Li Ping, Wu Yan-hua, Li Hui-min

1 Guangzhou Red Cross Hospital, Guangzhou 510220, China

2 Chongqing Three Gorges Medical College, Chongqing 404120, China

Treatment of 30 Cases of Vertigo due to Qi-blood Deficiency by Pricking Jingbailao (EX-HN 15) with Fire Needle Therapy

Li Ping1, Wu Yan-hua1, Li Hui-min2

1 Guangzhou Red Cross Hospital, Guangzhou 510220, China

2 Chongqing Three Gorges Medical College, Chongqing 404120, China

Objective: To observe the clinical effect of fire needle therapy on vertigo due to qi-blood deficiency by pricking Jingbailao (EX-HN 15).

Methods: Thirty cases with vertigo due to qi-blood deficiency in conformity with the inclusion criteria were treated with fire needle therapy by pricking Jingbailao (EX-HN15), once every day, seven sessions as one course. The clinical effects were assessed after one course of treatment.

Results: After one-course treatment, the results showed cure in 3 cases, remarkable effect in 14 cases, effect in 11 cases and failure in 2 cases out of 30 cases.

Conclusion: Fire needle therapy by pricking Jingbailao (EX-HN15) can obviously relieve the clinical symptoms in patients with vertigo due to qi-blood deficiency.

Vertigo; Qi-blood Deficiency; Points, Jingbailao (EX-HN 15); Fire-needle Therapy; Pricking Needling

Vertigo is named so because of its simultaneous appearance of blurred vision and dizziness[1]. In mild cases, vertigo can be stopped by closing the eyes. In severe cases, there would be symptoms of motion sickness, spinning of the objects, disability to stand up, or accompanied by nausea, vomiting, perspiration and even loss of consciousness. Vertigo is mostly induced by deficiency. For instance, vertigo is easily induced by internal stirring up of liver wind due to yin deficiency, malnutrition of the brain due to lack of blood, and insufficiency of the marrow sea due to deficiency of essence. The author has treated vertigo due to qi-blood deficiency by pricking Jingbailao (EX-HN 15) with fire needle therapy. Now, the report is given as follows.

1 Clinical Materials

1.1 Diagnostic criteria

Diagnosis and pattern identification criteria of traditional Chinese medicine were based upon the Criteria of Diagnosis and Therapeutic Effects of Diseases and Syndromes in Traditional Chinese Medicine[2].

The main symptoms are dizziness and blurred vision, aggravated by physical exertion; possibly accompanied by nausea, vomiting, nystagmus, tinnitus, deafness, and perspiration; manifested by symptoms of qi-blood deficiency, such as pale complexion, pale lips and nails, low spirit, lassitude, palpitation, insomnia, a pale tongue with thin and while tongue coating,thready and weak pulses. The organic diseases such as tumor and severe hematonosis were excluded by CT or MRI.

1.2 Inclusion criteria

In conformity with the above diagnostic criteria; age ranging from 16-70 years old; male or female.

1.3 Exclusion criteria

Those patients with contraindication of fire needle; those with vertigo induced by intracranial occupying lesions, infectious diseases and ocular diseases; those with the age below 16 or above 70; pregnant women; those companied with severe primary diseases in the cardiovascular, hepatic, renal or hematopoietic systems.

1.4 General data

Totally, 30 cases were recruited from the inpatients of Guangzhou Red Cross Hospital, including 13 males and 17 females, with the age ranging from 43 to 69 years old, at the average age of 56.9 years old, and with the duration ranging from 10 d to 23 months, at the average of 11.4 months.

2 Therapeutic Methods

Acupoint: Jingbailao (EX-HN 15)[3].

Operation: Generally the sitting position was adopted. The prone position was appropriate for those with weak constitution, for the patient’s comfort. After the skin of the neck was cleaned, the patient’s hair was completely wrapped with a sterile cap in order to avoid burning the hair during the treatment. The acupoint was located 2 cun directly above the spinous process of the seventh cervical vertebra and 1 cun lateral to the posterior midline. After a thin layer of Die Da Wan Hua Oil was applied, and the tip of the fire needle of 0.4 mm in diameter and 27 mm in length was burnt white over an alcohol lamp (Fig.1), Jingbailao (EX-HN 15) was quickly pricked for 5-8 mm, depending upon the thickness of the patient’s muscle. After the needle was taken out, the needle hole was pressed with dry cotton ball for a while. The treatment was given once every day and seven sessions made one course. After one course, the therapeutic effects were assessed.

Cautionary notes: Before the treatment, it is necessary to give the patients a detailed explanation about the therapeutic effects, indications and notes for attention regarding to fire needle therapy, in order to eliminate the patient’s fear of the fire needle therapy and reduce the accidents of fainting needle. After the treatment, Die Da Wan Hua Oil was applied to the needle hole and the patients were told to avoid water in the needle hole, and to eat plain and light food and avoid food of spicy, dry and hot in nature, and seafood. If the needle hole was infected, the drug should be changed every day and the infectious situation should be observed.

Fig.1 Fire needle operation

3 Observation of Therapeutic Effects

3.1 Criteria of therapeutic effects

The criteria of the therapeutic effects in this project were stipulated in reference to the criteria of the therapeutic effects for vertigo in the Criteria of Diagnosis and Therapeutic Effects of Diseases and Syndromes in Traditional Chinese Medicine[2].

Cure: The symptoms of vertigo disappeared.

Remarkable effect: The symptoms of vertigo were obviously relieved, with slight sleepiness or slight dizziness and blurred vision, but not accompanied by revolving sensation of the body or objects, and shaking sensation, and with ability for normal life and work.

Effect: Vertigo was relieved, only accompanied by slight revolving sensation of the body or object, able to work, but life and work were influenced.

Failure: No improvement or aggravation in the symptoms of vertigo.

3.2 Therapeutic results

After one-course treatment, the results showed cure in 3 cases, remarkable effect in 14 cases, effect in 11 cases and failure in 2 cases out of 30 cases. Among 30 patients, 17 cases were feared of fire needle before the treatment, and 3 cases were feared of fire needle after the treatment. During the treatment, there was no accident of fainting needle in any case, and there was no infection in any case after the treatment. The satisfaction rate of the patients was 97.6%.

4 Discussion

The term vertigo was first seen in Huang Di Nei Jing (Yellow Emperor's Classic of Internal Medicine). Themedical practitioners in the successive dynasties explored the pathogenesis of vertigo in different ways, believing that vertigo was situated in the brain marrow and its nature was deficient in the constitution and excessive in the symptoms[4-6]. Based upon pattern identification of traditional Chinese medicine, clinically it could be divided into the patterns of deficiency in qi-blood, insufficiency in the liver and kidney, and obstruction of the orifice by blood stasis.

Vertigo due to qi-blood deficiency is mostly induced by consumption and damage of qi-blood from lingering diseases, or no recovery from deficiency after loss of blood, or by deficiency of the spleen and stomach failing to transport water and grain for production of qi-blood, leading to deficiency of qi-blood and failure of clear-yang to ascend, so that the brain cannot be nourished due to blood deficiency, and hence vertigo develops.

Jingbailao (EX-HN 15) was first seen in Zhen Jiu Zi Sheng Jing (Canon of Nourishing Life with Acupuncture and Moxibustion), but its location was not described. The medical practitioners in the modern times believe that it is located 2 cun directly above Dazhui (GV 14) and one cun lateral to the posterior midline. Clinically, it is mainly used for the treatment of diseases induced by various deficiency and depletion[7-10].

Fire needle is also termed with several different Chinese terms. Fire needle therapy is supposed to insert the burnt needle quickly into the specific acupoint to obtain the therapeutic effects. It is believed in the modern times that the therapeutic effect of fire needle therapy is achieved by borrowing the power of fire[11-12]. In combination of the effects of the filiform needle in exciting the meridian qi, and of moxibustion’s ability of warming yang to expel cold, fire needle therapy can expel pathogens and disperse accumulation. And ‘to borrow fire to assist yang’ is the key to achieve the therapeutic effects. Vertigo due to qi-blood deficiency can be categorized under mild deficiencydepletion syndrome. Pricking Jingbailao (EX-HN 15) with fire needle combines the effect of acupuncture to activate meridian qi with the effect of fire to warm and dredge meridians, which is in accordance with the principle of tonifying the deficiency, and therefore it can effectively improve the symptoms of vertigo.

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[2] State Administration of Traditional Chinese Medicine. Criteria of Diagnosis and Therapeutic Effects of Diseases and Syndromes in Traditional Chinese Medicine. Nanjing: Nanjing University Press, 1994: 23.

[3] General Administration of Quality Supervision, Inspection and Quarantine of the People's Republic of China, Standardization Administration of the People’s Republic of China. Nomenclature and Location of Acupuncture Points (GB/T 12346-2006). Beijing: Standards Press of China, 2006: 9.

[4] Wang Y, Gao ML, Wang YM, Zhou QH, Qu MH. Observation on the improving effect of dermal scraping and pricking bloodletting interventions on vertebroarterial blood supply during frequent occurrence of vertigo. Shanghai Zhenjiu Zazhi, 2010, 29(6): 375-376.

[5] Liu GX, Chen Y, Yang Y. Observation on clinical efficacy of acupuncture therapy for posterior circulation ischemia vertigo. J Acupunct Tuina Sci, 2012, 10(3): 165-168.

[6] Bian XN. Clinical study on cervical vertigo treatment by acupuncture through regulating marrow sea. Shanghai Zhenjiu Zazhi, 2012, 31(10): 740-741.

[7] Zou B. Heated needle in treating cervical spondylosis of neck type. Shanghai Zhenjiu Zazhi, 2011, 30(5): 310-311.

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[9] Xu JX. Observation on the therapeutic effect of long-snake moxibustion on cervical spondylosis. Shanghai Zhenjiu Zazhi, 2012, 31(10): 738-739.

[10] Wei LY. Observation on the efficacy of warmingunblocking acupuncture and medicine therapy for cervical spondylosis vertebral arteriopathy. Shanghai Zhenjiu Zazhi, 2011, 30(8): 556-557.

[11] Lin GH. Li LX. Fire Needle Therapy. Beijing: China Medico-Pharmaceutical Science & Technology Publishing House, 2012: 8-10.

[12] Li GX, Zhang XS, Chen SY, Wang JL. Clinical observation on treatment of shoulder periarthritis by fire needling. Shanghai Zhenjiu Zazhi, 2008, 27(9): 27-28.

Translator: Huang Guo-qi

R246.2

B

Date: February 8, 2013

Author: Li Ping, supervisor nurse.

E-mail: lp1536@163.com