Facial paralysis and Wind stroke treated by acupuncture

Meridians and colleterals Central nervous system Peripheral nervous system

How do TCM think of N.S. Brain &Spinal cord Nerve Nao sui &Ji sui “sui” means essence Conginital essence Acquired essence Nerve 神经（shen jing) 经络（jing luo)-------------merdians and colleterals

Meridians and colleterals Transmit Qi and blood Obstruction of Qi and blood Overflow of Qi and blood Principles of acupuncture for neural diseases Activate Qi and blood circulation Regulate Yin and Yang

Peripheral facial paralysis

Symptoms Eye Mouth Frontal part Increasing eyelid fissure Inability to close eyes Mouth Deviation of nasolabial groove,lips Leaking from mouth Frontal part Disappearence of frontal line

No possible reason Infection Metabolism Tumor

YANG Face Foot yangming Foot shaoyang Foot taiyang Hand yangming DU F. taiyang Face Foot yangming Foot shaoyang Foot taiyang Hand yangming Hand shaoyang Hand taiyang Du F. shaoyang YANG H. shaoyang H. taiyag H. yangming F. yangming

TCM theories of peripheral paralysis Wind Cold DAMPNESS

Face Foot yangming—— Hand yangming —— Foot shaoyang —— Hand shaoyang —— Foot taiyang —— Hand taiyang —— Du —— Regulate Blood Regulate QI Dispel wind cold Supply Yang Qi

Case sharing 40y,male Unknown cause He suddenly find weakness of his face after waking up. Go to clinic immediately

TCM diagnosis Measures Channels Wind cold attacking Warm merdians and dispel wind cold Channels Taiyang Du Yangming

Methods Electrical acupuncture Warm needling moxibution

Hegu (LI 4) Location: on the dorsum of hand, between the first and second metacarpal bones, along the middle of the second metacarpal bone on the radial side.

Renzhong (DU 26) Location: at the junction of the super 1/3 and middle 1/3 of the philtrum

Cuanzu (BL 2) Location: in the depression on the media lend of the eyebow

Yingxiang (LI 20) Location: 0.5 cun lateral to the midpoint of the lateral border of ala nasi, in the nasolabial groove

After 2 weeks

WIND STROKE Middle cerebral artery Cerebral infarction Cerebral hemorrhage

Windstroke is one of four kinds of main diseases that endanger human health. Its morbidity lies in the first place in China. Companied with many sequelae, it has brought a heavy burden to both the society and families.

Wind-------风 Windstroke----------中风 Why people connect this disease with “wind”？

Main points Neiguan(PC 6,the Pericardium Meridian of Hand-Jueyin) Renzhong(DU 26,the DU Meridian) Sanjinjiao(SP 6,the Spleen Meridian of Foot-Taiyin)

Neiguan(PC 6)

RENZHONG (DU 26)

SP 6 SANYINJIAO

Supplementary points Jiquan(HT1,the Heart Meridian of Hand-shaoyin) Weizhong(BL40,the Bladder Meridian of Foot- Taiyang) Chize(LU5, the Lung Meridian of Hand-Taiyin)

HT1

LU5

BL40

Point Modification： For difficulty of swallowing Fengchi(GB 20),Yifeng(SJ 17) and Wangu(GB 12) are added. For failing to extend fingers with stiffness, Hegu (LI 4) is added. For slurred speech, Shanglianquan(EX-HN) is added, and Jinjin(EX-HN 12) and Yuye(EX-HN13) are used with blood-letting method. For strephenopodia, penetrating method from Qiuxu(GB 40) to Zhaohai(KI 6) is used

Fengchi(GB 20) Wangu(GB 12) Yifeng(SJ 17) Puncture Fengchi(GB 20),Wangu(GB 12) and Yifeng(SJ 17) in the direction of the laryngeal protuberance for 2-2.5 cun, with reinforcing manipulation of twirling and rotating the needle in high frequency and small amplitude for 1 minute to each acupoint.

Hegu(LI 4) to Sanjian(LI 3) Puncture Hegu(LI 4) 1-1.5 cun in depth with the needle tip toward Sanjian(LI 3), with reducing method of lifting and thrusting to make the patient’s second finger or five fingers extended freely.

Shanglianqu an (EX-HN) 针向舌根1.5~2寸，用提插泻法； Puncture Shanglianquan(EX-HN) for 1.5-2 cun, with the needle tip towards the root of the tongue and reducing method of lifting and thrusting the needle.

用三棱针点刺放血，出血1~2毫升； Jinjin(EX-HN12) Yuye(EX-HN13) Prick Jinjin(EX-HN12) and Yuye(EX-HN13) with the three-edged needle to cause bleeding for 1-2ml.

Qiuxu(GB 40) to Zhaohai(KI 6) Puncture Qiuxu (GB 40) 1.5-2 cun in depth with the needle tip toward Zhaohai(KI 6),until soreness and distension occurred locally.

Treatment of Complications

Constipation: Puncture Waishuidao(EX-CA), Waiguilai(EX-CA) and Fenglong(ST 40)

Incontinence of Urine, Retention of Urine: Puncture Zhongji(RN 3),Qugu(RN 4), Sanyinjiao (SP 6), Yinlingquan(SP 9). Moxibustion is applied on the local area, while massage and hot compress are applicable too.

Cervical Jiaji Points(EX-B2)

Double Vision:Puncture Fengchi(GB 20), Tianzhu(BL 10), Jingming(BL 1) and Qiuhou(EX-HN7)

Epilepsy: Puncture Daling(PC 7), Jiuwei(RN 15)

Periarthritis of Shoulder: Puncture Jianneiling(EX-UE), Jianliao(SJ 14), Jianzhen(SI 9), Jianzhongshu(SI 15), Jianwaishu (SI 14).Apply blood letting and cupping method to the local pain point.

Vascular Dementia:Puncture Baihui (DU 20), Sishencong(EX-HN1), Sibai(ST 2) and Taichong(LR 3).

Taichong(LR 3)

Paradoxic Sleep: Puncture Shangxing (DU 23), Shenmen(HT 7).

Course of Treatment Give acupuncture treatment twice a day, ten days as a course of treatment, commonly give the patients three to five courses of treatment.

EXPERIMENTAL RESEARCHES ON “XNKQ” ACUPUNCTURE THERAPY

The Research included： Morphology ,Biochemistry,The Central Nervous System and Molecular Biology,etc.

针刺治疗中风病是多层次、多途径、多靶点整体调 整。形态学的改变是观察脑缺血损伤及针刺调节作用的最直 接、最客观的证据，我们在相关研究中获得了重大发现。 Regulation of acupuncture on stroke is on multi-level, Multi-channel and Multi-target.Changes of Morphology are the most directive and The most objective evidence to observe ischemic brain injury and the function of acupuncture.We get major discovery in observations.

大脑中动脉阻断后所见大脑表面缺血区 ischemia area on brain surface after middle cerebral artery obstruction 缺血后代偿情况 the compensation status after ischemia 醒脑开窍针刺后的变化 the changes after “XNKQ” acupuncture method

采用透射电镜观察神经细胞胞浆、细胞膜和细 胞核的超微结构发现，醒脑开窍针刺后大部分神经元结 构和细胞器结构完整，随时间段的延长而不断改善，到 24小时时间段已接近正常。 Using TEM to observe cel’s ultrastructure,it can be shown that most of the lstructure of the neurons and cell are restoration after “XNKQ” acupuncture and continue to improve with the extension of the time,to 24 hours are back to normal.

针刺前神经细胞溶解、破坏。 Before acupuncture, the nerve cells be dissolved and damaged

“醒脑开窍”针刺3小时后神经细胞结构完整，线 粒体轻度肿胀。 3 hours after “XNKQ” acupuncture, the structure of the neurons and cell are restoration

针刺6小时后神经细胞结构清晰，胞浆、粗面内质网、游离核糖体完整、线粒体微肿胀。 6 hours after “XNKQ” acupuncture, the structure of nerve cells clear,cytoplasm and free ribosomes are integrity , mitochondria micro-swelling.

针刺12小时后神经细胞结构正常，线粒体完整，微管 微丝出现。 12 hours after “XNKQ” acupuncture, the structure of cell are restoration, mitochondria be normal, microtubule and microfilament appear.

针刺24小时后神经细胞已恢复正常。 24 hours after “XNKQ” acupuncture, nerve cells be back to normal.

Thanks