Discussion of Acupuncture Application through Typical Cases

By Kexin Bao, Ph. D., L. Ac.

 

After years of clinical practice and treating experience, the author found that some of the special treatments are workable and successful for treating the particular illnesses and diseases. As a result, the author is going to share several typical cases with the audiences and expose some of the treatment techniques for further reference. The author will start with general information about the particular illnesses and diseases. A detailed discussion is going to be held afterwards.

 

The typical cases include:

 

Disorders of TMJ

Definition:

WM: The term temporomandibular joint (TMJ) disorders can mean a multitude of problems in and around the jaw. This collection of signs and symptoms is usually associated with malocclusion (a dysfunctional bite), bruxism (teeth grinding), and loose ligaments surrounding the jaw that cause excessive movement between the bones, damage to the internal cartilage, and possible dislocation of the joint. TMJ disorders are also referred to as TMD, for temporomandibular joint disorders.

TCM: In TCM, this condition belongs to the disorder of jaw joint or dyskinesia of the joints caused by attack of the meridians by the pathogenic evils, such as wind, cold, dampness, heat, and fire.

 

Case History:

Patient Name: Linda

Sex: F.

Age: 46 Y.

Occupation: Office staff member.

Chief Complaint: The patient complains of experiencing pain in the right TMJ region for a couple of months. While chewing, she felt pain. She has been treated with acupuncture outside of the office for a couple of times and did not feel better, so she came for further treatment.

The Course of Treatment:

Point: Xiaguan (S 7), Tinggong (SI 19).

Method: Electrical acupuncture. Retain needles for 30 minutes and moxibustion with moxa stick for 15-30 minutes.

Result: Two days after the first treatment, the patient came for a visit and stated that her pain was almost gone; a couple more treatments were administered, and her pain was gone completely.

 

Myopia (Nearsightedness)

Definition:

WM: A condition marked by clear vision with close objects and blurred vision with distant objects.

TCM: In TCM, this is called “neng jin qie yuan zheng”. It is caused by improper use of eyesight, congenital deficiency, or congenital deficiency and heredity.

 

Case History:

Patient Name: Andrew

Sex: M.

Age: 12 Y.

Occupation: Student.

Chief Complaint: The patient complains of nearsightedness for one year due to watching too much television and playing too many computer games. His vision test result was: ……

The Course of Treatment:

Point: Jingming (B 1), Qiuhou (Extra 7), Yuyao (Extra 5), Yanglao (SI 6).

Method: Electrical acupuncture, gentle stimulation for 30 minutes.

Result: After three times of treatments, he felt much better. He did not have to wear eyeglasses, and his vision improved in a test report.

 

Hiccup (hiccough)

Definition:

WM: A spasmodic inhalation with closure of the glottis accompanied by a peculiar sound. Severe hiccups are sometimes seen after operation.

TCM: TCM refers to hiccups as a disease or a symptom. 1. When TCM refers to hiccups as a disease, it asserts that hiccups are mainly caused by attack of cold pathogens on the stomach, excessive stomach heat, qi stagnation, Yang deficiency of the spleen and stomach and stomach Yin deficiency, etc.

2. When TCM refers to hiccups as a symptom, it argues that hiccups are caused by upward reverse flow of qi, leading to uncontrollable and constant hiccupping with short and frequent sounds in the throat.

 

Case History:

Patient Name: H.

Sex: F.

Age: 43 Y.

Occupation: Housewife.

Chief Complaint: The patient complains of hiccupping for a couple of months. She has been treated with herbal medicine, and the symptoms have not improved, so she came for further treatment.

The Course of Treatment:

Point: Neiguan (P 6), Zhongwan (Ren 12), Gongsun (Sp 4).

Method: Electrical acupuncture, gentle stimulation for 30 minutes.

Result: Two days after the first treatment, the patient came for a visit and stated that her symptoms have decreased by a lot. After a few more treatments were administered, her symptoms were gone completely.

Additional comment: If the patient has acute hiccups and the onset of hiccups occurred suddenly, we can use the tip of our thumbs to press both sides of the upper eye orbits for seconds to minutes.  This usually leads to instant results.

 

Neuropathic palpitation

Definition:

WM: Forced or irregular pulsation of the heart perceptible to the patient, usually with an increase in frequency or intensity, with or without an irregularity in rhythm. This does not mean that the heart is beating irregularly; it is probably heating faster and harder, and a person is more aware of it. Another term for this is tachycardia.

TCM: Unduly rapid action of the heart which is noted by the patients, usually caused by the deficiency of vital energy and blood, fluid retention in the body, energy-sluggishness and blood stasis.

 

Case History:

Patient Name: Jenny

Sex: F.

Age: 48 Y.

Occupation: Registered nurse.

Chief Complaint: The patient complains of palpitation and insomnia for one year, she has had comprehensive physical examinations including EKG but did not find the problem, and so she came to seek help from herbal medicine. However, acupuncture treatment was suggested.

The Course of Treatment:

Point: Baihui (Du 20), Neiguan (P 6), Shenmen (H 7), Taixi (K 3).

Method: Acupuncture, retain needles for a half hour.

Result: Two days after first treatment the patient came for another visit and stated that her palpitation was gone but that the insomnia had not changed. One more treatment was administered. She did not come continuously for her insomnia. Months later, she invited my family to join her for a New Years dinner, during which she stated that her palpitation never occurred again.

 

Pain of Costal Cartilage

 

Definition:

WM: Pains in the region of cartilages that connect the distal ends of the ribs with the sternum and by their elasticity permit movement of the chest in respiration.

TCM: TCM refers to this condition as hypochondriac pain and chest pain. The channel of the liver supplies the costal and hypochondriac region. Emotional depression may restrain liver function and cause the inactive circulation of qi in the channel, which often results in costal and hypochondriac pain. Traumatic injuries, such as sprain and contusion, may also cause hypochondriac pain due to blood stasis in the collaterals.

 

Case History:

Patient Name: Lan

Sex: F.

Age: 48 Y.

Occupation: Housewife.

Chief Complaint: The patient complains of pain occurring on both sides of costal areas for a half year. She has had comprehensive physical examination including ultrasound for liver and gallbladder. She did not find problem, and her physician did not give her diagnosis, so she came to seek a diagnosis and treatment from TCM.

The Course of Treatment:

Point: Ahshi (about 6 points).

Method: Electrical acupuncture, retain needles for 30 minutes and moxibustion with moxa stick for 15-30 minutes.

Result: After one session of \treatment, the patient’s pain was reduced.  After she came continuously for about seven times, the pain was gone completely. It was noted that TDP infrared Lamp is useful for this condition.

 

Ganglion

Definition:

WM: Ganglion cysts are small connective tissue pouches filled with fluid. They grow on joint capsules or tendinous sheaths. They usually appear on the wrist, the hand, or the top of the foot.

TCM: In TCM, ganglion cysts are referred to as subcutaneous nodules, usually caused by dysfunction of the spleen and stomach and accumulation of phlegm-damp.

 

Case History:

Patient Name: Yue

Sex: F.

Age: 46 Y.

Occupation: Sewer.

Chief Complaint: The patient complains of pain on the dorsal side of the left foot lasting for months. There was a cyst-like object on the region of pain under the skin, 1.5 cm. X 1.5 cm. in size.

The Course of Treatment:

Point: Ahshi (on the object, 4 spots around the object).

Method: acupuncture, horizontally inserted needle, manipulated needle with lifting and trusting, twirling and rotating methods for a half minute to one minute to break the cyst and stimulate the tissue inside the cyst (thick fluid). After withdrawing the needles, use the thumb to press and knead the cyst until it disappears or almost disappears (about one to two minutes).

Result: Only one session of treatment was given, the ganglion did not come back. Several years late, it occurred again.  The same method was used to treat it, yielding the same results.

 

Lipoma

Definition:

WM: Lipomas are benign fatty tumors surrounded by a connective tissue capsule. They are common in the skin but may occur in virtually any tissue in the body, including the intestines, the liver, and the reproductive tract.

TCM: Lipoma in TCM belongs to mass, which is formation of mass on the surface of the body accompanied with slight distention or no feeling, caused by emotional upsets or an immoderate diet leading to damage and functional disorders of the liver and spleen, with formation of stagnated energy, blood stasis and phlegm.

 

Case History:

Patient Name: Shiao

Sex: F.

Age: 40 Y.

Occupation: Housewife.

Chief Complaint: The patient complains of joint pain lasting one or more years. She was diagnosed with arthritis and treated with Western medicine. However, the internist asked her to consult an acupuncturist. While the joint pain was treated with acupuncture, a lipoma on her left forearm was reported. In passing, acupuncture for treating the lipoma was given.

The Course of Treatment:

Point: Ahshi.

Method: horizontally inserted needle, manipulated needle with lifting and trusting, twirling and rotating methods for a half minute to one minute to stimulate the fatty tissue. After withdrawing the needles, use the thumb or major thenar eminence to knead by pushing the lipoma about one to two minutes.

Result: It was treated once every two days for a total of 10 times, and the lipoma disappeared.

 

Numbness (of fingers)

Definition:

WM: Characterized by a hindrance of tactile sensation, thalposis and pain sensation in limbs, or hypoesthesia.

TCM: According to TCM, this problem is caused by malnourishment of meridian resulting from qi and blood deficiency, or stagnation of qi and blood in meridian or damp-cold and phlegm accumulating in the vessels.

 

Case History:

Patient Name: Lihchien

Sex: F.

Age: 60 Y.

Occupation: Housewife.

Chief Complaint: The patient complains of numbness of fingers lasting one month. She has had comprehensive physical examinations, including X-rays of cervical spine, but she did not find problem, and so she came to seek TCM for treatment.

The Course of Treatment:

Point: Tip of fingers (Shixuan) (Extra 24).

Method: Pricking with blood letting.

Result: After only one session of treatment, the patient’s numbness of fingers was gone.

 

Heel pain (Cal-canodynia)

Definition:

WM: A disease characterized by pain at the bottom of the calcaneus caused by chronic sprains, accompanied by anterior spurs and tenderness in the tubercle of calcaneus.

TCM: According to TCM, this disease is mainly  caused by impairment of the kidney and insufficiency of the essence and blood.

 

Case History:

Patient Name: Lei

Sex: F.

Age: 42 Y.

Occupation: Vendor.

Chief Complaint: The patient complains of plantar pain lasting four months. She has had regular acupuncture at another office but did not receive therapeutic results, so she came to seek further treatment. There was severe tenderness on both soles, and she felt a lot of pain while they were pressed or while she was walking.

The Course of Treatment:

Point: Ahshi.

Method: Inserted needles perpendicularly, added electrical stimulation through the needles for 20~30 minutes.  She was treated twelve times.

Result: The plantar pain was cured.

 

Acute lumbar sprain

Definition:

WM: Injury of the lower back that is cause by sudden and violent force. It is characterized by sudden sprain of muscles, fasciae, ligaments and other soft tissues in the lumbar region and is usually caused by forward or backward over-flexion (beyond the normal range of movement), by carrying over-weight objects in an improper posture, or by direct knock on the waist due to accident.

TCM: TCM regards this disease as “Niu Cuo Shang” (sprain/contusion) in its classification.

 

Case History:

Patient Name: Bill

Sex: M.

Age: 52 Y.

Occupation: Construction contractor.

Chief Complaint: The patient complains of lower back pain for one day. Since a day ago, he had been having lower back pain, and the pain happened suddenly while he worked on a construction site. He cannot bow his low back; even slight movements can result in severe lower back pain. A physician saw him and painkiller was given, but his symptoms did not changed. While he came to my office, he had to walk on crutches.

The Course of Treatment:

Point: Ahshi points, usually on points Yaoyan (Extra 21), Qihaishu (B 24), Dachangshu (B 25), Guanyuanshu (B 26).

Method: Acupuncture. After needles were inserted, the therapist first searched acupuncture feeling, and then used electrical apparatus with rapid continuous waves to stimulate for 30 minutes.

Result: 30 minutes later, the needles were withdrawn, and he was told to move his back without crutches. Suddenly, he could walk freely.  Happily, he said, “Dr. Bao is really very skilled”.

 

Acute pain due to renal calculus (kidney stone or lithiasis in urinary system)

Definition:

WM: A disease, calculus in the kidney.

TCM: In TCM, renal calculus belongs to stranguria, which is caused by urinary stones that result from the retention of wetness and heat-evils in the lower warmer.  It is marked by pain or colics in the lower abdomen, loins, and urethra; difficulty in urination; and discharge of yellow, turbid urine or haematuria.

 

Case History:

Patient Name: Jiangni

Sex: M.

Age: 32 Y.

Occupation: Truck driver.

Chief Complaint: The patient complains of lower abdominal pain on his right side, accompanied by side lower back pain lasting several hours. He experienced a lot of pain at that time, less urine, normal defecation, sweating, and dusky and oily complexion. There was tenderness in the abdomen and lower back without rigidity of the abdomen (indicating peritoneal inflammation).

The Course of Treatment:

Point: Tianshu (S 25), Shuidao (S 38), Shenshu (B 23), Qihaishu (B 24), Zhaohai (K 6), Ahshi.

Method: Electrical acupuncture with irregular waves for 30 minutes.

Result: After the treatment, his pain was completely gone. He felt fatigue, and herbal prescriptions were given for further treatment. Later, he was diagnosed with kidney stones by a urologist.

 

Onset of dysmenorrheal

Definition:

WM: A disease, also know as menstrual abdominal pain, referring to cyclic abdominal or lumbosacral pain or even loss of consciousness because of pain during, before, or after menstruation.

TCM: In TCM, it is mostly caused by stagnation of qi and blood, retention of cold dampness, downward flow of damp heat, retention of internal cold due to Yang deficiency, weakness of qi and blood, and insufficiency of the liver and kidney, etc.

 

Case History:

Patient Name: Mei

Sex: F.

Age: 38 Y.

Occupation: Office staff member.

Chief Complaint: The patient complains of lower abdominal pain lasting a couple of hours. She felt significant pain at that time because she was in the middle of her menstrual period. Her family member called the office and sent her to have treatment. There was tenderness in the lower abdomen without abdominal rigidity (indicating peritoneal inflammation).

The Course of Treatment:

Point: At first, electrical acupuncture was applied to points on her front side such as Guilai (S 29), Guanyuan (Ren 4), Qihai (Ren 6), Sanyinjiao (Sp 6) for 30 minutes, but her pain did not stop. Thus, points on her back such as Ciliao (B 32), Xiaoliao (B 34), Ahshi were selected.

Method: The points were punctured and stimulated with rapid, continuous, electrical waves for 30 minutes.

Result: As a result, her pain was completely gone. Two hours later, we called her to follow up on her condition, and she answered, “Thank you. I do not feel pain anymore”.

 

Impotence

Definition:

WM: A name of a syndrome. It refers to the failure of the penis to become erect, or having erections that lack durability before the normal decline phase of the man’s sexual function.

TCM: In TCM, it is mostly caused by excess of the life gate, excessive fire due to the Yin deficiency of qi and blood or downward flow of damp heat.

 

Case History:

Patient Name:

Sex: M.

Age: 35 Y.

Occupation: Worker.

Chief Complaint: The patient complains of impotence lasting a couple of months. He married and has one child. Ten years ago, he divorced and has never had sex since. After he remarried a couple of months ago, he found that he was impotent, so he came for help.

The Course of Treatment:

Point: Huiyin (Ren 1).

Method: Acupuncture without retaining the needle.

Result: After one session of treatment, the patient’s condition improved greatly. To enhance the results, he had two more treatment every two days.   Soon, he never came back.

 

High blood glucose (hyperglycemia)

Definition:

WM: An excess of sugar in the blood is an index of diabetes mellitus. Diabetes mellitus is not a single disease, but rather a group of related disorders that all result in hyperglycemia, or elevated levels of sugar in the bloodstream, which are then shed in the urine.

TCM: High blood glucose only can be found via a blood test. If the patient does not have any symptoms, we would not be able to identify a disease of TCM. But once symptoms occur, we can identify the disease as belonging to Xiaoke. Xiaoke means 1. a disease characterized by polydipsia, polyphagia and polyuria, caused by over intake of greasy and sweet foods, immoderate diet, emotional upsets or overstress leading to dryness-heat of the viscera and yin-deficiency with hyperactivity of fire-evil; 2. Referring mainly to thirst.

 

Case History:

Patient Name: Linda

Sex: F.

Age: 55 Y.

Occupation: Office staff member.

Chief Complaint: The patient complains of excess of sugar in the blood lasting months. She has sought Western medicine to control the blood glucose. When she came to treat her arm pain, she asked, “Can acupuncture lower my blood sugar”? I answered, “Possibly”. Consequently, she began to have treatment for her excess sugar in the blood

The Course of Treatment:

Point: Tianshu (S 25), Daheng (Sp 15), Yinlingquan (Sp 9), Zusanli (S 36), Waiguan (SJ 5).

Method: Electrical acupuncture for 30 minutes, and infrared on the abdomen for 30 minutes. 1-2 time a week.

Result: After she began treatment, she reduced her dosage of medicine, and tested her blood sugar by herself often.  Test results fell in the normal range. She still comes for treatment every one to a couple of weeks.

 

Neuralgia of post-zoster (Postherpetic neuralgia)

Definition:

WM: A pain that lasts after the lesions related to herpes zoster has healed.

TCM: Herpes zoster is groups of deep-seated vesicles on erythematous bases distributed over one side of the waist and hypochondrium following the course of a nerve, associated with neuralgic pain; caused by the stagnation of fire and wetness evils in the heart and liver channels. Hypochondriac pain is a symptom due to asthenia of liver; it is accompanied by timidness, blurring of vision, and tinnitus.  It is attributed to the deficiency of liver-energy, while that with feverish sensation, dry mouth, and dizziness is attributed to the insufficiency of liver-blood.

 

Case History:

Patient Name: S.

Sex: F.

Age: 83 Y.

Occupation: Retired teacher.

Chief Complaint: The patient complains of pain in her right shoulder, back, and axillar region lasting two years after she had shingles, [[[which the skin lesion disappeared.]]] The pain was of a special type.  When pressure was applied to the positions of pain, she did not feel pain. But, strangely, while she put on clothes or engaged in certain motions, she felt pain. She was referred by a neurologist for acupuncture treatment.

The Course of Treatment:

Point: At first, points on right shoulder, back, axillar region and arm such as Jianyu (LI 15), Jianliao (SJ 14), Jianzhen (SI 9), Quchi (LI 11), Hegu (LI 4), Waiguan ((SJ 5), Dabao (Sp 21), Ahshi were selected with electrical acupuncture for 30 minutes every session, 3 time a week. But, after 7 times of treatments, her pain had only reduced slightly. Thus, stimulating zone on left scalp such as sensory zone was selected.

Method: The points were punctured horizontally and stimulated with electrical continuous waves for 30 minutes/each time.

Result: After one time of treatment of the scalp using acupuncture, the patient felt less pain, as stated by her daughter while she came for a visit. She came for two more times. Because her daughter’s car was broken, and because she had to travel out of town, she did not come again.

 

Due to the reason that I did not have enough time to prepare for this talk, I did not open the exact old files for the case studies. As a result, the case studies are not 100% accurate; however, the case studies are all actual cases and I have treated all of the patients mentioned.