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Three cases of endocrine diseases treated by acupuncture at “Tiānyŭu ( TE 16) five acupoints”
World Journal ofAcupuncture-Moxibustion (WJAM) ELSEVIER
• 53 •
Vol. 26, No.1, 30th Mar. 2016
Experience ofExperts Three cases of endocrine diseases treated by acupuncture at "Tianyou (~Jti TE 16) five acupoints"
Jeffl "xXi1i1C" 1itffl*J7tW~~3JJ!U wu Kai-xiao (~it ~)\
ZHUANG Juan-juan (li :!lU~i
1. Department of Rehabilitation Medicine of Hainan Province Nongken Sanya Hospital, Sanya 572000, Hainan Province, China; 2. Clinical Medical College of Acupuncture, Moxibustion and Rehabilitation of Guangzhou University ofCM (1. tfjfl¥i1!fi':.&~-=']f.~~)~Ur~~f4,~1¥i-=']f. 572000, 9='~; 2. )1N9='~ ~*~~ff<:*j[r[{Ij*~~~ ) ARTICLE INFO First author: WU Kai-xiao (1982-), male, attending physician. Research field: study on acupuncture in treatment of clinical diseases E-mail: [email protected] Accepted on November 1, 2015
ABSTRACT To explore and study the significant value of "Tianyou (:XWii TE 16) five acupoints" in treatment of clinical diseases based on analysis of three cases. Case 1: thyroid enlargement. Acupuncture was conducted at Renyfng LA Jill 5T 9), Futu (t1c~ LI 18), Shultu (*~ 5T 10) and Qishe (E(.~ 5T 11), and combined with Neiguan (pg *. PC 6). After ten courses of treatment, nodules and calcified lesions shrank. Case 2: hyperplasia of mammary glands. Acupuncture was conducted at bilateral 5T 9 and TE 16, and combined with Talchong ti\:ilP LR 3) and Danzhong (Jl:9=' CV 17). After eight courses of treatment, the breast lumps disappeared. Case 3: hyperprolactinemia, and amenorrhea for two years. Acupuncture was conducted at bilateral 5T 9, TE 16 and Tianfu (:x!11 LU 3), and combined with LR 3 and Xiaxi (~m GB 43). After eleven courses of treatment, the content of prolactin was normal. KEY WORDS: Tianyou acupuncture
The record of "Tianyou (:x1f TE 16) five acupoints" was first seen in Lingshii ( «3{.flR» , The Miraculous Pivot) [I] which said that Renying (AJ!I! ST 9) is at the artery of lateral neck. ST 9 belongs to foot yangming meridian, and before the sinew of lateral neck. Fum (t1c~ LI 18), behind the sinew of lateral neck, belongs to hand yangming meridian. TE 16 belongs to hand shaoyang meridian, Tianzhu (:XtI: BL 10) belongs to foot taiyang meridian, and Tianfii (*.1# LV 3), at the artery of oxter, belongs to hand taiyin meridian. All these acupoints are "TE 16 five acupoints". In this classic, ST 9, LI 18, TE 16, BL 10 and LV 3 were collectively referred to as "TE 16 five acupoints" because that the five acupoints are located at the neck, and TE 16 is in the center. According to relevant literature and clinical reports, "TE 16 five acupoints" were mostly used in treatment of nervous system diseases, ENT diseases and motor
(:x1li TE 16)
five acupoints; endocrine disease;
system diseases, while the application of "TE 16 five acupoints" in treatment of endocrine diseases was fewer. The cases of endocrine diseases treated with acupuncture at "TE 16 five acupoints" were reported as follows, aiming at appealing to others to pay attention to "TE 16 five acupoints", the field ignored.
THYROID NODULE The patient, female, was 50 years old. She went to hospital on June 25, 2014 for the first time for she found her thyroid was intumescent without other discomfort. The color Doppler ultrasound of thyroid showed: thyroid nodules multiply occurred on left lobe, maximum: 28 X 17 mm, and 11 X 7 mm on right lobe; the echoes were different in nodules with different intensities; lumps were found on the both sides, in which, several bulky, punctuate and calcified lesions were seen. The patient has a history of
·54·
WorldJournal ofAcupuncture-Moxibustion (WJAM) Vol. 26, No.1, 30th Mar. 2016
hysteromyoma. Physical examination showed: thyroid glands can be touched at both sides with the size of 28 X 15 mm, hard texture, and clear margin; there was no haphalgesia, and they were removable. Thyroid function: negative. Acupuncture was conducted at bilateral ST 9, LI 18, Shultii (7.K~ ST 10) and Qishe (~* ST 11), and combined with Neiguan (1*1* PC 6). The needles were retained for 20 min at each time, five times were considered as one course of treatment and five days were free of treatment between two courses. After three courses of treatment, on September 18, 2014, the thyroid nodules and calcified lesions shrank to 22 X 15 mm and 9 X 7 mm from 28 X 17 mm and 11X 7 mm, and the texture was soft. Another two courses of treatment were continued, and the color Doppler ultrasound of thyroid on December 8,2014 showed: the size and shape of thyroid glands at both sides were normal, and the echo was not enough homogeneous. An echolucent with the size of 0.5 cmXOA cmXOA em was found at the bottom of left thyroid gland with smooth margin and normal entrant sound. Note: it is believed in the theory of traditional Chinese medicine that goiter and tumor are formed by qi, phlegm and stasis, and the treatment should be rectify qi and dissolve phlegm, and disperse goiter and dissipate masses. The human anatomy indicates'<" that ST 9 is inside of platysma and at the anterior margin of sternocleidomastoid, on which there is superior thyroid artery. LI 18 is adjacent to ST 9; the complexity and specificity indicate that the two acupoints have significant clinical application value. In addition, it was said in Lingshii (<<~m» The Miraculous Pivot) that "Danzhong (JIf~ CV 17) is the sea of qi, and qi and blood is infused to the top and bottom of BL 10, and to ST 9." ST 9 is the portal of the sea of qi, with the functions of unblocking vessel, direct counterflow downward and rectify qi41• LI 18 is the hand-yangming large intestine meridian, and yangming is meridian full of qi and blood. Acupuncture at the two acupoints can promote free qi and blood circulation inside and outside of vessel, make ying and wei qi unblock, and soothe and moisten meridians. Combining with acupuncture at ST 10 and ST 11 can obtain better efficacy.
HYPERPLASIA OF MAMMARY GLANDS The patient, female, was 46 years old. She went to hospital on October 14,2014 for the first time. She complained that bilateral breast lumps were found through physical examination in November, 2002 after delivery in September, 2002. The breast lumps were
ELSEVIER
removable, with clear margin and local tenderness. The patient was of somnolence, and felt comfortable after sighing. The color Doppler ultrasound of mammary gland on August 15, 2014 showed: polyglandular condition was found in bilateral breast, the right breast was Category 2 of bilateral hypoechoic nodules (BT-RADS), and the left breast was Category 3. Acupuncture was conducted at bilateral ST 9 and TE 16, and combined with Taichong C~itF LR 3) and CV 17. After needling, the patient felt comfortable. The needles were retained for 20 min at each time, five times were considered as one course of treatment, and five days were free of treatment between two courses. After treatment for three courses, the pain of breast relieve, and lumps disappeared. According to reexamination on January 4, 2015, great part of her breast lumps disappeared. The color Doppler ultrasound of mammary gland showed: polyglandular condition was found in bilateral breast, the right breast was Category 0 of bilateral hypoechoic nodules (BTRADS), and the left breast was Category 2. Another course of treatment was continued, and the color Doppler ultrasound of mammary gland on January 27, 2015 showed: bilateral breast was symmetrical with normal shape. The organization structure of bilateral breast was slightly disorder, the echo was slightly thickened and enhanced, and was inhomogeneous. Obvious dilatation of mammary duct was not seen. A hypoechoic nodule with size of 5 mmX7.9 mm was found at the middle ofleft breast near the nipple, close to gland deep layer, with clear margin and regular shape. There was no obvious blood inside of and around the nodule. There was no obvious lump or echo in right breast. Note: hyperplasia of mammary glands belongs to the category of "breast lump" in traditional Chinese medicine, which is usually caused by binding constraint of liver and spleen. Treatment should be soothing the liver and resolving constraint, rectifying the spleen and dissipating masses. Breast is passed through by foot yangming stomach meridian, and ST 9 is affiliated to the meridian and it is a "branch" acupoint, therefore, acupuncture at ST 9 can not only unblock stomach meridian qi, but also dissipate binding constraint of breast. In addition, breasts are located at chest, where is the place of "the sea of qi", while ST 9 is the portal of "the sea of qi". Therefore, acupuncture at ST 9 can soothe meridian qi of chest, and regulate qi and blood of the lesion. Liang[S] et al also demonstrated that ST 9 has specificity in regulating the hormone level of patients with hyperplasia of mammary glands. TE 16 is the hand shaoyang three energizer meridian, ""R." means
ELSEVIER
WorldJournal ofAcupuncture-Moxibustion (WJAM) Vol. 26, No.1, 30th Mar. 2016
heaven, yang; "Ai" means windows. This acupoint name means that meridian qi and blood of the three energizer remove to heaven, and the dominant qi "enters into Quepen (fljk;~ ST 12), distributes in CV 17, and scatters in pericardium". Therefore acupuncture at TE 16 can mobilize yang qi, dispel haze, so as to eliminate breast lumps. Acupuncture at LR 3 can soothe the liver and discharge heat, at CV 17 can rectify qi, therefore, lumps can disappear automatically.
HYPERPROLACTINEMIA The patient, female, was 36 years old. She went to hospital on May 19, 2014. She complained that after cesarean in July, 2010, her bilateral breasts exuded large amount of serous fluid, menstruation was disordered, with little quantity of menses, and she has suffered from amenorrhea for two years. According to examination on March 5, 2014, the content of prolactin was up to 46.3 ng/mL. After treatment with combined therapy of Chinese and western medication, her disease was not healed (not quite clear), so she went to hospital for further treatment. Symptom: amenorrhea for more than two years, bilateral breasts exuded large amount of serous fluid, accompanied with distending pain and chest oppression, swelling in two hands, especially right hand, and dizziness; feeling comfortable after sighing; appetite and sleep were normal; tongue coating was thin, root coating was yellow and greasy, and pulse was deep and thready. Her symptom was liver constraint and qi stagnation, and damp-heat blocking the collaterals. Treatment should be soothing the liver and rectifying qi, and clear damp-heat. Acupuncture was conducted at bilateral ST 9, TE 16 and LV 3, and combined with LR 3 and Xiaxi (1~~ GB 43). The needles were retained for 20 min at each time, seven times were considered as one course of treatment, and five days were free of treatment between two courses. After treatment for three courses, according to reexamination on October 10,2014, the patient complained that breast distending pain relieved, milk regurgitation alleviated sharply, and swelling in hands disappeared. Treatment was continued. According to reexamination on November 5,2014, the patient complained arrival of the menses with moderate amount, and ended five days later. Another course of treatment was continued, and the content of prolactin was 16 ng/mL according to reexamination. So far, there is no relapse. Note: hyperprolactinemia, generally caused by hypothalamus-hypophysis lesion, hypothyroidism, polycystic ovarian syndrome, tumor, after delivery,
• 55 • and other reasons, is a syndrome featured by rise of content of prolactin (?25 ng/mL), amenorrhea, milk regurgitation, anovulia and infertility. It is believed in traditional Chinese medicine that the disease is caused by binding constraint of emotion, and disharmony of the thoroughfare and conception vessel. As the junction of chest qi pathway and head qi pathway, ST 9 can make qi and blood circulate freely, and dredge meridians and unblock collaterals. Tian's[6] obtained good efficacy in treatment of idiopathic hyperprolactinemia by taking ST 9 as the main acupoint. Tian believed that the efficacy might be related to the direct effect of acupuncture on hypothalamus-hypophysis through the afferent pathway of cervical sympathetic ganglia. In addition, modern researches'" also put forward that the action mechanism of acupuncture at ST 9 in treatment of hyperprolactinemia may be that the effects of a series of vegetative nervous reflex loop on brainstem, hypothalamus and cerebral cortex can regulate the function of "hypothalamus-hypophysis-gonad axis". This disease is liver constraint and qi stagnation, and acupuncture at TE 16 can transfer yang qi to soothe the liver and spleen. LV 3 is an acupoint belonging to lung meridian. It was said in Huangdi Neijing ( WJ*J~a , The Yellow Emperor's Inner Classic) that "Lung is the place where qi exchange and the heaven of zang-fu organs; lung qi is in this acupoint, so it is call LV 3". Acupuncture at this acupoint can dissipate lung pathogen, regulate lung qi, calm the mind and emotion. This patient gave birth to a baby over age, she worried about her baby's growth and development, so she suffered from qi movement obstruction and collaterals unblocking. Acupuncture at this acupoint can soothe and promote qi movement, and calm the mind and emotion. The authors usually obtained good efficacy in regulating ascending and descending of qi movement by acupuncture at this acupoint.
«.
SUMMARY The authors have the following experience in treatment of endocrine system disease by acupuncture at "TE 16 five acupoints": (1) as the hub of ascending and descending of qi movement and qi and blood circulation in head and body, the neck has complex blood vessels and nerves. In view of this, domestic scholars put forward that neck is composed of multidimensional anatomical system!", including carotid arterial system, musculi colli and nervous system. They also believe that the multidimensional anatomical system is closely related with heart and brain collaterals. Positive stimulation on neck acupoints can soothe and promote qi and blood
World Journal ofAcupuncture-Moxibustion (WJAM)
Vol. 26, No.1, 30th Mar. 2016
·56·
circulation, regulate multidimensional anatomical system, so as to directly influence nervous regulation of brain and cerebrovascular circulation, indirectly influence internal secretion, and make endocrine system tend to be steady. (2) Neck acupoints have significant clinical application value for the complexity and specificity of anatomical structure. (3) The authors have found that there is local induction on neck acupoints, and the acupuncture manipulation is particularly important, so the following should be paid attention to: CD Patients' position is important to the selection of acupoints which is the key factor of right location of the acupoint; ® the direction of needle tip should point to lesions; ® the physician should be familiar with the anatomical structure of neck, pay attention to the amount of stimulation, and should not hurt the vessels and nerves. It was said in The Miraculous Pivot that "both the blood and qi of twelve meridians and three hundred and sixty-five collaterals go through facial orifices", the neck is the important connecting link with throat, from which the food and air entering into lung and stomach, in front and the occipitalia, from which true qi upward into the brain marrow, behind. At the significant location, neck has unique function. It is a pity that there are rare articles on acupuncture, and clinical reports are also few. The authors here appeals
ELSEVIER
to others to pay attention to "TE 16 five acupoints", and make it give play to the important roles.
REFERENCES [1]
[2] [3]
[4]
[5]
[6]
[7]
Lingshii ( «~fI8:», The Miraculous Pivot) (Chin). Beijing: People's Medical Publishing House; 2005: 1718. Yan ZG. The transection of Renying UdillST 9). Shanghai J Tradit Chin Med (Chin) 1979; 19(3): 40. Anatomical teaching and research office of Jiangxi University of Traditional Chinese Medicine. Anatomy of Renying (.A:ifl! ST 9) and neural mechanism in treatment of hypertension. Jiangxi J Tradit Chin Med (Chin) 1959; 28(10): 14. Tian DQ, Yan ZG. Application and research of Renying (.A:ifl! ST 9) in ancient and modern times. Zhongguo Zhenjiu (Chin) 1997; 16(5): 305-306. Liang XB, Xiao F, Liu YT. The Treatment of Fibrocystic Dis-ease of the Breast by Acupuncture: A Report on 57 Cases. American J Acup 1992,20(4): 313-319. Tian DQ, Liu YT, Yan ZG. Clinical research on acupuncture in treatment of idiopathic hyperprolactinemia. J Shandong Univ Tradit Chin Med (Chin) 1995; 19(3): 177. Yuan K, Li WY, Xiong J, Wang JM. The influence of acupuncture at neck acuoints in blood pressure, serum nitric oxide and plasma endothelin-l of patients with primary hypertension. Lishizhen Med Mater Med Res (Chin) 2013; 24(6): 1528-1530.
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• 53 •
Vol. 26, No.1, 30th Mar. 2016
Experience ofExperts Three cases of endocrine diseases treated by acupuncture at "Tianyou (~Jti TE 16) five acupoints"
Jeffl "xXi1i1C" 1itffl*J7tW~~3JJ!U wu Kai-xiao (~it ~)\
ZHUANG Juan-juan (li :!lU~i
1. Department of Rehabilitation Medicine of Hainan Province Nongken Sanya Hospital, Sanya 572000, Hainan Province, China; 2. Clinical Medical College of Acupuncture, Moxibustion and Rehabilitation of Guangzhou University ofCM (1. tfjfl¥i1!fi':.&~-=']f.~~)~Ur~~f4,~1¥i-=']f. 572000, 9='~; 2. )1N9='~ ~*~~ff<:*j[r[{Ij*~~~ ) ARTICLE INFO First author: WU Kai-xiao (1982-), male, attending physician. Research field: study on acupuncture in treatment of clinical diseases E-mail: [email protected] Accepted on November 1, 2015
ABSTRACT To explore and study the significant value of "Tianyou (:XWii TE 16) five acupoints" in treatment of clinical diseases based on analysis of three cases. Case 1: thyroid enlargement. Acupuncture was conducted at Renyfng LA Jill 5T 9), Futu (t1c~ LI 18), Shultu (*~ 5T 10) and Qishe (E(.~ 5T 11), and combined with Neiguan (pg *. PC 6). After ten courses of treatment, nodules and calcified lesions shrank. Case 2: hyperplasia of mammary glands. Acupuncture was conducted at bilateral 5T 9 and TE 16, and combined with Talchong ti\:ilP LR 3) and Danzhong (Jl:9=' CV 17). After eight courses of treatment, the breast lumps disappeared. Case 3: hyperprolactinemia, and amenorrhea for two years. Acupuncture was conducted at bilateral 5T 9, TE 16 and Tianfu (:x!11 LU 3), and combined with LR 3 and Xiaxi (~m GB 43). After eleven courses of treatment, the content of prolactin was normal. KEY WORDS: Tianyou acupuncture
The record of "Tianyou (:x1f TE 16) five acupoints" was first seen in Lingshii ( «3{.flR» , The Miraculous Pivot) [I] which said that Renying (AJ!I! ST 9) is at the artery of lateral neck. ST 9 belongs to foot yangming meridian, and before the sinew of lateral neck. Fum (t1c~ LI 18), behind the sinew of lateral neck, belongs to hand yangming meridian. TE 16 belongs to hand shaoyang meridian, Tianzhu (:XtI: BL 10) belongs to foot taiyang meridian, and Tianfii (*.1# LV 3), at the artery of oxter, belongs to hand taiyin meridian. All these acupoints are "TE 16 five acupoints". In this classic, ST 9, LI 18, TE 16, BL 10 and LV 3 were collectively referred to as "TE 16 five acupoints" because that the five acupoints are located at the neck, and TE 16 is in the center. According to relevant literature and clinical reports, "TE 16 five acupoints" were mostly used in treatment of nervous system diseases, ENT diseases and motor
(:x1li TE 16)
five acupoints; endocrine disease;
system diseases, while the application of "TE 16 five acupoints" in treatment of endocrine diseases was fewer. The cases of endocrine diseases treated with acupuncture at "TE 16 five acupoints" were reported as follows, aiming at appealing to others to pay attention to "TE 16 five acupoints", the field ignored.
THYROID NODULE The patient, female, was 50 years old. She went to hospital on June 25, 2014 for the first time for she found her thyroid was intumescent without other discomfort. The color Doppler ultrasound of thyroid showed: thyroid nodules multiply occurred on left lobe, maximum: 28 X 17 mm, and 11 X 7 mm on right lobe; the echoes were different in nodules with different intensities; lumps were found on the both sides, in which, several bulky, punctuate and calcified lesions were seen. The patient has a history of
·54·
WorldJournal ofAcupuncture-Moxibustion (WJAM) Vol. 26, No.1, 30th Mar. 2016
hysteromyoma. Physical examination showed: thyroid glands can be touched at both sides with the size of 28 X 15 mm, hard texture, and clear margin; there was no haphalgesia, and they were removable. Thyroid function: negative. Acupuncture was conducted at bilateral ST 9, LI 18, Shultii (7.K~ ST 10) and Qishe (~* ST 11), and combined with Neiguan (1*1* PC 6). The needles were retained for 20 min at each time, five times were considered as one course of treatment and five days were free of treatment between two courses. After three courses of treatment, on September 18, 2014, the thyroid nodules and calcified lesions shrank to 22 X 15 mm and 9 X 7 mm from 28 X 17 mm and 11X 7 mm, and the texture was soft. Another two courses of treatment were continued, and the color Doppler ultrasound of thyroid on December 8,2014 showed: the size and shape of thyroid glands at both sides were normal, and the echo was not enough homogeneous. An echolucent with the size of 0.5 cmXOA cmXOA em was found at the bottom of left thyroid gland with smooth margin and normal entrant sound. Note: it is believed in the theory of traditional Chinese medicine that goiter and tumor are formed by qi, phlegm and stasis, and the treatment should be rectify qi and dissolve phlegm, and disperse goiter and dissipate masses. The human anatomy indicates'<" that ST 9 is inside of platysma and at the anterior margin of sternocleidomastoid, on which there is superior thyroid artery. LI 18 is adjacent to ST 9; the complexity and specificity indicate that the two acupoints have significant clinical application value. In addition, it was said in Lingshii (<<~m» The Miraculous Pivot) that "Danzhong (JIf~ CV 17) is the sea of qi, and qi and blood is infused to the top and bottom of BL 10, and to ST 9." ST 9 is the portal of the sea of qi, with the functions of unblocking vessel, direct counterflow downward and rectify qi41• LI 18 is the hand-yangming large intestine meridian, and yangming is meridian full of qi and blood. Acupuncture at the two acupoints can promote free qi and blood circulation inside and outside of vessel, make ying and wei qi unblock, and soothe and moisten meridians. Combining with acupuncture at ST 10 and ST 11 can obtain better efficacy.
HYPERPLASIA OF MAMMARY GLANDS The patient, female, was 46 years old. She went to hospital on October 14,2014 for the first time. She complained that bilateral breast lumps were found through physical examination in November, 2002 after delivery in September, 2002. The breast lumps were
ELSEVIER
removable, with clear margin and local tenderness. The patient was of somnolence, and felt comfortable after sighing. The color Doppler ultrasound of mammary gland on August 15, 2014 showed: polyglandular condition was found in bilateral breast, the right breast was Category 2 of bilateral hypoechoic nodules (BT-RADS), and the left breast was Category 3. Acupuncture was conducted at bilateral ST 9 and TE 16, and combined with Taichong C~itF LR 3) and CV 17. After needling, the patient felt comfortable. The needles were retained for 20 min at each time, five times were considered as one course of treatment, and five days were free of treatment between two courses. After treatment for three courses, the pain of breast relieve, and lumps disappeared. According to reexamination on January 4, 2015, great part of her breast lumps disappeared. The color Doppler ultrasound of mammary gland showed: polyglandular condition was found in bilateral breast, the right breast was Category 0 of bilateral hypoechoic nodules (BTRADS), and the left breast was Category 2. Another course of treatment was continued, and the color Doppler ultrasound of mammary gland on January 27, 2015 showed: bilateral breast was symmetrical with normal shape. The organization structure of bilateral breast was slightly disorder, the echo was slightly thickened and enhanced, and was inhomogeneous. Obvious dilatation of mammary duct was not seen. A hypoechoic nodule with size of 5 mmX7.9 mm was found at the middle ofleft breast near the nipple, close to gland deep layer, with clear margin and regular shape. There was no obvious blood inside of and around the nodule. There was no obvious lump or echo in right breast. Note: hyperplasia of mammary glands belongs to the category of "breast lump" in traditional Chinese medicine, which is usually caused by binding constraint of liver and spleen. Treatment should be soothing the liver and resolving constraint, rectifying the spleen and dissipating masses. Breast is passed through by foot yangming stomach meridian, and ST 9 is affiliated to the meridian and it is a "branch" acupoint, therefore, acupuncture at ST 9 can not only unblock stomach meridian qi, but also dissipate binding constraint of breast. In addition, breasts are located at chest, where is the place of "the sea of qi", while ST 9 is the portal of "the sea of qi". Therefore, acupuncture at ST 9 can soothe meridian qi of chest, and regulate qi and blood of the lesion. Liang[S] et al also demonstrated that ST 9 has specificity in regulating the hormone level of patients with hyperplasia of mammary glands. TE 16 is the hand shaoyang three energizer meridian, ""R." means
ELSEVIER
WorldJournal ofAcupuncture-Moxibustion (WJAM) Vol. 26, No.1, 30th Mar. 2016
heaven, yang; "Ai" means windows. This acupoint name means that meridian qi and blood of the three energizer remove to heaven, and the dominant qi "enters into Quepen (fljk;~ ST 12), distributes in CV 17, and scatters in pericardium". Therefore acupuncture at TE 16 can mobilize yang qi, dispel haze, so as to eliminate breast lumps. Acupuncture at LR 3 can soothe the liver and discharge heat, at CV 17 can rectify qi, therefore, lumps can disappear automatically.
HYPERPROLACTINEMIA The patient, female, was 36 years old. She went to hospital on May 19, 2014. She complained that after cesarean in July, 2010, her bilateral breasts exuded large amount of serous fluid, menstruation was disordered, with little quantity of menses, and she has suffered from amenorrhea for two years. According to examination on March 5, 2014, the content of prolactin was up to 46.3 ng/mL. After treatment with combined therapy of Chinese and western medication, her disease was not healed (not quite clear), so she went to hospital for further treatment. Symptom: amenorrhea for more than two years, bilateral breasts exuded large amount of serous fluid, accompanied with distending pain and chest oppression, swelling in two hands, especially right hand, and dizziness; feeling comfortable after sighing; appetite and sleep were normal; tongue coating was thin, root coating was yellow and greasy, and pulse was deep and thready. Her symptom was liver constraint and qi stagnation, and damp-heat blocking the collaterals. Treatment should be soothing the liver and rectifying qi, and clear damp-heat. Acupuncture was conducted at bilateral ST 9, TE 16 and LV 3, and combined with LR 3 and Xiaxi (1~~ GB 43). The needles were retained for 20 min at each time, seven times were considered as one course of treatment, and five days were free of treatment between two courses. After treatment for three courses, according to reexamination on October 10,2014, the patient complained that breast distending pain relieved, milk regurgitation alleviated sharply, and swelling in hands disappeared. Treatment was continued. According to reexamination on November 5,2014, the patient complained arrival of the menses with moderate amount, and ended five days later. Another course of treatment was continued, and the content of prolactin was 16 ng/mL according to reexamination. So far, there is no relapse. Note: hyperprolactinemia, generally caused by hypothalamus-hypophysis lesion, hypothyroidism, polycystic ovarian syndrome, tumor, after delivery,
• 55 • and other reasons, is a syndrome featured by rise of content of prolactin (?25 ng/mL), amenorrhea, milk regurgitation, anovulia and infertility. It is believed in traditional Chinese medicine that the disease is caused by binding constraint of emotion, and disharmony of the thoroughfare and conception vessel. As the junction of chest qi pathway and head qi pathway, ST 9 can make qi and blood circulate freely, and dredge meridians and unblock collaterals. Tian's[6] obtained good efficacy in treatment of idiopathic hyperprolactinemia by taking ST 9 as the main acupoint. Tian believed that the efficacy might be related to the direct effect of acupuncture on hypothalamus-hypophysis through the afferent pathway of cervical sympathetic ganglia. In addition, modern researches'" also put forward that the action mechanism of acupuncture at ST 9 in treatment of hyperprolactinemia may be that the effects of a series of vegetative nervous reflex loop on brainstem, hypothalamus and cerebral cortex can regulate the function of "hypothalamus-hypophysis-gonad axis". This disease is liver constraint and qi stagnation, and acupuncture at TE 16 can transfer yang qi to soothe the liver and spleen. LV 3 is an acupoint belonging to lung meridian. It was said in Huangdi Neijing ( WJ*J~a , The Yellow Emperor's Inner Classic) that "Lung is the place where qi exchange and the heaven of zang-fu organs; lung qi is in this acupoint, so it is call LV 3". Acupuncture at this acupoint can dissipate lung pathogen, regulate lung qi, calm the mind and emotion. This patient gave birth to a baby over age, she worried about her baby's growth and development, so she suffered from qi movement obstruction and collaterals unblocking. Acupuncture at this acupoint can soothe and promote qi movement, and calm the mind and emotion. The authors usually obtained good efficacy in regulating ascending and descending of qi movement by acupuncture at this acupoint.
«.
SUMMARY The authors have the following experience in treatment of endocrine system disease by acupuncture at "TE 16 five acupoints": (1) as the hub of ascending and descending of qi movement and qi and blood circulation in head and body, the neck has complex blood vessels and nerves. In view of this, domestic scholars put forward that neck is composed of multidimensional anatomical system!", including carotid arterial system, musculi colli and nervous system. They also believe that the multidimensional anatomical system is closely related with heart and brain collaterals. Positive stimulation on neck acupoints can soothe and promote qi and blood
World Journal ofAcupuncture-Moxibustion (WJAM)
Vol. 26, No.1, 30th Mar. 2016
·56·
circulation, regulate multidimensional anatomical system, so as to directly influence nervous regulation of brain and cerebrovascular circulation, indirectly influence internal secretion, and make endocrine system tend to be steady. (2) Neck acupoints have significant clinical application value for the complexity and specificity of anatomical structure. (3) The authors have found that there is local induction on neck acupoints, and the acupuncture manipulation is particularly important, so the following should be paid attention to: CD Patients' position is important to the selection of acupoints which is the key factor of right location of the acupoint; ® the direction of needle tip should point to lesions; ® the physician should be familiar with the anatomical structure of neck, pay attention to the amount of stimulation, and should not hurt the vessels and nerves. It was said in The Miraculous Pivot that "both the blood and qi of twelve meridians and three hundred and sixty-five collaterals go through facial orifices", the neck is the important connecting link with throat, from which the food and air entering into lung and stomach, in front and the occipitalia, from which true qi upward into the brain marrow, behind. At the significant location, neck has unique function. It is a pity that there are rare articles on acupuncture, and clinical reports are also few. The authors here appeals
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to others to pay attention to "TE 16 five acupoints", and make it give play to the important roles.
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