Objective To observe the clinical efficacy of Tiaoshen needling(dredging Governor Vessel and regulating mind)in the treatment of chronic insomnia(CI) and its effect on plasma melatonin(MT) and cortisol(CORT) levels

so as to explore its underlying mechanism. Methods Sixty patients with CI were randomly divided into the treatment group and the control group

with 30 cases in each group. Both groups were given sleep hygiene education before treatment. Patients in the treatment group received acupuncture or electroacupuncture at Baihui(GV20)

Shenting(GV24)

Yintang(GV29)

bilateral Shenmen(HT7) and Sanyinjiao(SP6). Patients in the control group received acupuncture or electroacupuncture at bilateral Shousanli(LI10)

Futu(ST32) and Feiyang(BL58). Both groups were treated every other day

3 times a week

for a total of 4 weeks. Before and after treatment

Pittsburgh sleep quality index(PSQI) and fatigue severity scale(FSS) were used to evaluate sleep qua-lity and daytime fatigue

the plasma MT and CORT levels were measured by enzyme-linked immunosorbent assay. Results Compared with before treatment

the PSQI scores and total FSS score of the treatment group decreased significantly(P<0.01

P<0.05)

and the plasma MT content increased and CORT decreased significantly in the treatment group(P<0.01)

while the sleep-onset time score

sleep disturbance score and the PSQI total score of the control group decreased significantly(P<0.05). Compared with the control group

the PSQI sleep disorder score and total score

and the total FSS score as well as plasma CORT level were significantly down-regulated(P<0.01

P<0.05)

while the plasma MT content was up-regulated(P<0.05) in the treatment group. Conclusion Tiaoshen acupuncture can significantly improve the sleep quality of patients with CI and relieve daytime fatigue

which may be related to the increase of plasma MT content in patients with CI

thereby inhibiting the excessive activation of the hypothalamic-pituitary-adrenal axis.