Wang Zhaoyang(王朝） Wang Duanyi(王端）

Beijing College of Acupuncture and Orthopedics, Beijing 100015, China

ABSTRACT

181 cases suffering from different kinds of headache were treated by the authors with scalp acupuncture with movement. The results of instant an d long-term therapeutic effects show that the scalp acupuncture with movement is a simple and effective skill. The instant therapeutic effects: the headache in 163 cases disappeared; in 9 cases the effect was quite obvious; and in 7 cases it was effective; the total effective rate amounted to 98.9%. The long term therapeutic effects: 135 cases(74.6%)were cured. The total effective rate was 77.2%.

KEY WORDS

Scalp acupuncture with movement Headache Observation of therapeutic effect.

Headache is a frequently encountered disease, it mostly happens around for ahead, vertex, temporal and occiput. In clinical practice, we find scalp acupuncture with movement not only has an obvious instant therapeutic effect but also has a good long-term effect.

The concept of scalp acupuncture with movement is that while the doctor manipulates the needle, the patient should move actively or passively under the help of other people. In this way, this method can activate the latent energy from both the doctor and patient so that it can improve the therapeutic effects by quickly acquiring the Channel qi and letting the Channel qi arrive at the suffered area. The authors had successfully treated 181 cases of headache by means of scalp acupuncture with movement and done the primary discussion on mechanism of scalp acupuncture with movement in treatment of the headache and the function of patient's active or passive movement when doctor manipulating the needles.

CLINICAL DATA

Among total 181 cases in this study, there were 97 males and 84 females. The age s of the patients ranged from 17 to 61. The average age is 33 years old. The duration of disease was under one month in 32 case; 87 were between one month and 2 years; 62 were between 2 years and 8 years. Therapeutic standards: Refer to Th e Practical Internal Medicine published by The People Health Publishing House in 1983.

THERAPEUTIC METHOD

Selection of stimulating the belts: Middle belt of forehead (0.25 cun wide on both sides of the line which is 1 cun long from GV 24 straightly downward a long the Du meridian), middle belt vertex (0.5 cun wide on both sides of the line directly connecting GV 20 and GV 21), occipital belt of vertex (0.5 cun wide on both sides of the line directly connecting GV 20 and GV 17), basic belt of cranium (0.5 cun wide on both sides through Du meridian, gallbladder meridian, and sanjiao meridian). Needling method and therapeutic course: Lifting and thrusting method with small amplitude was used. Therapeutic course: When the doctor stimulates the needles, the patients should relax on mind and mind concentrating on his Dantian. When the doctor manipulates the needles on the occipital belt of vertex, the assistant should press and mass age the exterior and middle one-third of basic belt of cranium. After that, the assistant should find the Ashi point and press for more while. When the doctor stimulates the needles on the middle belt of vertex, the assistant should gently knock at the scalp of headache. If the location of headache is on t he anterior side of temporal, the doctor should add anterior oblique belt of vertex-temporal (0.5 cun wide on the both side through Du, Foot Taiyang bladder meridian)(the same side of along the headache, the same as below). When the doctor manipulates the needles, the assistant should press the local area of the anterior side of temporal up and down by three fingers. If the location of the headache is in the middle of the side of the head, we should add the posterior oblique belt of vertex-temporal (directly connecting GB 4 and GB 6, 0.5 cun wide on both side and connecting with Du, Foot-Taiyang bladder and Foot Shaoyang gallbladder meridian) and press the Ashi points . If the location of the headache is on the back of occiput, we should add occipital belt of vertex or lower-lateral belt of occiput (directly connecting GB 9 and TE 10, 0.25 cun wide on both sides and belonging to Foot-Taiyang bladder meridian). If the headache is complicated with nausea, the doctor should use both sides of belt II lateral to forehead (1 cun long from GB 15 straightly downward along the meridian, and 0.25 cun wide on both sides and belong to Foot-Shaoyang gallblader). When the doctor manipulates the needles, the patient should press the stomach and take a deep breath and hold it for a little while. After finishing manipulating, the patient takes abdominal respiration. If the patient's headache is caused by liver-qi depression, or ascendant hyperactivity of liver yang, or vigorous liver fire or blood stasis, the doctor can add needles on the left side of the middle one-third belt of forehead-vertex (directly connecting GV 24 and GV 21, 0.5 cun wide o n both sides, which belong to Du meridian). If it is caused by phlegm turbidity clouding the upper clear orifice, the doctor can add right side of the middle one-third belt of forehead-vertex. All of above, we use the reducing method. If the headache is caused by deficiency of the kidney, the doctor should add the lower one-third of belt of forehead-vertex. It should be treated by the reinforcing method. If it is caused by the deficiency of qi and blood, we add needles in the middle one-third of belt of forehead vertex.

ANALYSIS OF THERAPEUTIC EFFECTS

(1) Criteria of the therapeutic effect

Cured: Headache with all the complicated symptoms are vanished. Follow-up for one year shows no relapse.

Markedly effective: Headache with all the complicated symptoms are basically re moved, though the headache relapse again in one year, the symptom is greatly reduced.

Effective: The headache is markedly reduced. The interval between two attacks of headache is prolonged. The lasting time of headache is reduced.

Ineffective: It has no change of headache.

(2) Result of the treatment. Among the total 181 cases treated for 1 or 3 therapeutic courses, 135 cases (74.5%) were cured. 28 cases (15 .5%) were greatly effective. 13 cases (7.2%) were effective; 5 cases (2.8%) were ineffective, the total effective rate was accounted for 97.2%. The instant therapeutic effects after treatment are also very good. Among the total 181 cases, 1 63 cases were cured, accounting for 90.1%. 9 were greatly effective, accounting for 4.9%. 7 were effective, accounting for 3.9%. 2 were not effective, accounting for 1.1%.

TYPICAL CASES

Mr Lin, 35 years old, an office worker, was admitted on July 20, 1997. He had a history of headache for 7 years and aggravated for 1 year. The headache happened once around a month, and the pain lasted for 5 or 7 days. The patient had to take the painkiller to stop the pain, he has visited many doctors, but the results of treatment were not satisfied. The patient's headache extended from the right temporal to his vertex. The right eye was red and he had a feeling of protruding. His mother also has such history of headache. When the doctor pressed on the middle one-third of right side of basic belt of cranium, the patient felt very painful. It was diagnosed as “the common headache? He was treated by the scalp acupuncture with movement. The chosen belt was middle belt of forehead, middle belt of vertex, right side of anterior oblique belt of vertex-temporal, the upper one-third of occipital belt of vertex, the middle one-third of basic belt of cranium, the left side of belt II lateral to forehead. Manipulation: When the doctor stimulated the needles on the occipital belt of vertex, firstly the assistant should massage the middle one third of right side of basic belt of cranium. Then, the patient gently pressed his right eye. When the doctor stimulated the needles on the middle belt of forehead and middle belt of vertex, the assistant should knock at the right side of the patient's head. When the doctor stimulated the needle on the anterior oblique belt of vertex-temporal, the assistant should press the affected area where is 1 cun behind the Taiyang point. When the doctor stimulated the belt II lateral to fore head, the patient should press both sides of hypochondria by his hand. After stimulating, the patient deeply kept down his breath. The doctor repeatedly manipulated the needles until the headache disappeared. At last, upper obliquely inserting one needle on the middle one-third of basic belt of cranium, the doctor did the electric needle together with the needles on the anterior oblique belt of temporal. When the patient visited the doctor for the second time, the headache has obviously reduced. He needed not take the pain-killer for stop the pain. After three times treatment, the patient told the doctor that the headache had disappeared. After another 13 times of treatment, the patient never complained the headache. No relapse was found during the following one year.

DISCUSSION

The concept of scalp acupuncture with movement is that at the same time of stimulating the needles on the head, we should move the patient's suffered area (including the active and passive movement). Clinical practice proves that moving the suffered area while manipulating the needles on head can improve therapeutic effects of the scalp acupuncture, especially on the speed of achieving effects. To its mechanism, there is not any detailed report until now. As an example of scalp acupuncture with movement in treatment of headache, we want to make a preliminarily inquiring into it. Firstly, why the scalp acupuncture has an obvious effect on headache. As we know, the suffered area of headache is on the head. The points and belts used in scalp acupuncture are also on the head. There are eight channels directly running along the head among the twelve regular channels and the eight extra channels. Another four channels can arrive at the head by their muscle regions or divergent channels. The channel qi stimulated by scalp acupuncture can directly arrive at the suffered area by these channels. All of them can more easily have the functions of freeing the stasis of qi and blood, regulating the yin and yang, strengthening the body resistance and eliminating the pathogenic factors. While stimulating the head, the patient's active and passive actions include the exhale and inhaled one by himself and the knocking, tapping, massage done by the assistant. All the se action will have certain function of regulating the flow of qi and blood, dissipating the transport of channels and collateral, nourishing the heart and quieting the spirit, The actions such as pressing or massage can further improve the body's function quickening the flow qi and blood, dissipating the transport of channels and collateral, relaxing tension and stopping the pain. We may consider the mechanism of the function of scalp acupuncture with movement as follow: The active and passive actions can promote part of channel qi on the suffered area. When this part of channel qi together with the channel qi promoted by scalp acupuncture run toward the location of headache, they can have a cooperated effect. The strengthening channel qi can more quickly arrive at the suffered area and have the function of stopping the pain by dissipating the channels and collateral. To some patients with long course of disease or severe conditions, the actions such as knocking, pressing or massage can more powerfully dissipated the pathogenic qi and stasis of qi and blood. The actions can also make the channel qi promoted by scalp acupuncture more easily run along the suffered area. The channel qi can better play full function of dissipating the transport of qi and blood. Also, the action of pressing on the suffered area can instantly make the painful feeling increased. The increasing pain sensation can not only more powerfully promote the self regulating function of patient's channels and collateral but also concentrate the patient's spirit-mind on the suffered area. The concentrated spirit mind can have the therapeutic function by guiding the channel qi promoted by scalp acupuncture quickly arrive at the suffered area.