ABSTRACT: The present paper reports a clinical study on treatment of apoplectic hemiplegia with balance-acupuncture therapy. Main (balance acupuncture) point used was Piantan (BP-HN 2), combined with Jiantong (BP-LE 6), Qitong (BP-UE 2), etc.. Of the 190 cases, 148 (77. 89 % ) were cured, 24 (12 .63 % ) had marked improvement, 12 (6. 32 % ) had improvement and 6 (3. 16% ) had no effect, with a cure rate of 77. 89% and an effective rate of 96. 84 %.
　　KEY WORDS : Apoplectic sequelae Balance-acupuncture therapy Piantan point
　　Since June of 1988, the authors of the present paper used balance- acupuncture- point, Piantan (BP-HN 2) as a main point in combination with Jiantong (BP-LE 6) and Qitong (BP-UE 2) to treat 190 cases of apoplectic hemiplegia and achieved satisfactory results. Here is the report.
　　CLINICAL DATA:
　　1. Sexes: Of the 190 cases, 114 were male, accounting for 60. 00% and 76 female, accounting for 40. 00 %.
　　2. Ages: Forty-three (22. 63 % ) cases were below 49 years, 88 (46.32% ) from 50 to 59 years and 59 (31. 05 % ) above 60 years.
　　3. Affected parts: The left side of the body involved was found in 77 cases, accounting for 40.53 % and the right side involved found in 113 cases, accounting for 59. 47 %.
　　4. History of disease: The longest duration of disease was 3 years and the shortest 7 days, including less than 6 months being in 75 (39. 47 %) cases, and more than 6 months being in 115 (60. 53 % ) cases.
　　5. Occupations: 112 (58. 95 % ) cases were physical workers and 78 (41. 05% ) mental workers.
　　6. Kinds Of disease: 152 (80. 00 % ) cases were ischemic hemiplegia and 38 (20. 00% ) hemorrhagic hemiplegia.
　　METHODS FOR OBSERVATION
　　1. Standards for Diagnosis
　　The standards of classification for cerebrovascular diseases formulated by The Symposium of Cerebrovascular Diseases of Chinese Medical Association in 1981 were adopted.
　　2. Standards for Evaluating the Therapeutic Effect
　　Cured: After treatment, the functional activity of the diseased side of body recovered, with the myodynamia being grade V, and the patients could take care of themselves in daily life.
　　Remarkable improvement: The functional activity of the diseased side recovered basically with the myodynamia being grade IV, and the patients could take care of themselves basically.
　　Improvement: The functional activity of the diseased side of the body had an improvement, with the myodynamia being grade III, but the patients could not take care of themselves.
　　Ineffective: After treatment, clinical symptoms and signs had no apparent changes.
　　TREATMENT METHODS
　　1. Treatment Group
　　Bilateral Piantan (BP-HN 2), 1cun above Shuaigu (GB 8 ) were employed in cross, i. e.,
　　with the right Piantan point being used for the left diseased side of the body, and vice versa.
　　Acupuncture methods: A filiform needle (3 cun long) was inserted into the point rapidly to a
　　depth of about 2 cun, with the needle tip toward Taiyang (EX-HN 5). After manipulating for a while, the needle was removed immediately. The treatment was given once daily, with 20 sessions being a therapeutic course. Auxiliary points were also used in accordance with the concrete situations. For example, Qitong (BP-LE2) was used for hemiplegia of the lower limb; Jiantong (BP-LE 6) used for hemiplegia of the upper limb; and Yatong (BP-HN 7) selected for aphasia.
　　2. Electro-acupuncture Control Group
　　Body acupuncture points: Jian (MA-SF 4 ), Quchi (LI 11 ), Shousanli (LI 10 ), Waiguan (TE 5), Hegu (LI 4), Yanglingquan (GB 34), Huantiao (GB 30 ), Fengshi (GB 31 ), Weizhong (BL 40), Chengshan (BL 57), Kunlun (BL 60 ), Jiexi (ST 41 ), Xuanzhong (GB 39) and Zusanli (ST 36) on the diseased side were used, combined with Jiache (ST 6), Dicang (ST 4 ), Yangbai (GB 14 ) and Neiting (ST 44) for deviation of the eye and mouth; with Lianquan (CV 23), Tongli(HT 5 ), Yamen (GV 15) and Shiyu point for dysphrasia. These points were stimulated for 10 minutes with intermittent waves and a moderate strength by using a G6805 therapeutic apparatus. The treatment was given once daily, 15 sessions being a therapeutic course and with an interval of a week between two courses.
　　3. Massage Control Group
　　Acupoints near the shoulder, elbow, wrist, hip, knee and ankle joints on the diseased side of
　　the body were massaged by using manipulations of holding-and-twisting, finger-pressing, pressing, rotatory kneading, shaking, palm-rubbing, lifting, tapping, etc. And the doctor helped the
　　patient to make stretching and bending movement. The procedures were conducted for 30 min. It was highly recommended that if the patient experienced sensations of soreness, numbness and distension after massage.
　　ANALYSIS OF THE THERAPEUTIC EFFECT
　　1. Treatment Group
　　Of the 190 cases, 148 (77.89%) were cured, 24 (12.63 %) had marked improvement, 12 (6.32% ) had improvement and 6 (3.16 %)had no change.
　　2. Electro-acupuncture Control Group
　　Of the 64 cases, 20 (33.33 %) were cured, 18 (30.00%) had significant improvement, 15(25.00 % ) had improvement and 7 (11. 67 % ) had no improvement.
　　3. Massage Control Group
　　Of the 60 cases, 20 (33.33 %) were cured, 18 (30.00%) had significant improvement, 15(25.00%) had improvement and 7 (11. 67 %) had no improvement. Statistical analysis displayed that there were significant differences as comparison of treatment group with each control group in the therapeutic effect (P < 0. 01). The effect of balance-acupuncture therapy was superior to that of electro-acupuncture which however, was superior to that of massage therapy.
　　TYPICAL CASES
　　1. Ischemic Hemiplegia
　　Mr Song, aged 61 years, a worker. His
　　first visit was in November of 1990. His dependant told us that he had suffered from cerebral
　　thrombosis for 3 months, he could not take care of himself and had difficulties in speaking and
　　movement of the right side of the body. When experienced this disease at the beginning, he was
　　hospitalized and treated by intravenous infusion of drugs. Through cerebral CT examination, it
　　was diagnosed as cerebral thrombosis. Examination showed the patient being fat and conscious;
　　the myodynamia of the right arm and right leg grade II and III separately; the largest limitation
　　of abduction or lifting both 30°, tendon hyperreflxia, and foot external rotatory test being positive. He could stand up and walk slowly with his hand on the bed edge. It was diagnosed as
　　 ischemic hemiplegia. Treatment was given to him by using balance-acupuncture therapy. Bilateral Piantan (BP-HN 2, main point), Qitong (BP-LE 2, auxiliary point) and Jiantong (BP-LE 6, auxiliary point ) were selected in cross. After one treatment, the functional activity of his diseased
　　upper and lower limbs had a clear improvement. After a half course of treatment, he could walk
　　by himself without either support of a walking stick or help of his dependant. Following two courses, the myodynamia of his upper and lower limbs recovered to grade IV and V respectively;
　　he could take care of himself in daily life and speak clearly.
　　2. Hemorrhagic Hemiplegia
　　Mrs Sun, aged 67 years, a farmer suburbs. Her first visit was on September 5, 1990 and had experienced cerebral hemorrhage for two months. Examination showed the patient being conscious, myodynamia of the left upper and lower limbs grade II; the left mouth angle deviating downward; hyperactivity of the knee and Achilles tendon reflexes; Babinski's reflex negative; and BP: 160/90 mmHg. CT examination suggested a hemorrhage of the right subarachnoid space. It was diagnosed as hemorrhagic hemiplegia and central facial paralysis.
　　Treatment was conducted by employing balance-acupuncture therapy and taking Piantan
　　(BP-HN 2), Jiantong (BP-LE 6), Qitong(BPLE 2) and Toutong (BP-LE 11). Following one course of treatment, her functional activities of the diseased limbs turned to normal except mild swollen of the wrist joint and fingers.

　　TREATMENT OF HICCUP BY ACUPUNCTURE IN 30 CASES OF MALIGNANT TUMOR PATIENTS AFTER CHEMOTHERAPIES

Shen Lida, Zhang Canzhen, Li Yunxia,
　　Tumor Hospital Of Yunnan Province, Kunming 650106, China

ABSTRACT: The curative effect of hiccup treated by acupuncture therapy was observed in 30 cases of malignant tumor patients after chemotherapies. The results show that hiccup disappeared completely in 28 cases after acupuncture at Zusanli (ST 36) and Neiguan (PC 6) on the both sides for 1 to 4 times, the total effective rate was 93. 3 %, it was very significant.
　　KEY WORDS: Acupuncture Malignant tumor Chemotherapy
　　Chemotherapy is one of the main therapies of malignant tumor, but most chemotherapeutic
　　drugs have reactions of gastrointestinal tract to a different extent. Hiccup is one of the reactions of
　　gastrointestinal tract, the continued hiccup often influences patients' emotion, appetite and sleep, adopting effective treatment, therefore, is very important. The authors have treated hiccup caused by chemotherapies using acupuncture at bilateral Zusanli and Neiguan, and got satisfactory result. It is reported as follows.
　　CLINICAL DATA:
　　1. Case Selection
　　Thirty cases were all patients of malignant tumor diagnosed definitely by the Department Of
　　Pathology of our hospital. Moreover, the diseases of central nervous system and intestinal
　　obstruction were excluded, and hiccup occurred frequently after chemotherapy and was ineffective 2 hours after sedative and antispastic treatments with Western medicine, these patients were enrolled in this study. Among them, 6 cases were gastric carcinoma, 4 cases hepatocarcinoma, 10 cases pulmonary carcinoma, 5 cases malignant lymphatic tumor, 2 cases mammary cancer and 3 cases malignant tumor of soft tissue; males were 20 cases, females 10 cases; their age ranged from 21 to 69 years old with an average age of 51. The protocol of chemotherapies is listed in the following Table.
　　2. Therapeutic Method
　　Bilateral Zusanli and Neiguan were selected, the needles were inserted perpendicularly after routine sterilization, the depth of needle insertion was 3 cm and 2 cm respectively, then the needle was lifted and thrusted, twisted and twirled until feeling the sensation of soreness, numbness and distention, then retained for 15-20 min, during the period, the needle was manipulated one time every 5 min, the acupuncture was given 1 -- 2 times a day. If it was ineffective 2 hours after the first treatment, then the needling was given again. In the period of acupuncture treatment, the patients didn' t take any drugs.

Table. Kinds of Disease and the Protocol Of Chemotherapies
　　___________________________________________________
　　 Protocol Of
　　 Kinds of diseases Cases chemotherapies
　　___________________________________________________
　　Gastric carcinoma 6 FAM
　　Hepatocarcinoma 4 CAP
　　Pulmonary carcinoma 10 CAP. MVP
　　Malig. lymphatic tumor 5 BACOP. COBDP
　　Mammary cancer 2 CAF
　　Malignant tumor of
　　Soft tissue 3 CAP
　　___________________________________________________

3. Evaluation of the Therapeutic Effect
　　Marked effectiveness: Hiccup disappears after one acupuncture and not recurs.
　　Effectiveness: Hiccup disappears after acupuncture for 2 -- 4 times and not recurs.
　　Ineffectiveness: Hiccup does not disappear after more than 5 times of acupuncture.
　　RESULTS:
　　Thirty cases were treated with above-mentioned treatment, 18 cases were markedly effective, 10 cases effective and 2 cases ineffective. The total effective rate was 93.3%. No patient had any adverse reaction after acupuncture.
　　DISCUSSION:
　　Chemotherapy is one of main treatments for malignant tumor, but most chemotherapeutic drugs have reactions of gastrointestinal tract to a different extent, such as nausea and vomiting, poor appetite and hiccup, etc.. Hiccup is called as" Hui symptom" in traditional Chinese medicine, the cause of disease is mostly due to pathogenic factors and retention of something in the stomach, or reversed flow of qi due to violent angry, imbalance of ascending and descending of stomach qi, travelling of qi upward reversely. Modern medicine hold that hiccup is caused by phrenospasm, which is induced reflectively by stimulation of vagus nerve and phrenic nerve. It should be treated with etiological treatment principally. In clinic, Paspertinum is routinely used to relieve the spasm of smooth muscle and Diazepamum used to relax the muscular tension induced by the excitation Of the central nervous system, but the effect is not satisfied. Some reference material show that needling Zusanli point might not only regulate the function of nervous system, but could protect the nervous system from nociceptive stimulation; Neiguan point has functions of soothing the chest oppression and regulating the flow of qi, tranquilizing and allaying excitement, and lowering the adverse flow of qi to arrest vomiting. Both points are important acupoints to treat hiccup,
　　combined use of these two points could soothe the chest oppression and regulate the stomach, lower adverse flow of qi and regulate qi, resulting in curing hiccup. This method is simple,
　　 inexpensive and practical; moreover, it produced an instant effect with a short therapeutic course. So it is beneficial to application in clinic.

(Wang wenyuan, Ji Yaurong, Wang Fei,Balance Acupuncture Treatment and Training Center Of the PLA, Beijing 100026, China)