Objective To observe the clinical efficacy of repetitive transcranial magnetic stimulation（rTMS） at precise positioning head acupoints in the treatment of primary insomnia. Methods A total of 72 patients with primary insomnia were divided into a treatment group and a control group

with 36 patients in each group. Touching parts of rTMS were placed at Baihui（GV20）

Sishencong（EX-HN1）

Benshen（GB13

bilateral）

Shenting（GV24） and Anmian（EX-HN22

bilateral）. The treatment group was treated with true rTMS

with F1（1 Hz）

vibration and 100% motion threshold stimulation. The control group was given rTMS sham stimulation. Pittsburgh sleep quality index（PSQI） scoring was performed before treatment

after 2-week and 4-week treatment respectively

and the clinical efficacy was determined after treatment. Results After 2-week and 4-week treatment

the total scores of PSQI and scores of all PSQI different dimensions in both groups were lower than those before the treatment

and those in the treatment group were significantly lower than those in the control group（P<0.05）. The PSQI total scores in both groups after 4-week treatment were lower than those after 2-week treatment within group

and the decrease of PSQI total score in the treatment group was more significant（P<0.05）. The total effective rate in the treatment group（88.89%） was significantly higher than that in the control group（75.00%

P<0.01）. Conclusion Repetitive transcranial magnetic stimulation at precise positioning head acupoints has significant clinical efficacy in the treatment of primary insomnia

and can improve sleep quality.