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

DING Zhi-ming(丁治明)

4.4　Blood stasis type

Main symptoms: Stabbing pain in the waist with the pain being in the fixed place, difficulty in making bending and lifting the upper part of the body in lighter lumbago cases, or failure of turning the body in severe lumbago cases, aversion to pressing the affected site, purplish dull tongue with ecchymosis, and uneven pulse.

Therapeutic principles: Promoting blood circulation to remove blood stasis, regulating circulation of qi to relieve pain.

Acupoints: Shenshu (BL 23), Dachangshu (BL 25),Ashi-point, Weizhong (BL 40) and Geshu (膈俞BL 17)Notes: Shenshu (BL 23) is used to replenish the kidney qi. Dachangshu (BL 25) andAshi-point are used to dredge meridian, regulateqi, and promote free flow of blood to relieve pain. Weizhong (BL 40) is theHo(Sea) point of the Bladder Meridian of Foot-Taiyang and is also called as“Xuexi”Point; and Geshu (BL 17) is an acupoint of the Bladder Meridian and“the converging point of blood”. Pricking these two acupoints to let a little bit of blood out can function in activating blood flow, dredging collaterals of the meridian, dissipating blood stasis and stopping pain.

4.5　Meridian-related lumbago

4.5.1　Governor Vessel lumbago

Main symptoms: Lumbar stiffness and pain, particularly in the lumbo-spine site, inability to bend and lift the upper part of the body.

Acupoints: Shuigou (GV 26), Houxi (SI 3), Weizhong (BL 40), Yaoyangguan (GV 3) andAshi point.

Notes: Shuigou (水沟GV 26) is the meridian point of the Govern or Vessel which runs in the internal part of the spinal column. Houxi (后溪SI 3) is one acupoint of the Taiyang Meridian and communicate with Governor Vessel, when punctured with reducing method, these two acupoints can dredge meridian-qi of both Governor Vessel and Taiyang Meridian to favor activities of the lumbus. Weizhong(BL 40), a remote acupoint from the focus and selected along the meridian course, is used to treat lumbago. Puncturing Yaoyangguan (GV 3) andAshi point in reducing method can regulate meridian-qi around the waist. All these acupoints used together can function in dredging collaterals of meridian around the waist to stop pain and favor lumbar activities.

4.5.2　Conception Vessel lumbago

Main symptoms: Lumbago with muscular spasm, pain involving the lower abdomen, excessive leucorrhea in women, or enuresis and prick in the pudendum in men.

Acupoints: Shenshu (BL 23), Guanyuan (CV4), Dachangshu (BL 25) and Lieque (列缺LU 7).

Notes: Shenshu (BL 23) and Dachangshu (B 25) are used to tonify the kidney for strengthenin the waist. Guanyuan (CV 4) is one acupoint of the Conception Vessel and also called as the gate of primordial qi; when stimulated jointly with acupuncture and moxibustion, it can both reinforce the primordial qi to consolidate the constitution and tonify the kidney to strengthen the waist, which also implie “treatingyang disorders by nourishingyin”. Liequ(LU 7), communicating with the Conception Vessel serves to regulateqiof the Conception Vessel, and dredge meridian-collaterals to relieve pain.

4.5.3　Thoroughfare Vessel lumbago

Main symptoms: Lumbago involving the lower abdomen, upward flow ofqiattacking the chest; in women, menstrual disorder and the pain worsening during menstruation.

Acupoints: Shenshu (BL 23), Qihai (CV 6), Yaoyan (EX-B 7) and Gongsun (公孙SP 4).

Notes: Shenshu (BL 23) is used to strengthen the kidney and the waist; Qihai (CV 6) serves to replenishqiand tonify the kidney. Yaoyan (EX-B 7), the local acupoint near the focus, is employed to dredge and regulate meridian-qipassing through the waist, combined with Gongsun (SP 4), a remote acupoint, is used to regulate functions of the Thoroughfare Vessel. The abovementioned acupoints used in combination can function in reinforcing the kidney to normalize activities of muscles, as a result, the lumbago is cured accordingly.

4.5.4　Belt Vessel lumbago

Main symptoms: Lumbago involving the pudendum and the medial side of the thigh, flaccidity of the lower limbs, abdominal distension and fullness, and leucorrhea with reddish discharge in female patients.

Acupoints: Shenshu (BL 23), Dachangshu (BL 25), Daimai (带脉GB 26) and Zulinqi(足临泣GB 41).

Notes: Shenshu (BL 23) is used to strengthen the kidney and waist, and Dachangshu (BL 25) employed to facilitate flow of meridian-qiin the lumbar region; Daimai (GB 26) has effects of governing activities of the lumbo-abdominal region; and Zulinqi(GB 41) serves to dredge the Belt Vessel. The afore mentioned acupoints used together function in restoring functions of the Belt Vessel, reinforcing the kidney and enhancing the waist.

4.5.5　Kidney Meridian lumbago

Main symptoms: Lumbago, cold feet with flaccidity, or pain in the post-medial thigh and popliteal fossa, accompanied with aching in the sole, dry mouth and throat.

Acupoints: Shenshu (BL 23), Mingmen (GV 4), Dachangshu (BL 25), Guanyuan (CV 4), Taixi(KI 3) and Fuliu (KI 7).

Notes: The waist is the house of the kidney and selecting the Kidney Meridian is aimed at reinforcing the kidney-qi. Mingmen (GV 4) and Dachangshu (BL 25) are used to warm the kidney and relax the muscles and tendons. Guanyuan (CV 4) is employed to replenish the primordialqiand enhance the constitution. Taixi (KI 3) and Fuliu (KI 7) are used to nourish the kidney-yin. The abovementioned acupoints used in combination can gain effects of reinforcing the kidney, replenishing essence to strengthen the waist.

4.5.6　Bladder Meridian lumbago

Main symptoms: Pain in the back and lumbar region, tearing pain in property, accompanied with cold, pain and numbness in the lower leg as if being dislocated in the ankle.

Acupoints: Yaoyangguan (GV 3), Dachangshu (BL 25), Yinmen (殷门BL 37), Kunlun (昆仑BL 60) and Weizhong (BL 40).

Notes: Yaoyangguan (GV 3) is situated in the Governor Vessel and Dachangshu (BL 25) in the lumbar region, when used in combination, they can facilitate flow ofqiof both Governor Vessel and Bladder Meridian. Yinmen (BL 37) and Kunlun (BL 60), two remote acupoints, are used to dredge meridian-qiand remove obstructions in the collaterals of the meridian to relieve pain. Weizhong (BL 40), the Ho(Sea)-point of the Bladder Meridian of Foot-Taiyang, serves to dredge the Bladder Meridian qi and relax muscle-tendons to relieve pain.

5　UNDERSTANDINGS ABOUT TREATMENT OF LUMBAGO

5.1　Never forgetting reinforcing the kidney

Deficiency of the kidney is the original cause of lumbago, and affection by exogenous pathogens or traumatic injury is its secondary cause.Zheng Zhi Zhun Sheng: Yao Tong(《证治准绳·腰痛》Standards for Diagnosis and Treatment: Lumbago) says,“Wind, dampness, cold, heat, sprain and contusion, blood stasis, stagnation ofqi, accumulation of phlegm, etc, are the incidental causes of lumbago,

while the deficiency of kidney is fundamental”. For this reason, in clinical treatment of cold-dampness, damp-heat and blood stasis types of lumbago, some acupoints for reinforcing the kidney to strengthen the waist are used in combination and can reach the aims of strengthening the body resistance to eliminate pathogenic factors at last.

5.2　Treating both primary and secondary aspects of the disease at the same time

In acupuncture treatment of lumbago, we should make clear to which pattern does it pertain, exopathy, internal injury, deficiency or excess, then determine the appropriate therapeutic principles as relieving exterior syndrome, or reinforcing deficiency or reducing excess. If the lumbago belongs to the mixed type of deficiency and excess, both the primary and secondary aspects of the disease are treated at the same time.

5.3　Points for attention

If the lumbago is caused by tumor or tuberculosis of the spinal column, performing acupuncture or moxibustion in the topical focus region is not suitable; when women are in the menstruation or pregnancy period, puncturing acupoints in the lumbosacral region is not recommended. During acupuncture treatment, the patient is asked to avoid wind cold, take care of daily life, strike a balance between work and rest and to be abstinent to sexual life.