浅谈理疗中经穴的点线面

理疗学科治疗疾病主要是通过人体某些特定部位(腧穴)获得一定的良性刺激,并通过经络的作用,机体从而产生自我修复调整的作用,而经穴的功能主治是治疗疾病的前提作用,经穴的分布又是具有一定的规律性的。笔者现就理疗中经穴的点线面三方面略谈如下。 所谓理疗经穴中的点,主要是指腧穴,“腧穴是经络空气通达于体表的特定部位。而腧穴中“以痛为腧”的阿是穴又占有绝大的位置。

RELATIONSHIP BETWEEN INTERNAL ORGAN(VISCERA) AND ACUPOINTS:TOWARD MERIDIAN THEORY

The theory of interrelation between acupoints and viscera （IBAV） is one of the most important parts in Traditional Chinese Medicine and the key concept in the theory of Zangfu and Jingluo （meridians）. IBAV expresses the rule between body surface and inner organs which guides the diagnosis and treatment in acupuncture practice. Yellow Emperor said. ＂The twelve-channel is the passage of the flowing of the blood and energy in human body, it has close relation with the existence of the flowing of the blood and energy in human body, it has close relation with the existence of man, the forming of disease, the human health and the recovery of disease... ＂ （Chapter 11 Jing Bie Yellow Emperors Canon Internal Medicine） Early studies noted that IBAV is bi-direetional by reflex reaction to the aeupoints on body surface. Stimulation on the acupoints can simultaneously regulate visceral functions. Recent research showed that acupuncture stimulations induced neuronal nitric oxide expression in the brainstem. Nitric Oxide in the medulla medicates various physiological reflexes. In this Review, the evidence of the relationship between viscera and acupoints will be summarized and emphases on the study of interrelation between acupoints and viscera is not only for improving clinical effects, but also for clarifying the mechanisms of acupuncture-moxibustion. A main way to treat visceral illnesses is choosing acupoints based on differentiation of symptoms and signs.

CLINICAL OBSERVATION ON TREATMENT OF 100 CASES OF NEURASTHENIA BY OTOPOINT PELLET-PRESSING THERAPY

This paper is aimed at observing the therapeutic effect of otopoint pellet-pressing therapy [auricular application of vaccaria seed (Wang Bu Liu Xing)] in the treatment of neurasthenia. Main otopoints used are Pizhixia (MA-AT 1), Chuiqian (MA-L), Ershenmen (MA-TF-1), Zhen (MA-AT), etc.. After application of plaster-adhered vaccaria seed at the otopoint, the patient is asked to press the otopoint 2-3 times daily, 3-5 min every time. After 2 courses (10 sessions) of treatment, of the 100 cases, 49 are cured, 37 have remarkable improvement and the rest 14 cases are relieved. Clinical practice shows that this therapy is effective for various kinds of neurasthenia.

Clinical Application of the Point Xuanzhong

Xuanzhong (GB 39), also called Juegu, belongs tothe Gallbladder Channel of Foot Shaoyang, and it isan Influential Point of the marrow.

OBSERVATION OF THERAPEUTIC EFFECT ON TREATMENT OF THE GREATER OCCIPITAL NEURALGIA WITH ACUPUNCTURE

To compare the differences in therapeutic effects on treatments of the greater occipital neuralgia between acupuncture and western medicine. Method. Sixty cases of the greater occipital neuralgia were randomized into acupuncture group （30 cases） and western medicine group （30 cases）. In acupuncture group, acupuncture was applied on Fengchi （ 风池 GB 20）, Chengling （承灵 GB 18）, Xuanzhong （悬钟 GB 39） and Ashi （阿是穴）, once everyday. In western medicine group, carbamazepine was administrated orally, 100 mg, Bid × 10 days. Results： In acupuncture group, 25 cases （83.3%） were cured, 4 cases （13.3%） remarkably effective, 1 case （3.4%） effective and 0 case ineffective. In western medicine group, 16 cases （53.3%） were cured, 7 cases （23.3%） remarkably effective, 2 cases （6.7%） effective and 5 cases （ 16.7 % ） ineffective. The cured-markedly effective rates of two groups were 96.6 % and 76.6 % respectively, indicating significant difference between two groups （P 〈 0.05）. Conclusion： The therapeutic effect with acupuncture on the greater occipital neuralgia was significant compared with that with carbamazepine.

SEGMENTAL DISTRIBUTION OF AFFERENT ELECTRO-ACUPUNCTURE SIGNALS FROM ACUPOINTS OF THE PERICARDIUM MERIDIAN IN THE RAT

Objective: To observe the segmental distribution of afferent Electroacupuncture (EA) signals from acupoints of the Pericardium (PC) Meridian and try to analyze the relative specificity of running route of PC Meridian.Methods: A total of 85 Wistar rats anesthetized with mixed solution of Chloralose (5 mg/100 g) and Urethane (42 mg/100g) were used in this study. Under microscopic observation, the micro-filaments of the distal end of the dorsal root were carefully separated after tearing the spinal pia mater to attach to a recording electrode. The reference electrode was placed beneath the skin of the incision. Two caudal and two rostral dorsal roots near the recorded one were cut off separately. Electrical activity of the isolated micro-filaments was observed before and after EA of "Daling" (PC 7) -"Jianshi" (PC 5), "Quze" (PC 3) of PC Meridian, "Yangchi"(TE 4)- "Zhigou" (TE 6), "Tianjing" (TE 10)-" Qin-glengyuan" (TE 11) of the Triple Energizer (TE) Meridian with electric current 1 mA and 2 mA and double pulses. Results: ① After EA (1 mA) of "Daling"(PC 7)-"Jianshi"(PC 5), the firing rates of 3 out of 10 (33.3%) micro-filaments in C5 segment, 5 out of 10 (50.0%) in C6, 7 out of 10 (70.0%) in 07, 3 out of 10 (30.0%) in C8 and 3 out of 13 (23. 1%) in T1 increased considerably；and after EA of "Quze" (PC 3), those of 3/10 of C5, 4/10 of C6, 6/10 of C7, 3/10 of C8, and 3/10 of T1 increased significantly. ② After EA (1 mA) of "Yangchi"(TE 4)- "Zhigou" (TE 6) and "Tianjing" (TE 10)- "Qinglengyuan" (TE 11). the firing rates of 2/10, 2/10 of micro-filaments In C5, 7/10, 3/10 of C6, 5/10 and 4/10 of C7, 1/10 and 1/10 of C8, and 2/13 and 1/10 of T1 increased significantly. It indicates that C7 dorsal root may play the first important role in conveying EA signals from PC Meridian acupoints to the spinal cord, while C6 and C7 may be mainly responsible for conveying EA signals from TE Meridian acupoints to the spinal cord. Conclusion: The peripheral afferent pathway for transmitting EA signals from PC Meridian acupoints probably has a relative specificity.

Multicenter randomly controlled trial on acupoint injection therapy with Chinese herbal medicines for oculomotor paralysis

Objective To evaluate the clinical effect of acupoint injection therapy for paralysis of oculomotor nerve with Chinese herbal medicines. Methods A total number of 456 patients from 3 centers with paralysis of oculomotor nerve were randomly divided into an acupoint injection group and a control group with 228 cases each. Patients in the acupoint injection group were treated with injection of Chinese herbal medicines to Jingming （晴明 BL 1）, Yangbai （阳白GB 14}, Sibai （四白 ST 24 Tongziliao （瞳子髎 GB I） on the affected side, and Ganshu （肝俞 BL 18） on both sides, Compound Angelica Injection was the main drug, and the corresponding acupoints and other injection drugs were also used according to differentiation of syndrome. Patients in the control group were treated with common western medicine. The treatment was given once a day, 10 times constituted one course with 3 days of interval. After 3 courses, the effect was assessed. TCM syndrome score, eyeball movement degree, the sizes of oculi rimae and pupil of the two groups were recorded before and after treatment. Results The effective rate of acupoint injection group was 91.7% （209/228）, and that of the control group was 73.6% （168/228）. There was statistical significance in comparing the difference between the two groups （P〈0.05）. TCM syndrome scores of the two groups after the treatment became less obviously than those before the treatment （P〈0.01, P〈0.05）, the score of acupoint injection group was more reduced than that of the control group （P〈0.05）. Eyeball movement degree and oculi rimae were enlarged and the pupil reduced in the affected eye in both groups after the treatment Call P〈0.05）. The musculus rectus medialis for the eyeball movement in the acupoint injection group was more improved than that of the control group, and the oculi rimae was bigger in the acupoint injection group than that in the control group （both P〈0.05）. Conclusion Acupoint injection therapy with Chinese herbal medicines has assured effect on the treatment of oculomotor paralysis.

Four cases of pyonex application by Professor WU Mao-wen

WU Mao-wen, the chief physician, applied intracutaneous pyonex in treatment of various pains, internal medicine diseases, and gynecological diseases. This therapy is not only based on such common methods in TCM as ＂retaining in static＂ and ＂selecting points based on pattern differentiation＂ in clinical point selection, but also extends Zhang Zhong-jing prescription theory to ＂acupoint selection＂ and ＂specialized in macro use＂ in acupoint selection of pyonex. The specific experience includes（1） rational use of specific points in fourteen meridians,（2） skillful use of extra points and empirical points in TCM,（3） holographic point selection, and（4） selection of positive points with painful locality taken as an acupoint. The application of pyonex by physician WU Mao-wen is perfect, professional and safe, without pain, and can significantly improve symptoms, so it is worth being promoted.

Preliminary Properties of Meridian System as a Complex Network

The system of meridians and acupoints in the traditional Chinese medication （TCM） builds up a complex network. We analyze the features and properties of the system of meridians and acupoints as a complex network based on knowledge of TCM and mathematics. The system shows some important features of complex networks such as the small-world effect and the scale-free property. A preliminary discussion on the robustness of the meridian system as a complex network, and the biomedical functions of such robustness is also given.

Therapeutic observation on herbal cake-partitioned moxibustion for dysmenorrhea due to deficiency cold

Objective:To observe the clinical efficacy of herbal cake-partitioned moxibustion for dysmenorrhea due to deficiency cold.Methods:A total of 70 patients with dysmenorrhea who met the inclusion criteria were randomized into a mild moxibustion group and a herbal cake-partitioned moxibustion group by the random number table,with 35 cases in each group.Shenque(CV 8),Zhongji(CV 3)and bilateral Zigong(EX-CA 1)were selected for both groups.The treatment continued for 3 menstrual cycles.The visual analog scale(VAS)and COX menstrual symptom scale(CMSS)were scored in both groups before treatment,after treatment and at the end of the 3rd menstrual cycle after treatment.The clinical efficacy was evaluated at the end of the 3rd menstrual cycle after treatment.Results:After treatment,the clinical efficacy of the herbal cake-partitioned moxibustion group had the tendency to be superior to that of the mild moxibustion group,while there was no statistically significant difference in the overall efficacy between the two groups(P>0.05).The VAS and CMSS scores after treatment and at the follow-up were significantly lower than those before treatment in both groups(all P<0.05).At the follow-up,the VAS scores in both groups had no significant intra-group differences from those after treatment(both P>0.05).The CMSS scores in both groups were significantly lower than those after treatment(both P<0.05).The VAS scores at the follow-up of both groups had no statistical differences from those after treatment(both P>0.05).After treatment,the CMSS score in the herbal cake-partitioned moxibustion group was significantly lower than that in the mild moxibustion group(P<0.05).At the follow-up,there were no statistical differences in the CMSS score between the two groups(P>0.05).Conclusion:The herbal cake-partitioned moxibustion has the same therapeutic efficacy for dysmenorrhea as the mild moxibustion;the two moxibustion methods can significantly improve the concomitant symptoms of dysmenorrhea,and the herbal cake-partitioned moxibustion is little better.

Therapeutic Observation of Needling Three Hand Yang Meridian Acupoints to Treat Postapoplectic Finger Contracture

To investigate the efficacy of acupuncture of points of three hand yang meridians for treating postapoplectic finger contracture. Methods： Sixty patients with postapoplectic finger contracture were randomly allocated to treatment and control groups, 30 cases each. The treatment group received acupuncture of points of three hand yang meridians and the control group, conventional acupuncture. The curative effects and posttreatment hand myodynamia scores were compared between the two groups. Results and Conclusion： All the cure rate, marked efficacy rate and total efficacy rate were significantly higher in the treatment group than those in the control group （P〈0.05）. Hand myodynamia score was significantly lower after treatment than before in both groups （P〈0.05）. There was a statistically significant difference between the two groups after treatment. It is indicated that clinical hand function was improved more in the treatment group than in the control group.

Therapeutic efficacy observation on needling Yangming method for facial palsy

Objective： To observe the clinical efficacy of Prof. Gao Yu-chun＇s needling Yangming method for facial palsy, as well as to inherit and further develop the academic idea.Methods： A total of 70 cases were randomly allocated into a treatment group（n=35） and a control group（n=35）. Cases in the treatment group were treated with needling Yangming method, whereas cases in the control group were treated with traditional acupuncture method. The treatment was done once a day in both groups（6 times a week） for a total of 6 weeks. Then the therapeutic efficacies were evaluated before and after treatment using the House-Brackmann（H-B） scale and scores of signs and symptoms. Results： After 2 weeks of treatment, patients in the treatment group obtained a better H-B score and recovery rate than those in the control group（P〈0.05）. After 4 weeks of treatment, the H-B score, scores of signs and symptoms and recovery rate in the treatment group were better than those in the control group（P〈0.05, P0.01, P〈0.05）. After 6 weeks of treatment, there were no between-group statistical differences in the above aspects（P〉0.05）. Conclusion： Needling Yangming method can obtain a faster effect, a higher early-stage recovery rate and shorter course of treatment than traditional acupuncture method.