Objective To investigate the clinical effect of Tongdu Tiaoshen needling in the treatment of chronic insomnia and its mechanism based on the hypothalamic-pituitary-adrenal(HPA) axis. Methods A total of 60 patients with chronic insomnia were randomly divided into treatment group and control group

with 30 patients in each group. In addition to the health education on sleep

the patients in the treatment group were given Tongdu Tiaoshen needling

i.e.

electroacupuncture at Baihui(GV20)

Shenting(GV24)

Yintang(EX-HN3)

bilateral Shenmen(HT7)

and bilateral Sanyinjiao(SP6)

and those in the control group were given superficial acupuncture at Shousanli(LI10)

Futu(ST32)

and Feiyang(BL58) at both sides

once every other day and three times a week for 4 consecutive weeks. Before and after treatment

the Pittsburgh Sleep Quality Index(PSQI) was used to assess the quality and efficiency of sleep

and ELISA was used to measure the serum levels of corticotropin-releasing hormone(CRH)

adrenocorticotropic hormone(ACTH)

and corticosterone(CORT). Results After treatment

the treatment group had significant reductions in the total PSQI score and the score of each component of PSQI(P<0.01)

and the control group had significant reductions in the total PSQI score(P<0.01) and the scores of all components except sleep duration(P<0.05); compared with the control group

the treatment group had significantly lower total PSQI score and the score of each component(P<0.01). After treatment

the treatment group had significant reductions in the serum levels of CRH

ACTH and CORT(P<0.05

P <0.01)

and compared with the control group

the treatment group had significant reductions in the serum levels of CRH

ACTH and CORT(P<0.01

P<0.05). Conclusion Tongdu Tiaoshen needling has a good clinical effect in the treatment of chronic insomnia and can significantly improve the sleep condition of patients with chronic insomnia

possibly by reducing the hormones associated with the HPA axis.