OBSERVATION ON THE THERAPEUTIC EFFECT OF ACU-MOXIBUSTION OF GUANYUAN (CV4) AND QIHAI (CV6) IN THE TREATMENT OF56CASES OF HICCUP

LI Jun-qing(李俊庆)  

Hiccup is a symptom characterized by a short, repeated involuntary sound from the larynx due to reversed upward flow ofqito stimulate the diaphragm(spasm of the diaphragm), followed by sudden closure of the glottis, which checks the inflow of air. It may occur along or appear in the developmental process of some acute or chronic diseases, and is often a sign of deterioration of the disease. From 2000 to 2004, the author of the present paper treated 56 cases of hiccup with acu-moxibustion of Guanyuan (关元CV 4) and Qihai (气海CV 6) and achieved satisfiedresults. Following is the summary. 

1　CLINICAL DATA

Of the 56 cases of hiccup, 32 were male and 24 female with an average age of 52 years and ranging in the duration of disease from 3 days to 1 month. Among them, 23 cases were cerebrovascular disease, 12 upper respiratory tract infection with fever, 14 chronic superficial gastritis, 5 esophageal carcinoma,and 2 gastrocarcinoma.

2　THERAPEUTIC METHODS

2.1　Operation

Filiform needles were straight inserted into Guanyuan (CV 4) and Qihai (CV 6) about 40-50 mm deep, manipulated repeatedly for a while till“Deqi”. For patients with chronic hiccup, the needl insertion was deeper, combined with suspended moxibustion. Before performing acupuncture, the patien whose bladder was full was asked to empty first, and operator should be careful in operation to avoid skin scald. The acupuncture treatment was given once daily, 7 sessions altogether.

2.2　Criteria for assessing the therapeutic effect Cured: After treatment, hiccup disappeared completely, and did not attacked again within a week. Markedly effective: Hiccup stopped basically, but occasional attack came again and lightly. Effective: Hiccup reduced in the attack frequency and severity. Failed: After 7 sessions of treatment, hiccup had no marked improvement.

3　RESULTS

After the treatment, all the 56 cases were effective. Among them, 19 cases were cured after one treatment, 23 cured after 2 treatments, and 11 cured after 3 treatments; the rest 3 (one case of esophageal carcinoma and 2 cases of gastrocarcinoma) experienced improvement in the attack of hiccup after 7 sessions of treatment.

4　TYPICAL CASE

A Mr., farmer, aged 47 years, hospitalized due to having got a fever and hiccup for 4 days. Before admission, he experienced fever, headache, poor appetite, abdominal distension and frequent cough without apparent causes, followed by appearance of hiccup on the following day. He received expectant treatment for 4 days by the local health-center, then, his body temperature decreased slightly, but the hiccup got worse, attacked repeatedly and in low voice and he could not control it by himself, accompanied with abdominal distension, poor appetite, dyspneic respiration with asphyxiating feeling, poor sleep, scanty

yellow urine, and scanty dry stool. Physical examination showed body temperature: 38℃,pulse rate 104 beats/min, respiration frequency 22 cycles/min, blood pressure 120/80 mmHg, consciousness, development being alright, speech (normal), flush complexion and reddish chest skin, skin of the other part(-), lymph node (-), head (-), five sense-organs (-), throat (reddish), heart (-), lung (-), abdomen (-), liver (-), spleen (-), bowel sound (weak), neck (-), spinal column (-), four limbs(-), nerve reflexes (-); WBC 5.8×109/L, neutrophil leukocytes (74%), lymphocytes (26%), Pts: 130×109/L, eosinophilic leucocytes: 22/L, liver function (normal). It was diagnosed as upper respiratory tract infection by Western medicine and hiccup by Chinese medicine. He was treated by intravenous drip of Aminobenzylpenicillin, dexamethasone and normal saline for 4 days, oral administration of 3 doses ofZhuye Shigao Tang(竹叶石膏汤Lophatherum and Gypsum Decoction) and one dose of Da Chengqi Tang(大承气汤Drastic Purgative Decoction). On the 4thday, his temperature got normal, on the 5thday, his bowel movement turned to normal and his abdominal distension reduced but the hiccup remained unchanged. Acupuncture of Neiguan (内关PC 6), Zusanli (足三里ST 36), Yifeng (翳风TE 17), Tiantu (天突CV 22), etc was given to him, once daily, 4 times altogether, followed by acupoint-blocking with compound Wintermin for 3 times and carotid artery pressure once. His hiccup still had no remarkable improvement. On the 10thday Guanyuan (CV 4) and Qihai (CV 6) were punctured straight about 40-50 mm deep. After“Deqi”, an ignited moxa-stick (about 2.5 cm long) was attached to the needle-handle for moxibustion. When the second moxa stick segment was going to burn out, his hiccup stopped suddenly. Then the 3rdsegment of ignited moxa-stick was given to him continuously. He was then cured and left the hospital. Half-year’s follow-up showed no relapse.

5　COMMENTS

Modern medicine holds that hiccup results from spasm of the diaphragm, while traditional Chinese medicine considers it to be caused by upward reversed flow of the stomach-qito stimulate the diaphragm. Zheng Zhi Zhun Sheng (《证治准绳》Standards for Diagnosis and Treatment)says,“In the treatment of hiccup, performing moxibustion over Guanyuan (CV4) with 7 moxa-cones may cure it immediately. This method proved effective every time when applied in clinic”. In recent years, the treatment of hiccup with Guanyuan (CV 4) has been seldom seen. The author of the present paper tried treating hiccup using moxibustion with warm needle at Guanyuan (CV 4) and Qihai (CV 6) and achieved a better therapeutic effect at last. Clinical observation showed that the therapeutic effect of this remedy is better for hiccup with short duration of disease; in order to consolidate this effect, the primary disorder(s) needs being treated simultaneously. For chronic hiccup patients with deficiency syndrome, particularly for those with severe disease at the late stage, the therapeutic effect is often poor due to severe consumption of the vitalqi.Under the circumstances, moxibustion and acupuncture should be used in combination.

Guanyuan (CV 4), the confluence point of the threeyinmeridians, the source of the primordialqi of the tri-energizer, and is also the Front-Mupoint of the Small Intestine Meridian. TheMu-point is the site whereqiof theZang-fuorgans converge in the chest or the abdomen. Qihai (CV 6), the sea for producingqi,can function in eliminating stagnation of qiand treat disorder ofqidue to wind attack by acupuncture. Therefore, the two acupoints used together may regulateqiof the upper-middle-and lower-energizer and normalize their functional activities, harmonizing the stomach, relieving stuffiness of the chest, normalizing activity of the diaphragm, lowering the reversed flow of stomach-qi, as a result, hiccup stopped automatically. Guanyuan (CV 4) and Qihai (CV 6) are two important acupoints for strengthening the body constitution, when stimulated with moxibustion with warming needle, the body’s resistance is enhanced and disorders are cured spontaneously.