The author has been working on acupuncture clinic for many years, and looking for obtaining a better therapeutic effect by selecting fewer points and proper combination of different points. The contents on combination and application of acupoint pairs were recorded early in “Canon of Acupuncture and Moxibustion in Poems" in Yuan and Ming Dynasties, that was the summary of many acupuncturists' clinical experience. Most of the point pairs have their own clinical indications and are combined together properly, avoiding mutual interference among points. Thus, it is of higher clinical value. Chize (LU 5) and Yinglingquan (SP 9), a point pair used frequently by Prof. Wang Juyi, have been selected also by the author to treat cough, frequent micturition, constipation, diarrhea and allergic dermatitis in recent one year. It was found that this point pair has a regulatory effect on functional disorders of the lung,s pleen and Qi as well as some diseases caused by disturbance of Qi-transformation and retention of water in the body.

Case 1. Dyspepsia

Mr. Yu, 30 years old, suffered from abdominal distention (being worse on the right side of the abdomen) for more than two months. He visited our hospital on July 5, 1999 and complained of having poor appetite and loose stool (3-5 times every day). Examination showed that he had got light red tongue with white sticky coating, deep pulse, pressing pain at Yinlingquan(SP 9, indicating that the Spleen Meridian of Foot-Taiyin was involved), hardness and tenderness near the right side of the umbilicus. Differentiation of syndromes: Disorder of the Taiyin Meridian and dysfunction of the spleen in transportation and transformation. Treatment principle: strengthening the spleen, regulating Qi and removing damp. Point s election: main points Chize(LU 5) and Yinlingquan (SP 9); and supplementary point Gongsun (SP 4). Manipulation: Twirling the needles with uniform reinforcing and reducing method.

Process of treatment: After one time of treatment, the patient felt his abdominal distention alleviated, and discharged formed stool. After two treatments, his abdominal distention alleviated obviously, but the pressing pain near the right side of the umbilicus was still there. After another three treatments by using the aforementined points combined with Tianshu(S 25), his abdominal distention almost disappeared and his appetite was improved. The next step for treatment was to regulate the functions of the spleen and stomach. Points Tianshu(ST 25), Zusanli (ST 36) and Gongsun (SP 4) were punctured, once every day, 4 days altogether. The patient then turned to normal completely.

Comments: The main manifestations of this case were abdominal distention, poor appetite and loose stool, which were caused by disorder of the spleen and stomach in sending up the lucid-Qi and sending down the turbid-Qi.Sticky coated tongue revealed an internal damp. The Spleen Meridian of Foot-Taiyin showed some reactions via meridian examination. The pressing pain near the right side of the umbilicus belonged to the lung Meridian. Selection of Chize (LU 5) and Yinlingquan (S P 9) as main points and Gongsun (SP 4) as the supplementary point  aiming to regulate Qi of Taiyin Meridian, eliminate damp, ascend the food essence and descend the waste substances, and get rid of the abdominal distention.

Case 2. Retention of urine

Ms. Chen, female, 65 years old, visited our hospital on July 13, 1999.At the treatment time she had suffered from retention of urine for 4 hours. In the emergency department, the doctor was going to treat her with urethral catheterization , but she asked for acupuncture treatment first. Examination showed tender-point being at Chize (LU 5,the Lung Meridian of Hand-Taiyin was involved), lower abdominal enlargement, and tenderness below the umbilicus. Differentiation of syndromes: disturbance of Qi in transformation of the Taiyin-Meridian. Treatment principle: Promoting flow of Qi to eliminate water pathogen. Chize (LU 5) and Yinlingquan (SP 9) were selected as the main points and Shuiquan(KI 5) as the supplementary point.

Chize (LU 5) was punctured at first, with the needling sensation controlled to propagate towards the hand, and then Yinlingquan, was punctured, with the sensation controlled to conduct to the leg at first and then upward to the lower abdomen. The needles were twirled with uniform reinforcing and reducing method. 2min after treatment, the patient felt her lower abdomen contracting and wanted to discharge. Then, Shuiquan (KI 5) was needled. When the needling sensations were achieved, the needle was withdrawn immediately, and the needles in Chize (LU 5) and Yinlingquan (SP 9) were kept for 10 min. After acupuncture treatment, the patient had a micturition immediately.

Case 3. Allergic dermatitis

Ms. Xu, male, 43 years old, visited our hospital on November 13, 1999. He suffered from red granule papule and itching for 7 days. At the night of treatment, after eating seafood, his papule spread rapidly over his abdomen, back, lower and upper limbs with extreme itching. Examination showed light red tongue with thin white coating and rapid slippery pulse. The Taiyin-Meridian had some positive responses. Pressing pain in Du Meridian (Lingtai GV 10) was obvious. Differentiation of syndromes: Blockage of Taiyin-Meridian by accumulated damp heat. Treatment principle: Clearing away heat prom the blood, eliminating damp and stopping itching. Chize (LU 5) and Yinlingquan (SP 9) were selected as the main points, and Fengshi (GB 31) and Lingtai (GV 10) as the supplementary points. These points were punctured and stimulated with reducing method by lifting thrusting and twirling the needle repeatedly.

Most of papule disappeared 5 minutes after acupuncture of the points. The needle were retained for 15 min, After removal of the needle, Lingtai (GV 10) was pricked with bleeding and cupped. Afterwards, the patient felt his itching relieved. The color of the skin recovered to normal and only a few of granule papules left.

Discussion

Chize(GV 5) and Yinlingquan(SP 9) are the “He-points" of the Hand and Foot Taiyin Meridians respectively. Both meridians have a same name (Taiyin) and their relation was considered to be mother and son. According to the doctrines of meridians and Qi transformation of TCM, and characteristics of acupoints, the clinical significance of this point pair may be:

1. Taiyin dominates damp. It was recorded in “Plain Question" that the Taiyin- Meridian is in charge of damp Qi. From the source of the name of the Taiyin- Meridian we know that this meridian corresponds to the damp Qi in the natural world and the spleen connects with Lung Meridian in human body. Damp can be divided into external clamp and internal damp. The metabolic activity of water and d amp is regulated by the lung and spleen. Opening (closing), covering and pivoting theory of the six meridians reveal the Qi transformation function of the meridian. Taiyin is the superficial portion of the three yin meridians. It guided internal Qi to get out and has functions of draining water passage eliminating damp , promoting and regulating free flow of Qi.

2. “He-point" has the function of regulating Qi in its meridian. In the Chapter the 68th problem of Difficult Classic it is recorded that the He-point serves to lower the reversed flow of Qi. The lung also dominates Qi of the entire body. Spleen is located in the middle-Jiao and dominates ascending of Qi. He-poin t of Taiyin-Meridian plays a more prominent action on regulating Qi than other meridians. Chize (LU 5) is the son of the Lung Meridian of Hand-Taiyin and belongs to water. It is often used to treat Qi-fullness in the upper part of the body including asthma, shortness of breath, cough and spit, and can also be used t o treat swollen of the four limbs and abdomen, frequent micturition with abnormal color, poor memory, and difficulty in lifting upper limbs. Yinlingquan (SP 9) is frequently used to treat coolness, fullness and distention in the abdomen, poor appetite, asthma, cholera, hernia, urinary incontinence and diarrhea.

3. The key for identifying syndromes by using Chize(LU 5)-Yinlinhhusn(SP 9) pair is to examine the meridian carefully. In clinical practice, it should be kept in mind that suitable acupuncture manipulations and flexible combination o f points should be taken on the basis of differentiation of syndromes, patients' condition, excess or deficiency of the meridian, etc. In this way, a higher therapeutic effect can be achieved.

By Cai Changrong,