Objective: To observe clinical effects of acupuncture combined with blood-letting by a three-edged needle for treating Bell’s palsy of wind-heat syndrome at the acute stage.
Methods: One hundred patients were randomly divided into a treatment group (50 cases) treated by acupuncture plus blood-letting and a control group (50 cases) treated by simple acupuncture. Four courses of treatments were given in both groups. The main symptoms and signs were observed and clinical effects evaluated with scores after one week, 2 weeks and one month of treatments respectively.
Results: After treatment, the scores for symptoms and signs were significantly different from those before treatment in both groups (P<0.05 or P<0.01). After one month of treatment, the improvement of the symptoms and signs in the treatment group was more than that in the control group with a significant difference (P<0.05). Conclusion: Acupuncture plus blood-letting can produce good therapeutic effects on Bell’s palsy of wind-heat syndrome at the acute stage.
DISCUSSION Mostly, Bell’s palsy at the acute stage is of an excess type. In patients with either innate excess of yang in the body or heat accumulation in the Yangming Stomach Meridian, wind-cold, is more likely to be transformed into heat because of excessive yang and stagnation of pathogens in the Yangming and Shaoyang Meridians, which may result in relaxation of facial muscles with such heat manifestations as hot feeling on the face, red tongue proper with yellow fur and superficial pulse. It can be differentiated as a wind-heat syndrome, and treatment should be given to expel wind and clear heat, and dredge the meridian passage. Needling local points is a basic principle for treating the disease which should be combined with needling remote points according to syndrome-differentiation of meridians and zang-fu organs and selecting points based on etiological factors and symptoms and signs. 1) Needling local points is to regulate the muscle regions of the face. Since muscles along the three Foot-Yang Meridians and the Hand-Yangming Meridian all end in the face, where the pathogens are located, it is very important to regulate the local points on the face. So, Zanzhu (BL 2), Sizhukong (TE 23), Sibai (ST 2), Yangbai (GB 14), Dicang (ST 4), Jiache (ST 6), Quanliao (SI 18) and Yingxiang (LI 20), especially those located around the mouth and musculus orbicularis oculi, are often selected. 2) Needling remote points along meridians can treat and adjust the affected meridians. According to meridian syndrome-differentiation, Yangming and Shaoyang Meridians are affected, for which Hegu (LI 4) of the Hand-Yangming Meridian and Guanchong (TE 1) of
the Hand-Shaoyang Meridian are chosen to regulate qi and blood of the two affected meridians. 3) Needling points based on etiological factors is to expel the pathogen of wind-heat,which should not be neglected in acupuncture prescriptions. Guanchong (TE 1) and the ear apex are used to remove wind and purge heat.
It is one of the basic principles in acupuncture to puncture deeply for the cases if the pathogenic factors invade the body deeply, but to puncture superficially for those with superficial invasion by pathogen. At the acute stage of Bell’s palsy, the pathogenic factors invade into Yangming and Shaoyang Meridians superficially, for which shallow needling insertion should be given with light even reinforcing and reducing maneuver. Later on, pathogenic factors get deeply into meridians, for which transcutaneous penetration and perpendicular insertions with moderate and intensive stimulation are mainly used. Based on the principles of reducing the excess and tonify the deficiency, and needling the points of the related meridians for the cases of neither excess nor deficiency, Hegu (LI 4) was punctured with strong stimulation with a reducing maneuver to dredge qi of the Yangming and Shaoyang Meridians to facilitate circulation of qi and blood, so as to dredge meridians and regulate blood circulation and expel wind to clear heat. Since the cases treated in the present study were Bell’s palsy at the acute stage of wind-heat syndrome, blood-letting at the ear apex and Guanchong (TE 1) with a three-edged needle was added to dispel wind-heat and reduce fire to stop pain. It is indicated that by selecting facial points combined with remote points along Yangming and Shaoyang Meridians plus points chosen based on symptoms and signs to expel the pathogen of wind-heat, acupuncture combined with blood-letting can produce good therapeutic effects on Bell’s palsy of wind-heat syndrome at the acute stage.
Autoren: ZHAO Ji-ping 䍉ঢ়ᑇ, PIAO Yan-zheng ᴈᔺᬓ & WANG Jun ݯ⥟ Department of Acupuncture, Dongzhimen Hospital, Beijing TCM University, Beijing 100700, China
Quelle: Journal of Traditional Chinese Medicine, June 2010, Vol. 30, No. 2