The acupuncture strategies for insomnia caused by liver depression and internal heat are as follows:

Acupoint selection and location

Xingjian: Located on the dorsal side of the foot, between the first and second toes, at the junction of the red and white flesh behind the webbed edge of the toes, it is the Xing point of the liver Meridian and can clear liver fire.

Taichong: Located in the depression in front of the junction of the first and second metatarsals on the top of the foot, it is the Shu and Yuan points of the liver Meridian, capable of soothing the liver and regulating qi, as well as calming the liver and subduing wind.

Fengchi: Located at the nape, below the occipital bone, at the same level as Fengfu, in the depression between the upper end of the sternocleidomastoid muscle and the trapezius muscle, it can dispel wind, clear heat, and clear the head and eyes.

Shenmen: Located at the ulnar end of the transverse wrist crease, in the depression on the radial side of the flexor carpi ulnar tendon, it is the yuan point of the Heart Meridian and can nourish the heart and calm the mind.

Ganshu: Located on the back, 1.5 cun lateral to the spinous process of the 9th thoracic vertebra, it can regulate liver function and soothe the liver and regulate qi.

Danshu: Located on the back, 1.5 cun lateral to the spinous process of the 10th thoracic vertebra, it can regulate the function of the gallbladder. When combined with Ganshu, it enhances the effect of soothing the liver and promoting bile secretion.

Operation method

Position selection: The patient should be in a prone or sitting position to facilitate exposure of the acupoints on the back. Lie on your back to facilitate the needling of acupoints on the limbs and head and face.

Disinfection: Use 75% alcohol cotton balls to disinfect the skin around the acupoints. The disinfection area should be about 5 centimeters in diameter, and wipe from the center to the periphery. Avoid repeated application.

Acupuncture: The rapid needle insertion method is adopted, and the fine needle is quickly inserted into the subcutaneous tissue. For acupoints such as Xingjian, Taichong and Fengchi, the catharsis method can be adopted. That is, after the needle is inserted and qi is obtained, the lifting, thrusting, twisting and turning techniques are performed to enhance the sensation of the needle, increase the frequency and increase the amplitude. Acupoints such as Shenmen, Ganshu and Dangshu can be appropriately treated with tonifying and purging techniques based on the patient’s constitution and condition. Generally, tonifying methods are used for deficiency syndromes and purging methods for excess syndromes. The depth of acupuncture varies depending on the location of the acupoint and the patient’s constitution. For instance, 1 to 1.5 cun can be inserted into acupoints on the limbs, and 0.5 to 1 cun can be inserted into acupoints on the back.

Needle retention: The needle retention period is generally 20 to 30 minutes. During this time, depending on the patient’s condition and reaction, the needle can be inserted every 5 to 10 minutes to enhance the effect of the needle puncture.

When the retention time for the needle is up, first slowly lift the needle under the skin, then quickly pull it out. Press the needle hole with a sterilized cotton ball for a moment to prevent bleeding.

Course arrangement

Acupuncture treatment for insomnia caused by liver depression and internal heat is generally carried out 2 to 3 times a week, with 10 sessions constituting one course of treatment. Depending on the severity of the patient’s condition and the treatment effect, 2 to 3 consecutive courses of treatment can be carried out. During the treatment process, the improvement of the patient’s sleep should be closely observed, and the treatment plan should be adjusted in a timely manner.

Precautions

Psychological adjustment: Patients with insomnia caused by liver depression and internal heat often experience significant mood swings. During acupuncture treatment, patients should be guided to engage in psychological adjustment, such as relaxing their bodies and minds by listening to music or taking walks, to avoid excessive tension and anxiety, thereby enhancing the therapeutic effect.

Living habits: Instruct the patient to maintain good living habits, keep a regular schedule and avoid staying up late. Avoid using electronic devices before going to bed. You can drink some tea with heat-clearing and calming effects appropriately, such as chrysanthemum tea. Have a balanced diet and avoid spicy, greasy, and irritating foods, as well as stimulating beverages like coffee and strong tea.

Avoid fatigue: During the treatment period, patients should pay attention to proper rest, avoid working or studying continuously for long periods of time, and can engage in some relaxing outdoor activities appropriately, such as walking or Tai Chi, to relieve physical and mental fatigue.