MY UNDERSTANDINGS ABOUT ACUPUNCTURE TREATMENT OF LUMBAGO ACCORDING TO SYNDROME-DIFFERENTIATION (A)

DING Zhi-ming(丁治明)

Lumbago is a disease manifested mainly by pain on one side or bilateral sides of the lumbar region. Due to close connection between the lumbus and the spinal column, the pain is often located in the median of the spinal column or on the bilateral sides of the spinal column, thus, it is frequently called as lumbospinal pain in clinic, but generally called as lumbago. Because the lumbus is the house of the kidney, lumbago is most closely related to the kidney. Lumbago is a commonly-seen disease in clinic; particularly, chronic lumbago is higher in the morbidity and poor in the therapeutic effect, and thus often brings the patient a lot of sufferings.

Through more than 30 years’ clinical practice, the author realizes that in the treatment of lumbago, acupuncture and moxibustion therapies have their unique advantages. For instance, in the treatment of deficiency-syndrome type lumbago, reinforcing needling maneuver is adopted; for the excess-syndrome type, reducing needling technique applied; for the heat-syndrome type, heat-clearing needling method applied; for cold-syndrome type, moxibustion therapy used; and for the blood stasis-syndrome type, removing needling method employed. In emergency cases, acupuncture can be used to treat the acute symptoms first; when these symptoms are relieved, it may also be employed to treat the fundamental causes, or treat both the incidental and fundamental aspects simultaneously in the light of the concrete situations. Thus, acupuncture therapy is a rather effective remedy for lumbago in clinic.

1　PATHOGENIC CAUSES AND PATHOGENESIS OF LUMBAGO

Generally, the pathogenic causes of lumbago are exopathy, kidney deficiency, and qi-stagnation and blood stasis. But the author of the present paper observed in clinical practice that many patients’ lumbago has a close relation to abnormal changes of the meridians rather than any of the abovementioned three pathogenic causes. That is to say, disorders of the meridians may also lead to lumbago. Su Wen:

Gu Kong Lun (《素问·骨空论》Plain Questions: On the Apertures ofBones)  says, “In cases of disorders of the Governor Vessel, stiffness of the spinal column with limited motion will occur”. Nan Jing: Er ShiJiu Nan (《难经·二十九难》Classic on Medical Problems:The29thProblem) says,“ When the Belt Vessel falls into disorder, the patient will feel full in the abdomen with his loin seeming to be in the water”. Hence, in the present paper, symptoms of meridians and lumbago will be discussed together.

1.1　Exopathy type

Exogenous pathogenic factors as wind, cold, dampness, heat, etc., all may result in lumbago. Among them, the cold-dampness syndrome and damp-heat syndrome types are most frequently encountered in clinic. Being brave the rain to wade, sitting on the damp land for long, and being sweating to face wind, keeping putting on wet clothes, etc. may all lead to cold-damp syndrome type lumbago because of obstruction of meridians and stagnation of qi and blood and owing to the contractive property of the accumulated cold and the stick property of the damp pathogen. In Jin Gui Yao Lue: Wu ZangFengHan JiJu Bing (《金匮要略·五脏风寒积聚病》Synopsis of the Golden Chamber: Chronic Wind and Cold Syndromes of the Five Zang-Organs), it is recorded that “If a person is sweating due to heavy work and then keeps putting on cold-damp clothes, and if this situation goes continuously for a long time, he or she will get lumbago”. But if the cold and dampness pathogens accumulate for long and transform into heat, lumbago similar to damp-heat syndrome type will appear.

1.2　Kidney-deficiency type

Su Wen: Mai YaoJing Wei Lun (《素问·脉要精微论》Plain Questions: On the Essential Points of Pulse Taking) says, “The lumbar region is the house of the kidney, and if failing in moving freely, gradually, the kidney-qi will be exhausted”. In case of deficiency of the kidney-essence and malnutrition of muscles and vessels due to congenital weak constitution, or being worn with age, or weak constitution

caused by chronic disease, or intemperance in sexual life, etc., lumbago will occur.

1.3　Qi-stagnation and blood stasis type

In case of injury of meridians and muscles in the waist and the resultant disturbance of qi and blood circulation due to over-exertion of the waist, traumatic injury caused by fall or stumble or improper motion, lumbago may appear.

(To be continued.)