Clinical Applications of Acupoints Baihui （GV 20） and Sishencong （Ex-HN 1）

Through clinical practice over the last decade, , I have been using Baihui （GV 20） and Sishencong （Ex-HN 1） for treating various diseases or symptoms. It is now reported as follows.

Clinical Observation on Suspended Moxibustion at Baihui （GV 20） for Insomnia

Insomnia is a common disease with frequently disturbed sleep which can strongly influence the patients＇ daily life, work and study, so it should be treated as early as possible. A more effective and less harmful therapy was recently sought by the clinical researchers due to serious side-effects of drugs. The author treated insomnia with suspended moxibustion at Baihui （GV 20）, the report is as follows.

Comparative Study on the Effect of Baihui （GV 20）, Shuigou （GV 26） and Shenmen （HT 7） on Cognition of Patients with Vascular Dementia

Objective： To study the relative specificity of Baihui （GV 20）, Shuigou （GV 26） and Shenmen （HT 7） in improving the cognitive function of patients with vascular dementia （VD）. Method： Fifty VD cases were randomized into 5 groups, which were treated with routine points, routine points plus Baihui （GV 20）, routine points plus Shuigou （GV 26）, routine points plus Shenmen （HT 7）, and routine points plus the above-mentioned three points together respectively. The scale of elderly cognitive function （SECF） was measured before and after the treatment for statistical management. Results： The total score of SECF was markedly increased after Baihui （GV 20）, Shuigou （GV 26） and Shenmen （HT 7） were added to the routine points, more specifically, with addition of Baihui （GV 20）, the patients with VD got increased scores in such aspects as orientation, instant memory, long-term anamnesis, animal names, cancellation and calculation, and classification and analogy; with addition of Shuigou （GV 26）, the patients with VD got increased scores in such aspects as orientation, cancellation and calculation, and classification and analogy; with addition of Shenmen （HT 7）, the patients with VD got increased scores in such aspects as digital scope, animal names, and classification and analogy. Conclusion： Baihui （GV 20）, Shuigou （GV 26） and Shenmen （HT 7） could improve the cognitive function of patients with VD, and the combination of the three points got the best result despite their respective specificity.

CLINICAL OBSERVATION ON 32 CASES OF FUNCTIONAL ENURESIS TREATED WITH ACUPUNCTURE AT BAIHUI(GV 20)

Acupuncture at Baihui（GV 20）was employed in treating 32 cases of functionalenuresis.As a result,the curative rate reached 81.25％,but that in control group of 32 cases withoutneedling Baihui point was 56.25％.There was a significant difference in statistics（P【0.05）.It indi- cates that Baihui can enhance the therapeutic effect of acupuncture on treating enuresis.

A COMPARATIVE STUDY ON THE TREATMENT OF VASCULAR DEMENTIA BY PUNCTURING BAIHUI (GV20), SHUIGOU (GV26) AND SHENMEN (HT7)

Objective: To observe the relative specialty of the therapeutic effect of acupuncture of Baihui (百会 GV 20), Shuigou (水沟 GV 26) a nd Shenmen (神门 HT 7) in the treatment of vascular dementia (VD) patients. Methods: F ifty VD patients were randomly divided into routine treatment group (control gro up), Baihui (GV 20) group (GV 20 group), Shuigou (GV 26) group (GV 26 gr oup), Shenmen (HT 7) group (HT 7 group) a nd GV 20+GV 26+HT 7 group (joint treatment group), with 10 cases in ea ch group. In control group, acupoints used were Jianyu (肩NFDA1 LI 15), Quchi (曲池 L I 11), Waiguan (外关 TE 5), etc. (which were also used in the other four groups) on the paralyzed side. The treatment was conducted once a day except weekends, 20 session s all together. Clinical Dementia Rating Scale (CDR), Mini-Mental State Examin at ion (MMSE) test, Blessed Dementia Rating Scale (BDR) and Clinical Neurological D eficit Rating (CNDR) were used to assess the patients’ intelligence state befor e and after acupuncture treatment. Results: After acupuncture tr eatment, the VD patients’ intelligence in all the five groups was improved at different degrees . Additional acupuncture of each of GV 20, GV 26 and HT 7 had a remarkable e ffec t in improving the VD patients’ fluid intelligence, and could obviously promote their abilities of temporal orientation, spatial orientation and figure drawing ; and additional joint acupuncture of the three acupoints could improve their co gnitive and non-cognitive functions, such as reducing the severity of dementia , raising the temporal orientation, spatial orientation, calculation, short-term m emory and figure drawing abilities, and improving their activities of daily livi ng and personality. Besides, acupuncture of GV 20 could improve the abilities of calculation and short term memory, and correct the personality change of VD pat ients, while acupuncture of GV 26 could improve the abilities of naming and sh or t-term memory. Conclusion: Acupuncture of GV 20, GV 26 and HT 7 all had a certai n therapeutic effect in improving VD; the therapeutic effects of acupuncture of GV 20 and GV 26 were better than that of acupuncture of HT 7; and the effica cy of the three points used in combination was the best.

Acupuncture through Baihui (DU20) to Qubin (GB7) mitigates neurological impairment after intracerebral hemorrhage

Inflammation plays an important role in nerve defects caused by intracerebral hemorrhage. Repairing brain damage by inhibiting the macrophage-inducible C-type lectin/spleen tyrosine kinase （Mincle/Syk） signaling pathway is a potential new target for treating cerebral hemorrhage. In this study, we aimed to determine whether acupuncture through Baihui （DU20） to Qubin （GBT） is an effective treatment for intracerebral hemorrhage through the Mincle/Syk signaling pathway. An intracerebral hemorrhage rat model was established by autol- ogous blood infusion into the caudate nucleus. Acupuncture through Baihui to Qubin was performed for 30 minutes, once every 12 hours, for a total of three times. Piceatannol （34.62 mg/kg）, a Syk inhibitor, was intraperitoneally injected as a control. Modified neurological severity score was used to assess neurological function. Brain water content was measured. Immunohistochemistry and western blot assay were used to detect immunoreactivity and protein expression levels of Minde, Syk, and CARD9. Real-time polymerase chain reaction was used to determine interleukin-1[~ mRNA levels. Hematoxylin-eosin staining was performed to observe histopathological changes. Our re- suits showed that acupuncture through Baihui to Qubin remarkably improved neurological function and brain water content, and inhibited immunoreactivity and expression of Mincle, Syk, CARDg, and interkeukin-1β Moreover, this effect was similar to piceatannol. These find- ings suggest that acupuncture through Baihui to Qubin can improve neurological impairment after cerebral hemorrhage by inhibiting the Mincle/Syk signaling pathway.

Electroacupuncture at Baihui (DU20) acupoint upregulates mRNA expression of NeuroD molecules in the brains of newborn rats suffering in utero fetal distress

Neuro D plays a key regulatory effect on differentiation of neural stem cells into mature neurons in the brain.Thus,we assumed that electroacupuncture at Baihui（DU20） acupoint in newborn rats exposed to in utero fetal distress would influence expression of Neuro D.Electroacupuncture at Baihui was performed for 20 minutes on 3-day-old（Day 3） newborn Sprague-Dawley rats exposed to in utero fetal distress;electroacupuncture parameters consisted of sparse and dense waves at a frequency of 2–10 Hz.Real-time fluorescent quantitative PCR results demonstrated that m RNA expression of Neuro D,a molecule that indicates Neuro D,increased with prolonged time in brains of newborn rats,and peaked on Day 22.The level of m RNA expression was similar between Day 16 and Day 35.These findings suggest that electro acupuncture at Baihui acupoint could effectively increase m RNA expression of molecules involved in Neuro D in the brains of newborn rats exposed to in utero fetal distress.

针刺百会、曲鬓穴对急性期脑出血大鼠的影响及其作用机制研究

目的 观察针刺百会、曲鬓穴对急性期脑出血(ICH)大鼠白细胞分化抗原36(CD36)、Toll样受体4(TLR4)表达的影响,探讨针刺治疗脑出血的作用机制。方法 选择144只Wistar雄性大鼠,采用随机数字表法分为假手术组、模型组、针刺组、抑制剂组4组,每组36只,每组按1、3、7 d时间点再分为3个亚组,每组12只。采用立体定位自体血注入法建立ICH大鼠模型。模型组仅接受ICH模型制备,不进行任何治疗;假手术组接受类似模型组各项手术操作,但不进行注血制作;抑制剂组造模后6 h,腹腔注射TLR4抑制剂TAK242,3 mg/kg,1次/d,连续5 d;造模12 h后,针刺组各亚组开始接受针刺治疗,穴位选择百会穴(顶骨正中)、右侧曲鬓穴,采用透刺方法,进针深度20 mm,以100 r/min小幅度捻转,持续捻转2 min,每间隔5 min捻针1次,共留针30 min,期间捻转3次,1次/d,针刺组各亚组分别治疗1、3、7 d。分别于治疗后第1、3、7天,采用改良神经功能缺损评分(mNSS)评估大鼠神经功能;检测脑组织血肿体积;采用Western blot法检测脑组织CD36、TLR4蛋白表达水平;采用免疫荧光法观察CD36、TLR4在星形胶质细胞中的表达。结果 (1) mNSS评分:与假手术组同一时间点比较,模型组、针刺组、抑制剂组治疗后1、3、7 d mNSS评分均明显升高(P<0.05);与模型组同一时间点比较,针刺组、抑制剂组治疗后1、3、7 d mNSS评分均明显降低(P<0.05);与针刺组同一时间点比较,抑制剂组治疗后1 d mNSS评分明显降低(P<0.05)。(2)血肿体积:与模型组同一时间点比较,针刺组、抑制剂组治疗后3、7 d脑血肿体积均明显降低,抑制剂组治疗后1、3、7 d脑血肿体积明显降低(P<0.05);与针刺组同一时间点比较,抑制剂组治疗后1、3、7 d脑血肿体积明显降低(P<0.05)。(3) CD36、TLR4蛋白表达水平:与假手术组同一时间点比较,模型组、针刺组、抑制剂组治疗后1、3、7 d CD36、TLR4蛋白表达水平均明显升高(P<0.05);与模型组同一时间点比较,针刺组、抑制剂组治疗后1、3、7 d CD36蛋白表达水平均明显升高(P<0.05),针刺组、抑制剂组治疗后3、7 d TLR4蛋白表达水平均明显降低(P<0.05);与针刺组比较,抑制剂组治疗后1、3、7 d CD36蛋白表达水平均明显升高,TLR4蛋白表达水平均明显降低(P<0.05)。(4) CD36、TLR4在GFAP中的表达水平:假手术组大鼠脑组织内可见少量CD36、TLR4表达。与假手术组同一时间点比较,模型组治疗后1、3、7 d CD36、TLR4在GFAP表达均明显增加(P<0.05);与模型组同一时间点比较,抑制剂组、针刺组治疗后1、3、7 d CD36在GFAP表达明显增加,TLR4在GFAP表达明显降低(P<0.05)。结论 针刺百会、曲鬓穴可以改善急性期ICH大鼠神经功能,减轻脑出血血肿体积,可能与促进CD36蛋白表达、抑制TLR4蛋白表达有关。

Hippocampal gene expression in a rat model of depression after electroacupuncture at the Baihui and Yintang acupoints

Preliminary basic research and clinical findings have demonstrated that electroacupuncture ther- apy exhibits positive effects in ameliorating depression. However, most studies of the underlying mechanism are at the single gene level; there are few reports regarding the mechanism at the whole-genome level. Using a rat genomic gene-chip, we profiled hippocampal gene expression changes in rats after electroacupuncture therapy. Electroacupuncture therapy alleviated depres- sion-related manifestations in the model rats. Using gene-chip analysis, we demonstrated that electroacupuncture at Baihui （DU20） and Yintang （EX-HN3） regulates the expression of 21 genes. Real-time PCR showed that the genes Vgf, lgf2, Trnp32, Loc500373, Hifla, Folrl, Nrnb, and Rtn were upregulated or downregulated in depression and that their expression tended to nor- malize after electroacupuncture therapy. These results indicate that electroacupuncture at Baihui and Yintang modulates depression by regulating the expression of particular genes.

A Comparative Study on the Acupoints of Specialty of Baihui, Shuigou and Shenmen in Treating Vascular Dementia

Objective： To study the relative specialty of the acupoints of Baihui （DU20）, Shuigou （DU26） and Shenmen （HTT） in treating vascular dementia （VD）. Methods： Fifty patients suffering from VD were divided into 5 groups randomly and treated by conventional acupuncture for hemiplegia, or conventional acupuncture plus needling in DU20, DU26, HT7 respectively or simultaneously. Clinical symptoms were observed, and the scales such as Hasegawa＇s dementia scale-recension （HDS-R）, activities of daily living （ADL） and functional activities questionnaire （FAQ） were used for assessment before and after acupuncture treatment. The scores were processed statistically. Results： DU20 and HT7 could improve the abilities of memory, orientation, reaction and reduce adamancy and trance. Bedsides, DU 20 was helpful in improving the abilities of understanding, calculating and social adapting. While DU26 is helpful in treating retardation, failure in daily activities, trance and poor memory. The combination of the 3 acupoints could improve the intelligence and social adapting ability of VD patients. Conclusion： DU20, DU26 and HT7 had its own effect in treating VD, but the effect of three points used in combination was the best.

Effect of electroacupuncture at Neiguan(PC 6) and Baihui(GV 20) on CHOP and caspase-12 gene expressions in rats after ischemia-reperfusion injury

Objective： To investigate the effects of electroacupuncture （EA） at Neiguan （PC 6） and Baihui （GV 20） by observing the changes of CCAAT/enhancer-binding protein（C/EBP） homologous protein （CHOP） and caspase-12 gene expressions in rats after cerebral ischemia-reperfusion injury （IRI）, and explore whether the apoptosis pathway of endoplasmic reticulum stress （ERS） is involved in the protective mechanisms of EA. Methods： Sixty rats were randomly assigned to five groups （12 in each group）： a normal control group （group A）, a sham-operation group （group B）, an operation group （group C）, an Edaravone group （group D） and an EA group （group E）. The cerebral IRI rat model was induced by middle cerebral artery occlusion （MCAO） using intraluminal monofilament. 2,3,5-triphenyl tetrazolium chloride （TTC） staining was adopted in the measurement of cerebral infarction volume. Real-time polymerase chain reaction （RT-PCR） was used to determine the mRNA expressions of CHOP and caspase-12. Results： Compared with group A and group B, the volume of cerebral infarction and mRNA expressions of CHOP and caspase-12 in group C, group D and group E were increased, with statistical significances （P〈0.05 or P〈O.01）; compared with group C, the volume of cerebral infarction and mRNA expressions of CHOP and caspase-12 in group D and group E were decreased significantly （P〈0.05 or P〈0.01）; there were no significant differences between group D and group E in comparing the above items （P〉0.05）. Conclusion： EA at Neiguan （PC 6） and Baihui （GV 20） can effectively suppress the volume of cerebral infarction. Furthermore, the underlying mechanism of EA at Neiguan （PC 6） and Baihui （GV 20） is possibly related to the down-regulation of CHOP and caspase-12 mRNA expressions, so as to decrease cell apoptosis.

Forty Cases of Insomnia Treated by Suspended Moxibustion at Baihui (GV 20)

Objective： To observe the therapeutic effect of suspended moxibustion at Baihui （GV 20） for insomnia. Methods： 75 cases were divided randomly into two groups, with 40 cases in the treatment group treated by suspended moxibustion over Baihui （GV 20） and 35 cases in the control group treated by oral administration of Estazolam. Results： The difference in therapeutic effect between the two groups was not statistically significant （P〉0.1）. Conelusion： It was concluded that suspended moxibustion at Baihui （GV 20） is as effective as Estazolam for insomnia.

Effect of long-time needle retaining at Baihui(GV 20) on cognitive impairment in post-stroke patients

Objective： To observe the clinical efficacy of long-time needle retaining at Baihui（GV 20） in treating post-stroke cognitive impairment. Methods： A total of 60 eligible patients with post-stroke cognitive impairment were randomized into a treatment group and a control group by random digital table, 30 cases in each group. The control group was intervened by basic treatment including routine therapy in Neurology department and Western medicine rehabilitation therapy, while the treatment group was intervened by same treatment in the control group combined with long-time needle retaining at Baihui（GV 20）. Mental state of patients was evaluated by National Institute of Health stroke scale（NIHSS） and mini-mental state examination（MMSE） after 4 weeks of treatment. Results： After 4-week treatment, the NIHSS score dropped in both groups, and intra-group comparisons showed statistical significances（both P〈0.05）, and the score in the treatment group was statistically lower than that in the control group（P〈0.01）; the MMSE score in the treatment group was significantly higher than that in the control group, there was a statistical inter-group difference（P〈0.01）; the total effective rate was 93.3%, and the marked effective rate was 50.0% in the treatment group, versus 76.7% and 20.0% in the control group, there were significant differences in the total effective rate and the marked effective rate between the two groups（all P〈0.05）. Conclusion： Long-time needle retaining at Baihui（GV 20） can produce a safe valid therapeutic efficacy in treating post-stroke cognitive impairment.

《史记·扁鹊仓公列传》“外三阳五会”新考

在既往研究基础之上,结合《素问·缪刺论篇》《针灸甲乙经·缪刺》及出土汉代医简等现有证据,并基于胡天雄、黄龙祥的学术观点,考证《史记·扁鹊仓公列传》中“外三阳五会”具体指代何经、何穴。认为《素问·缪刺论篇》尸厥一条与《史记·扁鹊仓公列传》关系密切,应采录自扁鹊医书,但因传世本《素问·缪刺论篇》对扁鹊医书原文抄录有误,具体为心主之误、阴阳之误、穴位之误,造成了“外三阳五会”解读上的错误。经考证与校订,认为“外三阳五会”所指应为关冲、足窍阴、少泽、至阴、厉兑五穴。

Clinical observation on moxibustion at Baihui(GV20)plus Tuina for children with postnasal drip syndrome

Objective:To observe the clinical efficacy of moxibustion at Baihui(GV20)plus Tuina(Chinese therapeutic massage)for children with postnasal drip syndrome(PNDS).Methods:A total of 60 cases were divided into an observation group and a control group according to the random number table method,with 30 cases in each group.Cases in the control group received mometasone furoate nasal spray and nasal irrigation with 0.9%normal saline.Cases in the observation group received additional moxibustion at Baihui(GV20)plus Tuina at the head and face.All the cases were treated for four consecutive weeks.The clinical efficacy and traditional Chinese medicine(TCM)symptoms score were compared between the two groups.Results:The total effective rate of the observation group was 93.3%while that of the control group was 70.0%.The difference between the two groups was statistically significant(P<0.05).After treatment,the TCM symptom scores in both groups declined significantly,showing a statistical difference from that before treatment(P<0.05),and the score of the observation group was notably lower than that of the control group(P<0.05).Conclusion:The clinical efficacy of moxibustion at Baihui(GV20)plus Tuina at the head and face on the basis of nasal spray with Western medicine is more significant than that of Western medicine alone for PNDS in children.

Treatment of 35 Cases of Parietal Headache with Baihui （GV20） and Taichong （LR 3）

针刺百会和双侧太冲穴，治疗巅顶痛患者35例，痊愈14例，显效13例，好转6例，无效2例，总有效率94．3％。

艾灸健康人百会穴对脑血管血液动力学的影响

目的：探讨艾灸百会穴治疗脑血管病的可能机制。方法：选择本校健康男性学员30名,年龄20-22岁。取百会穴,悬起温和灸,每次5-10 min,每日1次,共5次。应用上海麦登电子设备有限公司生产的脑血管血液动力学分析仪（CBA CV-300型）,探头频率5 MHz,由固定专人操作,分别于艾灸治疗前及艾灸治疗后测试脑血管血液动力学各项指标。结果：艾灸百会穴5 d后,受试者收缩压、舒张压及心率虽有不同程度的变化,但与艾灸前比较无统计学差异（P〉0.05）;左右两侧颈总动脉血液Qmean（平均流量）、Vmean（平均流速）及Vmin（最小流速）增加显著（P〈0.01）,脑血管Rv（外周阻力）、DR（动态阻力）明显降低（P〈0.05）。结论：艾灸健康人百会穴可使颈总动脉血流速度明显加快,脑部外周血管阻力明显降低,脑部血液供应明显改善。这对揭示艾灸百会穴治疗缺血性脑血管病的机制具有一定的意义。

艾灸健康人百会穴对右侧大脑中、后动脉血流动力学影响的研究

目的 :探讨艾灸百会穴治疗缺血性脑血管病的机理。方法 :选择本校健康男性学员 3 0名 ,年龄 2 0～ 2 2岁之间 ,应用美国AcusonSequoia51 2型超声诊断仪 ,探头频率 4 0MHz,由固定专人操作 ,分别于艾灸前及艾灸后 ,测试右侧大脑中、后动脉Vmax(最大血流速度 )、Vmin(最小血流速度 )、PI (搏动指数 )、RI (阻力指数 )等血流动力学有关参数。结果 :艾灸百会穴 5天后 ,右侧大脑后动脉Vmin增加显著 (P <0 0 5) ,右侧大脑中动脉Vmax、Vmin及右侧大脑后动脉Vmax、PI、RI增加非常显著 (P <0 0 1 ) ,右侧大脑中动脉PI、RI各指标虽有不同程度的改变 ,但无统计学意义。结论 :艾灸百会穴可使右侧大脑中、后动脉血流速度明显加快 ,脑血流量增加 ,脑部血液循环明显改善。这对揭示艾灸百会穴治疗缺血性脑血管病的机理具有重要意义。

针刺配合艾灸百会穴治疗中风后失眠疗效观察

目的观察针刺配合艾灸百会穴治疗中风后失眠的临床疗效。方法将65例中风后失眠患者随机分为治疗组33例和对照组32例。治疗组采用针刺配合艾灸百会穴治疗,对照组采用常规针刺治疗。观察两组治疗前后SPIEGEL量表评分及脑卒中专用生活质量量表(SS-QOL)评分变化情况,并比较两组临床疗效。结果两组治疗后SPIEGEL量表评分和SS-QOL评分与同组治疗前比较,差异均具有统计学意义(P<0.05)。治疗组治疗后SPIEGEL量表评分和SS-QOL评分与对照组比较,差异均具有统计学意义(P<0.05)。治疗组总有效率为93.9%,对照组为68.8%,两组比较差异具有统计学意义(P<0.05)。结论针刺配合艾灸百会穴是一种治疗中风后失眠的有效方法。

电针百会穴对脑梗死后认知障碍患者听觉P300的影响

目的观察电针百会穴对脑梗死后认知障碍患者听觉事件相关电位P300的影响。方法将59例脑梗死患者随机分为治疗组30例和对照组29例。治疗组采用电针配合认知功能训练治疗,对照组采用单纯认知功能训练治疗。比较两组治疗前后蒙特利尔认知评价量表(MoCA)评分及P300检测情况。结果两组患者治疗后MoCA量表各项评分与同组治疗前比较,差异均具有统计学意义(P<0.05)。除言语项目外,治疗组患者治疗后MoCA量表各项评分与对照组比较,差异均具有统计学意义(P<0.05)。两组治疗后P300潜伏期、波幅与同组治疗前比较,差异均具有统计学意义(P<0.01)。治疗组治疗后P300潜伏期、波幅与对照组比较,差异均具有统计学意义(P<0.05)。P300潜伏期与MoCA评分呈负相关性,P300波幅与MoCA评分呈正相关性。结论电针百会能改善脑梗死后认知障碍患者的认知功能。