Effects of pricking blood therapy at meridian sinews on upper limb spasm of post-stroke patients

Objective:To observe effects of pricking blood therapy at meridian sinews on upper limb spasm of poststroke patients.Methods:A total of 72 patients with post-stroke upper limb spasm were randomly divided into a comprehensive group of pricking blood therapy at meridian sinews with rehabilitation training(comprehensive group)and the simple rehabilitation training group(rehabilitation group),and there were 36 patients in each group.On the basis of routine therapy,the patients of the two groups received rehabilitation therapy for 6 consecutive days and 1-day rest,for 4 weeks in total.On the above basis,the patients in the comprehensive group received pricking blood therapy at meridian sinews,once every other day,3 times per week,for 4 weeks in total.Before treatment,after the first treatment,and after 4-week treatment,the patients were observed for changes of upper limb spasticity(Modified Ashworth Scale,MAS),upper limb movement function(Fugl-Meyer Assessment,FMA),activity of daily living(Modified Barthel Index,MBI),and biceps and triceps integrated electromyogram(IEMG)values were observed as well as the therapeutic effects.Results:(1)After the first treatment,there were statistically significant differences of the MAS scale grades in patients of the two groups(P<0.05).The FMA scores in the comprehensive group were increased than that before treatment(P<0.05),and the MBI scores of the two groups were increased than those before treatment(both P<0.05).The FMA and MBI scores in the comprehensive group were higher than those of the rehabilitation group(both P<0.05).The biceps and triceps IEMG values were not improved than those before treatment(all P>0.05).(2)After 4-week treatment,there were statistically significant differences of MAS grades in patients of the two groups(P<0.05).The FMA and MBI scores in the two groups were increased than those before treatment(all P<0.05),and the FMA and MBI scores in the comprehensive group were higher than those in the rehabilitation group(both P<0.05).Through comparison of the differences of FMA and MBI scores of the two groups,the difference values in the comprehensive group were higher than those of the rehabilitation group(both P<0.05).The biceps and triceps IEMG values in the two groups were decreased than those before treatment(all P<0.05),and those in the comprehensive group were lower than those in the rehabilitation group(both P<0.05).The biceps and triceps IEMG values in patients of the comprehensive group were higher than those before treatment(both P<0.05).(3)After 4-week treatment,the total effective rate in the comprehensive group was 83.3%(30/36),and that was 58.3%(21/36)in the rehabilitation group.The total effective rate in the comprehensive group was higher than that in the rehabilitation group(P<0.05).Conclusions:The pricking blood therapy at meridian sinews can release affected upper limb flexor muscle spasticity and movement function of the patients with post-stroke upper limb spasm,decrease biceps IEMG values of the affected side,and improve activities of daily living.

A Novel Apprehension of the Primary Lung Meridian, Sinew Channel, Divergent Channel, Luo-Connecting Channel Acting as a Single Unit System to Serve Respiration Function Based on Modern Neurophysiology and Kinesiology

The TCM philosophy of a meridian and associated channels pertains to the specific function of one or more organs. We define the Lung Primary Meridian (LUM) together with the Lung Sinew (LUSC), Divergent (LUDC), Luo-connecting (LULCC) Channels as a system of routes plus some parts of the body (such as muscles) to fulfil respiration, as a main function under different situations. There is very limited information about the Lung associated channels in classical literature of TCM. With a clear focus on the function of respiration, we have carried out a detailed analysis of the biomedical consequence of stimulating the LUM, analysed the roles played by LUSC, LUDC, and LULCC. The updated LUM and LUDC include acupoints of other meridians, serving the same purpose of performing satisfactory respiration starting from checking the quality of the inflow through the nose. The LUSC includes the respiratory muscles (plus the associated connective tissues) extending to various parts of the body. The muscles of the limb (as part of the LUSC) embrace the nerves that provide routes for somatosensory reflexes and play the role of locomotion, providing voluntary respiration via the pectoralis muscles. The muscles of LUSC are bounded by stiff connective tissue layers, forming compartments, and are part of the pulley system for various body locomotions. Within a compartment, the interstitial fluid, blood, lymph flows must be potent to protect the associated nerves related to LUM;the healthy state of the LUSC also provides freedom of various types of locomotion. The LULCC exists because the vagus nerve has a part of it passing through the spinal cords all the way down to the sacrum domain, with exiting nerve innervating two-third of the large intestine. The crucial steps of our deductions are supported by experimental evidence based on modern neurophysiology and kinesiology. We discover that all the four channels stated above work as a unit system to allow respiration to be possible under various postures/conditions. The complexity of structures and processes is eased off by providing 29 figures and 13 tables for the relevant muscles and nerves. In addition to respiration, the Lung system in TCM context includes interaction of this system with the sweat gland and neuroendocrine system;such aspects will be left to another study.

Influence of muscle regions of meridians needling method combined with auricular point sticking on pain and range of motion in patients with chronic nonspecific low back pain

Objective:To observe the effects of muscle regions of meridians needling method combined with auricular point sticking on pain and lumbar range of motion in patients with chronic nonspecific low back pain.Methods:A total of 100 patients with chronic nonspecific low back pain were randomly divided into a control group and an observation group,with 50 patients in each group.Both groups received auricular point sticking treatment,while the control group received additional conventional acupuncture treatment,and the observation group received additional muscle regions of meridians needling method.The total effective rate of the two groups was compared after 4 weeks of treatment.Before treatment and after 1 week and 4 weeks of treatment,the visual analog scale(VAS)score was used to assess the degree of low back pain,and the modified-modified Schober(MMS)score was used to evaluate the lumbar range of motion.Results:There was statistical significance in comparing the total effective rate between the two groups(P<0.01).During the treatment process,as the number of treatments increased,the VAS score gradually decreased,and the MMS score gradually increased in both groups.After 1 week and 4 weeks of treatment,the VAS score in the observation group was lower than that in the control group(P<0.01),and the MMS score in the observation group was higher than that in the control group(P<0.01).During the treatment period,no serious adverse reactions occurred in either group.Conclusion:Based on auricular point sticking treatment,muscle regions of meridians needling method is more effective than conventional acupuncture in treating chronic nonspecific low back pain since it is able to significantly reduce the pain and improve the lumbar range of motion.

Revitalization and application of ancient round-sharp needle based on Nèijīng

The emergence of nine needles in Nèijīng（《内经》, The Inner Classic） laid a foundation for the formation and development of needling instruments and acupuncture manipulation in later ages, but the application of nine needles was not realized during clinical practice of acupuncture-moxibustion in later ages. Round-sharp needle is one of the nine needles. In this study, round-sharp needle was taken as an example to introduce the excavation and revitalization of nine needles and diagnosis and treatment rules explored by Mr. CHEN Lixin according to The Inner Classic. The needle shape, needling manipulation and clinical application of round-sharp needle based on The Inner Classic were described in detail.

Combined acupuncture and Chinese herb decoction for 5 cases with graphospasm

Combined acupuncture and Chinese herb decoction were applied for 5 cases with graphospasm.Acupuncture included scalp acupuncture and body acupuncture.Using transcranial repeated needling,Baihui(百会GV20),Chorea-trembling controlled area,Emotional area,as well as Dazhui(大椎GV14),Fengchi(风池GB20),and Yingxiang(迎香EX-HN8)etc.were stimulated by proposed by Sun Shentian.Meanwhile,the patients took orally Chinese herb decoction,on the basis of the Siwu decoction(四物汤four substances decoction)addition and subtraction,relieve symptoms under syndrome differentiation.The treatment was carried out for 4 courses in total.One course consisted of 5 days,with an interval of 2 days between two courses.After treatment of 5 patients,2 patients were cured,2 patients achieved markedly effective response,and 1 patient achieved effective response.

A Reflection on the Management and Treatment of Cervical Spine Neuropathies with East Asian Medicine:Acupuncture

There is much material demonstrating the use of acupuncture and moxibustion as an effective method of treatment in a variety of neurological conditions involving both peripheral and central nervous system dysfunction. Acupuncture＇s effects are experienced throughout the body but specifically acupuncture can be seen to contribute significantly to nerve metabolism and rebuilding. However, very little is written on the mechanisms for this nerve recovery. This paper will reflect on these mechanisms in relation to the treatment of neck problems associated with nerve root impingement.

Treatment of 78 patients with knee osteoarthritis by acupuncture, moxibustion, and tuina

Objective To observe the clinical efficacy of triple-therapy in treatment of knee osteoarthritis（KOA）. Methods Meridian sinew needling, tendonsoothing maneuver and medicine moxa sticks were applied for treatment of 78 patients with knee osteoarthritis, and clinical efficacy was evaluated after treatment for two weeks by reference to Guidelines for Diagnosis and Treatment of Osteoarthritis. Results The therapy was markedly effective in 28 cases（35.8%）, and effective in 45 cases（57.8%）, with the total effective rate of 93.6%. Conclusion Meridian sinew needling, tendon-soothing maneuver and medicine moxa sticks promote each other mutually, and triple-therapy is confirmed to be one of the effectively complex treatment methods in treatment of KOA.

Therapy of auricular subcutaneous penetration needling combined with row acupuncture at the meridian sinew in 103 cases of prolapse of lumbar intervertebral disc

Objective To observe the clinical efficacy of auricular subcutaneous penetration needling combining with row acupuncture at meridian sinew on prolapse of lumbar intervertebral disc. Methods One hundred and three patients with prolapse of lumbar intervertebral disc were treated with a combined treatment of auricular subcutaneous penetration needling and row acupuncture at meridian sinew. Results Of 103 patients, 46 cases were cured, 33 were markedly effective, 21 effective and 3 ineffective. The total effective rate was 97.1% （100/103）. Conclusion The combined treatment of auricular subcutaneous penetration needling and row acupuncture at meridian sinew has a significant efficacy for the treatment of prolapse of lumbar intervertebral disc.

Effect of meridian sinew row needling combined with dermal needling on spasticity of post-stroke patients with upper limb hemiparalysis: a multi-center randomized controlled trial

Objective To explore the effect of meridian sinew row needling combined with dermal needling on spasticity of post-stroke patients with upper limb hemiparalysis. Methods Four hundred and eighty-eight cases of post-stroke patients with upper limb spasticity were randomly divided into two groups at the ratio of 1： 1, the group of meridian sinew row needling combined with dermal needling （group A, 244 cases） and western medication group （group B, 244 cases）. Coupled with rehabilitation, the patients in the group A were given meridian sinew row needling combined with dermal needling where five shu points were specifically selected, and three yang meridians of the hand were treated with acupuncture with muscle region, and three yin meridians of the hand were treated with dermal needles; the patients in the group B was treated with conventional western medication with piracetam injection and cerebroprotein hydrolysate included. Clinical efficacy was evaluated among patients in the two groups after three weeks of continuous treatment, and upper limb spasticity and motor functions were observed through modified Asworth Scale and FugI-Meyer Assessment Scale （FMA） before and after treatment. Results For Asworth Scale, group A was significantly superior to group B （3.04 ± 1.29 vs 3.88 ± 1.54, P〈0.05）; for FMA scale, group A was also significantly superior to group B （48.67± 15.64 vs 42.96±14.72, P〈0.05）; mitigations of motor status of upper limb joints in group A, such as remission of shoulder adduction （90.5%）, pronation of forearm （70.7%）, elbow joint flexion （73.1%）, wrist joint flexion （80.9%） and finger flexion （88.1%）, were superior to those of group B （70.0%, 60.0%, 61.9%, 57.4%, 63.2%, all P〈0.05）. Conclusion Good clinical efficacy of the treatment with combined with dermal needling on spasticity of post-stroke patients with upper limb hemiparalysis is achieved.

A randomized controlled trail on the treatment of knee osteoarthritis with acupotomy therapy based on the meridian sinew theory

Objective: To compare the clinical efficacy differences of acupotomy therapy guided by the meridian sinew theory and acupotomy therapy guided by the anatomy theory of western medicine in the treatment of knee osteoarthritis.Methods: Sixty-three patients were randomly divided into the acupotomy group of the meridian sinew theory(Group A, n = 32) and the acupotomy group of the anatomy theory(Group B. n = 31). For Group A, with positive reaction points such as the tenderness points of three yang meridians and three yin meridians of the foot, and funicular nodules as the points of needle insertion, the needle-knife, after disinfection and anesthesia, gives priority to longitudinal dissection after insertion, and then carries out subcutaneous sweeping maniplation. For Group B, with 8 points for needle insertion, including the origins and terminations of the medial and lateral collateral ligaments, the origins and terminations of the patellar ligament, the terminations of the quadriceps femoris tendon, and pes anserinus bursa point, the treatment was performed in strict accordance with the four-step procedures of acupotomy(positioning,orientating, pressurizing to separate, and puncturing) after disinfection and anesthesia. The treatment was conducted once a week and three times in total. Statistical analysis was conducted with the Western Ontario and McMaster Universities(WOMAC) Osteoarthritis Index and Visual Analogue Scale(VAS)for overall pain before treatment and at week 2 and 4 during treatment, and the adverse reactions of patients were observed and recorded to evaluate the curative effect.Results: During the treatment period, the overall response rates(ORRs, that is markedly effective + effective) were compared between the two groups. The ORR of Group A was 90.63% and that of Group B was 87.09%. There was no statistical significant difference between the two groups(P>0.05).After treatment, the WOMAC function score of Group A was significantly lower than that before treatment(17.28 ±10.22 vs 32.75 ± 14.88, P <0.001), and that of Group B was lower than that before treatment(24.87 ±16.48 vs 30.90 ±16.64, P< 0.05). there was a statistical significant difference between the two groups(P<0.05). As for the comparison of VAS pain scores, in Group A, there was statistical significant difference(4.48 ± 1.60 vs 5.05 ± 1.60. P< 0.05) between at Week 2 and before treatment, and statistically significant difference(1.88 ± 1.03 vs 5.05 ± 1.60, P<0.001) between at Week 4 and before treatment.In Group B, there was no significant difference(P>0.05) between at Week 2 and before treatment, and there was statistically significant difference(3.31 ± 1.56 vs 4.77 ± 1.68, P<0.001) between at Week 4 and before treatment. The VAS pain score of Group A was significantly lower than that of Group B(P< 0.001),and 2 cases of mild adverse reactions occurred in Group A and 3 in Group B.Conclusion: Both acupotomy therapies guided by the meridian sinew theory and by the anatomy theory of Western medicine have good curative effect on knee osteoarthritis, but acupotomy guided by the meridian sinew theory has more superiorities in operability, safety and effectiveness, which is easy to be generalized in grass-roots and community hospitals.

Analgesic Effect of Sinew Acupuncture for Patients with Soft-Tissue Injuries: A Pilot Trial

Objective: To investigate the immediate analgesic effect of sinew acupuncture for patients with soft-tissue injuries (STIs). Methods: Two hundreds eligible adult patients suffering from STIs were recruited and received sinew acupuncture with flexible treatment schedules. The number of treatment sessions was pragmatically decided by each patient on the basis of their pain relief. The outcome measurement was the change of pain rating in the Visual Analogue Scale (VAS) during the first 5 sessions. The adverse effect was also observed. Results: Of the 200 patients recruited, 7 were excluded due to incomplete data. In total, 888 sinew acupuncture treatments were administered to patients at 14 injury sites (including head, neck, shoulder, arm, chest, elbow, wrist, hand, waist and hip, knee, thigh, calf, ankle, and foot) where pain was felt. Compared with the baseline, the VAS rating after the first and last treatments were both significantly reduced at all the injury sites (P<0.01). The VAS rating was also significantly reduced after each session of treatment in the first five sessions (P<0.01). No serious adverse effect was observed. Conclusion: Sinew acupuncture had not only an immediate analgesic effect for STIs, but also an accumulated analgesic effect during the first 5 treatment sessions.

Distribution Characteristics of Meridian Sinew(Jingjin) Syndrome in 313 Cases of Whiplash-Associated Disorders

Objective：To investigate and analyze the characteristics of Meridian Sinew（Jingjin） syndrome in patients with whiplash-associated disorders（WAD）.Methods：From August 2010 to September 2011,313 WAD cases from New York and California states were collected.The survey mostly collects the information of ＂Sinew Knotted Points＂ and symptoms of four types of Meridian Sinew differentiation—Taiyang,Shaoyin,Shaoyang and Yangming.Results：Among the cases which are on the average of medium injury level,the higher frequency of ＂Sinew Knotted Points＂ tenderness were found on Jianwaishu（SI 14）,Jianzhongshu（SI 15）,Tianchuang（SI 16）,C3-6 Spinous Process,Dazhui（GV 14）,Fengchi（GB 20）,Tianliao（SJ 15） and Tianding（LI 17）.The most commonly presented symptoms were widespread spasm and tenderness in the neck（Taiyang）,difficulty in lateral flexion（Shaoyang）,problems of extension and flexion（Taiyang）,and stiffness and pain during neck movement（Yangming）.Among the cases,237 cases（75.72%） were related to Taiyang Meridian Sinew syndrome,82 cases（26.20%） to Shaoyin syndrome and 175（55.91%） and176（56.23%） cases to Shaoyang and Yangming syndrome respectively.The most of cases presented in a combination format.The syndrome distribution under Grade Ⅰ,Ⅱ and Ⅲ reflected that more combination of the Meridian Sinew syndromes in the whiplash injury patients which is resulted from more severity of injury.Conclusion：It is practical to identify the location of abnormality through Meridian Sinew differentiation,considering both ＂Sinew Knotted Points＂ tenderness and corresponding symptoms,for the local neck symptoms of WAD.

Therapeutic effect observation on refractory facial paralysis treated with meridian sinew needling therapy

Objective:To observe the differences in the therapeutic effect on refractory facial paralysis between meridian sinew needling therapy and routine penetrating needling therapy.Methods:A total of 46 patients with refractory facial paralysis were randomly divided into a meridian sinew needling group and a routine penetrating needling group,23 cases in each one.The same acupoints were selected in the two groups.Besides using routine acupuncture technique,a part of acupoints were stimulated with the meridian sinew needling technique in the meridian sinew needling group.In the routine penetrating needling group,a part of acupoints were stimulated with the routine penetrating needling technique.In both of the groups,the needles were retained for 30 min and the treatment was given once every two days,10 treatments made one course.A total of 3 courses of treatment were required at the interval of 2 days.The score and grade of facial nerve function were recorded before and after treatment in the patients of the two groups.The clinical therapeutic effect was evaluated.Results:After treatment,the scores of facial nerve function were significantly improved compared with that before treatment in the patients of the two groups(both P<0.05).The difference value of the score of facial nerve function before and after treatment in the meridian sinew needling group was higher than that in the routine penetrating needling group,indicating a statistical significance(P<0.05).The grades of facial nerve function after treatment were different significantly as compared with those before treatment in the patients of the two groups(both P<0.05).However,the difference was not significant between the two groups after treatment(P>0.05).After treatment,the total effective rate in the meridian sinew needling group was 100%,which was higher than 91.3%in the routine penetrating needling group,while without statistical significant difference(P>0.05).Conclusion:Meridian sinew needling therapy of acupuncture greatly improves facial nerve function as compared with routine penetrating needling therapy.It would be an potential effective acupuncture technique for refractory facial paralysis.