Discussion on Distinct Features of Acupuncture-Moxibustion

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[b:5627a01824]Discussion on the Distinct Features of Acupuncture and Moxibustion[/b:5627a01824]

During the development in thousands of years, with the long-term historical deposit, Chinese acupuncture has formed its unique distinct features which exhibit the great difference both between acupuncture and medications and between acupuncture and modern physiotherapy.
The distinct feature of acupuncture and moxibustion is the display of its theoretical features, the practical features, and the advantage during the process of diagnosis and treatment. Since the distinct feature of acupuncture is closely related with the therapeutic effect of acupuncture, attention should be paid on preserving and promoting the distinct features of acupuncture in the clinical treatment, education, and scientific research.
In order to draw the attention on the distinct acupuncture-moxibustion features from the academic circle of acupuncture and moxibustion, this article would explore the following three aspects, namely, the display of the distinct features of acupuncture and moxibustion, the significance of preserving and promoting the distinct features of acupuncture and moxibustion, and how to preserve and promote the distinct features of acupuncture and moxibustion in the process of modernization of acupuncture and moxibustion.

1. The display of the distinct features of acupuncture and moxibustion
1). Differing from medication, acupuncture cannot eliminate directly the pathogens from the body, neither can replenish the indispensable chemical substance which the body needs but rather achieves the goal of medical treatment and health preservation by means of regulating the physiological functions of the body and inspire the inborn disease-resisting and auto-repairing abilities of the body. This action character which is based on the physiological mechanism enables acupuncture to be of very evident advantages of safety and large variety of indications, differing greatly from the medications that are characterized by the well-confined indications and contraindications. In treating some diseases, despite that they do not seem like the indications of acupuncture from the superficial view, acupuncture can be still used as the supplementary therapy, e.g. fracture, to which acupuncture certainly cannot be used for the reduction and fixation, but it helps repercussion and analgesia, promotes the porosis, and accelerates the union. Acupuncture can be also done to the healthy population because of its immunity-enhancing and anti-aging actions.
2). It is the essential difference between the clinical treatment of traditional Chinese medicine and that of western medicine that the individual variations are taken into consideration and the treatment is based on the differential diagnosis of syndromes which are determined in accordance with the theory of traditional Chinese medicine. Acupuncture is a component part of traditional Chinese medicine, it surely lays great attention on the treatment on the basis of the differential diagnosis of syndromes. However, acupuncture differs from Chinese herbal medicine for it emphasizes the different aspects though following definitely the principles of the treatment on the basis of the differential diagnosis of syndromes in the clinical practice. To acupuncture, the theoretical core which guides the clinical treatment is the meridian-collateral theory, so the emphasis of the differential diagnosis is put on the focus of the disease, especially the meridians in where the diseases occur and the other affected meridians must be determined so as to provide the ground for prescribing the acupoints for the treatment. Meanwhile, the nature of the diseases should also be differentiated, especially the status of the flow of Qi and blood and the situation of excess, deficiency, cold and heat, which can direct the operation of acupuncture techniques.
3). Acupoint is a unique concept in acupuncture therapy, while taking acupoints as the site of performing the acupuncture techniques is another feature of acupuncture. The acupoints which are discussed here today include the conventional meridian points, extra points, and Ashi points on one hand and the operation sites of the micro acupuncture systems on the other hand. Acupoints have some relatively special properties which are similar to those of medications. However, acupoints have the bi-directional regulating property, for example, Zhongji (CV 3) can treat both retention of urine and enuresis; Neiguan (PC 6) can be used for both antiemetic and emetic actions; Zusanli (ST 36) can treat both diarrhea and constipation; and Sanyinjiao (SP 6) can treat both dysfunctional uterine bleeding and amenorrhea. Apparently, this is the greatest difference between acupuncture and medications.
4). It is the basic modality of acupuncture performance to thrust a special needle-like tool into acupoints or to smoke and heat the acupoints with burning moxa wool. On the basis of this modality, several dozens of needling techniques of acupuncture and moxibustion techniques have been formed, among which the filiform needle techniques include various manipulating methods such as obtaining arrival of Qi, waiting for arrival of Qi, promoting flow of Qi, reinforcing Qi, reducing Qi, and regulating Qi so as to regulate or adjust the flow of Qi in meridians and collaterals. These techniques or methods of acupuncture and moxibustion with various features are the important means and measures to achieve the effects of dredging the meridians, regulating Qi and blood, reinforcing the deficiency and reducing the excess, warming the cold and clearing the heat, and strengthening the anti-pathogenic Qi in the body and eliminating the pathogenic factors from the body.
From the features of the above four aspects, it can be generalized that acupuncture-moxibustion therapy is the scientific technology on one hand and the performing skill on the other hand. The treatment on the basis of differential diagnosis of syndromes can be likened as playing chess, which needs the reasoning and deducing; while the acupuncture-moxibustion performance can be compared to the calligraphy and painting which require the manual skills. Because of the different levels of the practitioners’ performing techniques, the therapeutic effect of acupuncture can hardly be repeated by different operators.

2). The significance of preserving and promoting the distinct features of acupuncture and moxibustion
Therapeutic effect remains always the topic of acupuncture physicians and the essential goal of why the preservation and promotion of the distinct features of acupuncture and moxibustion is emphasized is to improve the therapeutic effects. As to the close relationship between the distinct features of acupuncture and moxibustion and the therapeutic effect of acupuncture, in addition to the deep understanding of the acupuncture physicians in ancient time and nowadays through their clinical practice, the modern clinical and experimental research have acquired the similar opinions, which are presented as follows.
1). The influence of the acupoints on the human body is much more remarkable than that of the non-acupoint sites. For instance, needling Zusanli (ST 36) can exert remarkable influence on the gastrointestinal peristalsis while the same needling stimulation on the side of the point cannot make the similar result, or even no result at all; needling Hegu (LI 4) or Dashu (BL 11) can alleviate the bronchial spasm induced by the methacholine while the same needling at the non-acupoint site has not achieved the similar effect; needling Neiguan (PC 6) can exert the benign influence on the blood supply to the hearts of the patients with coronary heart disease while needling the Waiguan (TE 5), an acupoint located opposite to it on the dorsal aspect of the forearm cannot exert such influence. In recent years, the study of the acupoint injection (also known as hydro-acupuncture) has proved from the clinical view the difference between the acupoints and non-acupoint sites. For example, the injection of isoproterenol in Neiguan (PC 6) can noticeably increase the contraction of the heart muscles, while the same injection in the loci on both sides of the acupoint can hardly have any effect; injection of 0.5mg of reserpine can achieve the better effect of lowering blood pressure superior to the intramuscular injection of 1.0 mg of the same agent; and injection of interferon, hepatitis B vaccine, and thymosin in Ganshu (BL18), Shenshu (BL 23), Xuehai (SP 10), and Zusanli (ST 36) and it has achieved for the chronic carriers of hepatitis B virus a good therapeutic effect which is superior to the intramuscular injection.
2). Differential diagnosis of syndromes of traditional Chinese medicine, especially the differential diagnosis of syndromes for the meridians, the differential diagnosis of syndromes for the Zang-Fu organs, the differential diagnosis of syndromes for the Qi and blood, play an important significance in guiding the selection of acupoints in acupuncture-moxibustion treatment. From the ancient time up to now, acupoints could be only selected from the places nearby the focus of the disease or distant from it. It is always easy for acupuncture physicians to make a good selection of the nearby acupoints, while to select the distant ones, the physician will lost what to do if he does not grasp the differentiating methods to find the affected meridians and to determine the imbalanced status of Zang-Fu organs and Qi and blood.
The analysis of the articles concerning the treatment of diseases by single distant acupoint which have been published in the recent years has demonstrated that there exist the meridian connection between the majority of the single acupoints and the focus of diseases which they are engaged in the treatment, so there have been fairly marked clinical effects of the acupuncture-moxibustion treatment, e.g. selecting Yinjiao (GV28) to treat internal hemorrhoids and selecting Houding (GV 19) to treat pain of coccyx bone are all because the running course of Du meridian passes through the perineum and the coccycal and sacral area; selecting Dadun (LR 1) to treat painful penis is because the liver meridian “curves around the external genitalia” ; selecting Fengchi (GB 20) to treat heel pain is because of the Yangqiao meridian which “starts from inside the heel” and “moves up to enter Fengchi (GB 20)”; selecting Yanglingquan (GB 34) to treat shoulder pain is because the running course of gallbladder meridian passes the “shoulder” and the acupoint is also the Influential Point of Tendons.
Besides, it is also beneficial to improving the therapeutic effect by differentiating the imbalanced status of Zang-Fu organs and Qi and blood and selecting acupoints according to the differentiation of syndromes, e.g. Taichong (LR 3) for treating hyperactivity of liver Yang, Taixi for treating insufficiency of kidney Qi, Qihai (CV 6) for Qi deficiency, and Geshu (BL 17) for blood heat, etc.
3). The techniques of acupuncture, including the techniques of achieving arrival of Qi and controlling the movement of Qi and the ones for reinforcing the deficiency and reducing the excess, are all related closely with clinical effect. Far back to the book “Yellow Emperor’s Internal Classic” written over 2,000 years ago, it is said “It is the key in acupuncture that only the arrival of Qi can achieve the therapeutic effect ”. It is also stressed the importance of “Qi reaching the focus of diseases” in the book “Prescriptions for Universal Relief” which was written in 1406 A. D. In modern time, the feeling of the patients with the arrival of Qi achieved by the acupuncture needling is known as the needling sensation and the movement of Qi and the arrival of Qi reaching the focus of disease are all called “the propagation of needling sensation along meridians”. The analysis of more than forty articles published before 1988 concerning the research of the propagation of needling sensation along meridians has revealed a common rule that the more marked the propagation of needling sensation along meridians is, the higher the therapeutic effect is while no propagation of needling sensation along meridians, the therapeutic effect is unsatisfactory.
In line with the deficiency or excess of the syndromes, reinforcing or reducing needling techniques are used during acupuncture treatment and it is also the treating principle emphasized repeatedly in “Yellow Emperor’s Internal Classic”. The modern research has also proved that the correct application of the reinforcing and reducing techniques of acupuncture treatment can achieve the satisfactory therapeutic effect. For example, observation was made on the effect of acupuncture needling at Dazhui (GV 14) and Zusanli (ST 36) for alleviating the toxic reaction of the anticancer chemical drugs and the result showed that although both reinforcing and reducing techniques are markedly effective, the reinforcing technique is superior to the reducing one. Observation was also made on the acupuncture needling at Fengchi (GB 20) and Taichong (LR 3) for treating hypertension and the result showed that the treatment of reinforcing the deficiency and reducing the excess in accordance with the differential diagnosis of syndromes obtained the highest therapeutic effect, while the neutral needling technique for all the syndromes obtained the medium therapeutic effect, and the treatment of reinforcing the excessive syndromes and reducing the deficiency ones obtained the worst effect, and there was a very noticeable difference.
The aforementioned relationship between acupuncture needling techniques and clinical effect has showed that different needling tools and methods of manual manipulation have certain values in the treatment which cannot be replaced easily by other stimulating methods. For instance, observation was made on acupuncture for its de-addiction effect of heroin addicts and its potentiality of preventing the relapse of the addiction and the result showed that the treatment based on the differential diagnosis of syndromes is much more noticeably effective than the trans-cutaneous electric stimulation on acupoints by the Han’s Narcotic-Abstinent Apparatus.
4). The unique effect of moxibustion can never be simply compared to the local thermotherapy. From ancient time up to now, acupuncture and moxibustion have taken half of the share in the acupuncture-moxibustion circle. It is said in “Yellow Emperor’s Internal Classic”: “when acupuncture is not indicated in the treatment, moxibustion can be an appropriate measure.” According to the recordings in the ancient medical literatures, moxibustion is noticeably effective in treating skin infections, tuberculosis, seizures of hysteria, apoplexy, asthma, infantile convulsion, and many other disorders differentiated as deficiency and cold syndromes. Recently, observation was made on moxibution at Zhiyin (BL 67) for correcting the abnormal fetus position and it has been found that the success rate was higher than the natural version rate. Observation was also made on the influence of festering moxibustion on the premonition of apoplexy, whole blood viscosity, and blood fat and it was found that the therapeutic effect of the festering moxibution in combination with acupuncture is much noticeably higher than that of medication of Compound Salvia Injection in combination with acupuncture. Clinical effect was observed on treatment of asthma with acupuncture and moxibustion and it was found that the effect of the festering moxibustion is noticeably higher than that of the indirect moxibustion with ginger slice while the effect of latter is noticeably higher than that of simple acupuncture.
The traditional moxibustion therapy is performed with moxa wool. The modern research has proved that the action of moxibustion is not only the physical therapy but the products during the burning of the moxa wool have also the medicating effects. In fact, in traditional moxibustion in addition to the use of moxa wool, some other herbal materials are selected according to the need of various disease conditions, so the medicating actions of moxibustion should not be neglected. In the recent years, some acupuncture physicians use infrared lamps instead of moxibustion for the sake of avoiding the smoking and the scorching of the fire, as a matter of fact, this type of local thermotherapy can neither achieve the effect of “arrival of Qi” as the traditional moxibustion does, nor can acquire the therapeutic action as that of the traditional moxibustion.
By the above analysis, it is apparent that whether or not the acupuncture-moxibustion features are distinct is closely related to the effectiveness of acupuncture and moxibustion. To preserve and promote the distinct acupuncture-moxibustion features is not only beneficial to obtaining good effects in the treatment of disorders with confirmed diagnosis, but also the diseases which cannot be clearly diagnosed by western medicine or the new-found diseases can also be treated with acupuncture and moxibustion by prescribing acupoints and performing manipulating techniques in line with the theories of traditional Chinese medicine for differential diagnosis of syndromes since the distinct features of acupuncture and moxibustion are the display for the thinking mode of diagnosis and treatment of traditional Chinese medicine. Taking chronic fatigue syndrome as an example, modern medicine has not yet found its pathogenesis and moreover lacks of the effective treating approaches, while on the other hand, the differential diagnosis of syndromes in acupuncture clinic holds that heart, spleen, liver, and kidney are involved in this disorder, so Baihui (GV 20), Dazhui (GV 14), Guanyuan (RN 4), Qihai (RN 6), Neiguan (PC 6), Zusanli (ST 36), Sanyinjiao (SP 6), Taichong (LR 3), and the related Back-Shu points can be done with acupuncture and good therapeutic effect has been achieved. Another example, peripheral neuropathy complicated from AIDS is usually treated by means of nerve-nourishing medications which are not quite effective, while acupuncture was used at Guanyuan (RN 4), Qihai (RN 6), Dazhui (GV 14), Taodao (GV 13), Pishu (BL 20), and Shenshu (BL 23) and the effect was noticeably higher than that of injection of Vitamin B1 and Vitamin B12.

(to be continued)