Gu Jun-qing

Rehabilitation Department, Guanghua Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai Changning District, Shanghai 200052, China

Shu-Stream Points for Two Cases with Time-related Disease

Gu Jun-qing

Rehabilitation Department, Guanghua Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai Changning District, Shanghai 200052, China

To introduce two cases with orthopedic and traumatic diseases attacking at specific time periods treated by the Shu-Stream points, and explain the theory ‘select Shu-Stream points for condition that alleviate or aggravate in certain time periods’ that was recorded inLing Shu(Spiritual Pivot).

Acupuncture Therapy; Points, Shu-Stream (Five Shu); Osteoarthritis; Osteoporosis; Chronotherapy

It is recorded inLing Shu(Spiritual Pivot) that ‘select Shu-Stream points for condition that alleviate or aggravate in certain time periods.’ It means that for diseases aggravated or relieved with obvious time regularity, it is necessary to select Shu-Stream points among the Five Shu acupoints for treatment[1-3]. Inspired by this sentence, I treated two cases of orthopedic and traumatic diseases with specific attack time. Now, the report is given as follows.

1 Lumbar Osteoarthritis

A 68-year-old female patient.

Chief complaint: Low back pain.

History of present illness: Low back pain and sore attacked on specific time, usually worse in the early morning. She woke up from sleep by soreness at 3-4 o’clock in the morning. After getting up in the morning and doing exercise, the symptoms relieved and the low back sore become mild throughout the day. X-ray examination showed hyperosteogeny of the lumbar vertebrae. CT indicated slight bulge of the lumbar intervertebral disc and bone mineral density test showed low bone mass. The rest laboratory indexes were normal. The tongue body was slight red in color, with a thin coating, and the pulse was thready, especially in Chi region of the left side pulse and bilateral Cun regions. She used to undergo a subtotal pulmonary lobectomy due to pulmonary tumor many years ago.

Diagnosis of Western medicine: Lumbar osteoarthritis.

Diagnosis of traditional Chinese medicine: Low back pain (insufficiency of the kidney yin).

Treatment process: First,Zuo Gui Wanwas given to nourish yin and tonify the kidney. But, the therapeutic effect was poor. After the patient was hospitalized,Bai He(Bulbus Lilii),Sha Shen(Radix Glehniae),Wu Wei Zi(Fructus Schisandrae) andJie Geng(Radix Platycodi), etc., were given according to the principle of simultaneous promotion between the lung and kidney, plus acupuncture treatment. After two weeks of treatment, the low back pain was relieved slightly, but the patient was still woken up by low backpain and sore. Afterward, the patient was treated in accordance with the principle of ‘select Shu-Stream points for condition that alleviate or aggravate in certain time periods.’ This patient’s problem broke out at 3-4 o’clock in the early morning. This moment belongs to two-hour time period of the Earthly Branch No.3. By the rule of Midnight-noon Ebb-flow, it is the time period of the Lung Meridian of Hand Taiyin, therefore the Shu-Stream point, Taiyuan (LU 9), should be selected. Then, bilateral Taiyuan (LU 9) was punctured and the needles were retained for two hours. After one treatment, the patient’s symptoms were relieved substantially. After two treatments, the symptom that was woken up by low back pain and sore disappeared completely.

Note: Teacher Gao Shu-zhong explains his understanding of ‘select Shu-Stream points for condition that alleviate or aggravate in certain time periods’ in his book ofOne Needle Therapy. In accordance with Teacher Gao Shu-zhong’s experience, Shu-Stream point from the meridian of the time period can be selected to treat this type of diseases. The time period of the Earthly Branch No.3 is in the flourishing moment of the lung metal and is good for descending qi to nourish the kidney water[4-7]. But the patient’s lung qi is in severe deficiency, it is unable to develop when it should develop, and the kidney water is unable to be nourished, thus leading to low back sore. After getting up from the bed, the motion is supposed to produce yang, and the symptoms can be naturally relieved after qi and blood can flow smoothly. The patient’s condition is manifested in the kidney, but the root is in the lung. Therefore, by the time period at its moment, success can be achieved in the treatment just by only selecting Shu-Stream point of the Lung Meridian, Taiyuan (LU 9).

2 Osteoporosis

An 81-year-old female patient.

Chief complaint: Low back pain and sore for three years.

History of present illness: The patient had low back pain and sore for three years, worse at noon, and the symptom would be relieved by rest. T value of the outpatient bone density test was -3.3 standard deviations, indicating osteoporosis. X-ray showed degenerative changes in the lumbar vertebrae. The tongue was slight red with thin coating and the pulse was thready.

Diagnosis of Western medicine: Osteoporosis.

Diagnosis of traditional Chinese medicine: Low back pain (insufficiency of the kidney yin).

Treatment method: After hospitalization, Thyrocalcitonin was given to treat osteoporosis, plusZuo Gui Wanfor nourishing the kidney yin. First the routine acupuncture was given, but the effect was not content. In accordance with Teacher Gao Shu-zhong’s experience, because of the patient’s low back pain at the noon time, the moment of the Heart Meridian of Hand Shaoyin by the rule of Midnight-noon Ebb-flow, its Shu-Stream point, Shenmen (HT 7), was selected only. But, it failed after two treatments. Later, it was considered that the noon time is the flourishing moment for qi of the Heart Meridian, but the patient was originally deficient in the kidney, and water was unable to control fire and would be counteracted by fire, so that deficiency of the kidney water was aggravated. Then, Shu-Stream point, Taixi (KI 3), was selected only in accordance with the principle of ‘select Shu-Stream points for condition that alleviate or aggravate in certain time periods.’ After one treatment, the symptom of low back sore at the noon time was relieved substantially. After five treatments, the patient’s symptom basically disappeared.

Note: The context of the original text ‘select Shu-Stream points for condition that alleviate or aggravate in certain time periods’ is that ‘when the problem is in Zang organs, Jing-Well acupoints are selected; when the problem is in complexion, Xing-Spring acupoints are selected; select Shu-Stream points for condition that alleviate or aggravate in certain time periods; when problem is in voice, Jing-River acupoints are selected; when the meridian is full with stagnant blood, problem in the stomach, and problem caused by improper food ingestion, He-Sea acupoints are selected.’ It is clear that the quotation talks about the indications of Five Shu acupoints. The understanding of ‘Shu-Stream points’ is correct and the understanding of ‘worse by time’ is also correct. But, this paragraph does not tell from which meridian the acupoint should be selected. Teacher Gao Shu-zhong’s experience is to select Shu-Stream point from the meridian flowing at the actual time. Is it possible to select Shu-Stream points from other meridians clinically? Judging from my clinical experience, Shu-Stream points selected from the meridian flowing in the actual time are effective for all time-related diseases. And when the corresponding acupoints are selected by ‘looking for the basic causes in treating diseases’ and from the angle of simultaneous promotion and inter-action of the Five Elements, if reflects the soul of the dialectic thinking in pattern identification of traditional Chinese medicine, and better clinical effects will be achieved.

3 Summary

The time-related diseases are seldom in clinic. There is no good explanation about the mechanism and there is even fewer therapeutic methods for the problem in modern medicine. But, the formulation that ‘select Shu-Stream points for condition that alleviate or aggravate in certain time periods’ inLing Shu(SpiritualPivot) points out a shortcut undoubtedly for the treatment of time-related diseases and greatly saves the time and reduces the difficulty for the treatment of time-related diseases.

[1] Chen M. Therapeutic observation on point-through-point acupuncture at Five-Shu points for pain-dominant sub-health. Shanghai Zhenjiu Zazhi, 2013, 32(6): 476-477.

[2] Gao SZ, Zhao LH, Tan QW, Zhang T. The experience in clinical application of ‘select Shu-Stream points for condition that alleviate or aggravate in certain time periods’. Zhongguo Zhenjiu, 1998, 18(7): 431-432.

[3] Zhou YY. Clinical application of Five-Shu acupoints. Shanghai Zhenjiu Zazhi, 2001, 20(6): 31-32.

[4] Chen Y, Liu GX. Clinical study on treatment of biliary colic with midnight-noon ebb-flow day-prescription of acupoints. J Acupunct Tuina Sci, 2011, 9(2): 101-103.

[5] Miao WX. Therapeutic observation on midnight-noon ebbflow method combined with electroacupuncture in treating cervical spondylosis. Shanghai Zhenjiu Zazhi, 2012, 31(12): 902-903.

[6] Slopek A. Feng HT. Qi, time and acupuncture. J Acupunct Tuina Sci, 2009, 7(2): 75-79.

[7] Su W, Zhao H, Liu YS. Randomized controlled trial of midnight-midday ebb-flow syndrome differentiation lowfrequency therapeutic device for the treatment of genual osteoarthritis. Shanghai Zhenjiu Zazhi, 2009, 28(2): 95-96.

Translator: Huang Guo-qi

R246.2

B

Date: August 5, 2013

Author: Gu Jun-qing, associate chief physician.

E-mail: gjq1973@sohu.com