phlegm-heat, reducing the disturbance to the heart spirit.

Zhongwan: The Mu point of the stomach, it can aid digestion, eliminate food stagnation, and harmonize stomach qi. It has a good therapeutic effect on symptoms such as fullness and distension in the epigastrium and nausea caused by internal disturbance of phlegm-heat.

Combination of acupoints

Weishu: A back-shu point of the stomach, it can regulate the function of the stomach, enhance the digestive and diastolic effects of Zhongwan, further improve the function of the spleen and stomach, and reduce the generation of phlegm and dampness.

Zusanli: An important acupoint on the Stomach Meridian, it can strengthen the spleen, harmonize the stomach and eliminate accumulation. When combined with Zhongwan, it can enhance the effects of strengthening the spleen and harmonizing the stomach and promote the transformation and transportation of phlegm and dampness.

Neiting: It belongs to the Xing point of the Stomach Meridian and can clear and purge stomach fire. It has a good heat-clearing effect on conditions where phlegm-heat is internally disturbed and accompanied by excessive stomach fire, such as thirst, excessive drinking, and constipation.

Acupuncture manipulation

The purgation method is the main approach: Insomnia caused by internal disturbance of phlegm-heat belongs to the syndrome of excess. During acupuncture, the purgation method is often adopted, such as rapid, forceful and continuous stimulation, to clear phlegm-heat and restore the excited function to normal. For instance, when needling acupoints such as Neiting and Fenglong, the twisting and purging method can be adopted. The intensity of the stimulation can be appropriately increased to the extent that the patient can tolerate it.

Retention time of the needle: Generally, the needle is retained for 20 to 30 minutes. During the retention period, the needle can be inserted every 5 to 10 minutes to maintain the sensation of the needle and enhance the therapeutic effect.

Adjuvant therapy

Moxibustion: For patients with a cold constitution or excessive phlegm and dampness, moxibustion can be combined after acupuncture. Moxibustion on acupoints such as Zhongwan and Zusanli can warm and unblock the meridians, dispel cold and dampness, strengthen the spleen and harmonize the stomach, and promote the transformation and transportation of phlegm and dampness. However, it should be noted that patients with severe phlegm-heat and a hot constitution are not suitable for moxibustion.

Cupping: Cupping can be performed on the bladder meridian on the back, such as between the Feishu and Shenshu points. The cupping is adhered by the flash fire method and moved back and forth. Then, the cupping is retained for 8 to 10 minutes to unblock the meridians and eliminate phlegm and dampness.

Treatment course planning

Treatment frequency: Generally, acupuncture treatment is conducted 2 to 3 times a week, and a continuous treatment course lasts for 4 to 6 weeks. The specific course of treatment can be adjusted according to the patient’s condition and treatment effect.

Regular assessment: During the treatment process, it is necessary to regularly evaluate the patient’s sleep improvement, including the time it takes to fall asleep, sleep depth, and sleep duration, etc. Meanwhile, observe the changes in other symptoms of the patient, such as chest tightness, nausea, bitter taste in the mouth, etc. Adjust the treatment plan in a timely manner based on the assessment results.