(1) Body Acupuncture
Acupoints Selected: Sanyinjiao (SP6), Qihaishu (BL24), Shenmen (HT 7) and Baihui (GV 20).
Modification: For asthenia of the liver and kidney, Taixi (KI3), Taichong (LR 3) and Ganshu (BL 18) are added; for asthenia of spleen and kidney yang, Pishu (BL20), Zusanli (ST 36), Yinlingquan (SP9) and Zhongwan (CV 12) are added; for imbalance between the heart and the kidney, Tongli (HT5), Xinshu (BL15), Shenshu (BL23) and Zhishi (BL 52) are added; for stagnation of phlegm and qi, Fenglong (ST 40) and Tanzhong (CV 17) are added.
Performance: Each time 5 - 6 acupoints are selected according to the pathological conditions. Sanyinjiao (SP6), Qihaishu (BL24) and Shenmen (HT 7) are needled with reinforcing technique; while Fengchi (GB 20) and Baihui (GV 20) are needled with reducing technique. For the treatment of asthenia of liver and kidney yin, Taixi (KI3) and Ganshu (BL 18) are needled with reinforcing technique, while Taichong (LR 3) is needled with reducing technique; for the treatment of asthenia syndrome of spleen and kidney yang, reinforcing needling technique is used and needle-warming moxiubstion or moxa-roll moxibustion is used; for the treatment of imbalance between the heart and the kidney, Tongli (HT5) is needled with reducing technique and the rest acupoints are needled with reinforcing technique; for the treatment of stagnation of phlegm and qi, reducing needling technique is used.
(2) Ear Acupuncture
Acupoints Selected: Endocrine (CO18), Internal genitalia (TF2), Sympathetic Nerve (AH6a), Subcortex (AT4), Kidney (CO10) and Liver (CO12).
Performance: Each time 2 - 3 acupoints on one side are selected to seal with Wangbuliuxingzi (Semen Vaccariae). The patient is advised to press the sealed seeds on the selected ear acupoints 3 times a day. The sealed seeds are changed once every 3 - 4 days. Five to ten days make up one course of treatment.
(3) Acupoints Selected: Fengchi (GB 20), Guanyuanshu (BL 26), Qihaishu (BL24), Zhongwan (CV 12), Shenshu (BL23), Hegu (LI 4), Zusanli (ST 36), Qugu (CV2), Yintang (EX- HN 3) and Jiaoxin (KI8). For liver-kidney yin-deficiency, Taixi (KI3), Ganshu (BL 18) and Baihui (GV20) are added; for heart-kidney disharmony, Xinshu (BL15), Tongli (HT 5) and Zhishi (BL 52) are added; for spleen-kidney yang-deficiency, Pishu (BL20), Yinlingquan (SP9) and Sanyinjiao (SP6) are added; for yindeficiency and liver-hyperfunction, Zhaohai (KI 6), Taichong (LR 3) and Daling (PC7) are added.
Action: Nourishing liver and kidney, and regulating yin and yang.
Elucidation: Climacteric syndrome means a syndrome in women at certain ages (generally 45 - 55 years old) chiefly manifested by menstrual disorder, hectic fever, vexation, agitation and irritability. Chinese medicine holds that when menstruation is to be ceased, kidney-qi increasingly declined; thoroughfare and conception vessels gradually become empty; kidney-yin and kidney-yang inbalance, consequently, the viscera dysfunction. It presents with kidney-yin deficiency, or yin-essence insufficiency, or yin-deficiency and yang-hyperactivity or spleen-kidney yang-deficiency. The disease is mainly caused by the disharmony between kidney-yin and kidney-yang.
In this prescription, Guanyuanshu (BL 26) and Qihaishu (BL24), two points on conception vessel in the lower abdomen, together with Qugu (CV2) can regulate the qi in the thoroughfare and conception vessels and enrich primary-qi. Zhongwan (CV 12), the Front-Mu point of stomach, and Zusanli (ST 36), the He-Sea-point of spleen meridian, have the effect to nourish and regulate the spleen and stomach. Shenshu (BL23), the Back-Shu point of kidney, and Jiaoxin (KI8), the Shu-Stream-point of kidney meridian, are effective to regulate and invigorate kidney. Hegu (LI 4), the Yuan-Source-point of large intestine meridian of hand yangming, is clinically effective against many diseases; together with Fengchi (GB 20), an acupoint of gallbladder meridian of foot shaoyang on the head, and Yintang (EX- HN 3), an extra point on the head, can smooth the qi in the meridians on the head.
For yin-deficiency of liver and kidney, Taixi (KI3), the Yuan-Source-point of kidney meridian, and Ganshu (BL 18), the Back-Shu point of liver, can nourish liver and kidney; together with Baihui (GV 20), Hegu (LI 4) can treat the diseases on the head caused by yin deficiency and subsequent yang hyperfunction. For disharmony between heart and kidney, Xinshu (BL15), the Back-Shu point, and Tongli (HT5), the Luo-Connecting-point of heart meridian, in combination with Zhishi (BL 52), a point of bladder meridian on the back have the effect to harmonize heart and kidney, nourish heart and calm mirid. For spleen-kidney yang deficiency, Pishu (BL20), the Back-Shu point of spllen, Yinlingquan (SP9), the He-Sea-point of spleen meridian and Sanyinjiao (SP6) on spleen meridian are selected to warm qi of spleen and kidney. For liver hyperactivity due to yin deficiency, Zhaohai (KI 6) on the kidney meridian is selected to invigorate kidney yin, Taichong (LR 3), the Yuan-source-point of liver meridian, is selected to clear liver heat, Daling (PC7), the Yuan-Source-point of pericardium meridian, is selected to nourish heart and quieten mind.
Indication: Climacteric syndrome. Women at the age of around 50 exhibit menstrual disorder, more or less, vexation, agitation, irritability, depression, anxiety, nervousness, bad mood, unusual crying and laughing, even absolutely depressive psychosis, occasional mania and delusion. Case with deficiency syndrome may present psychentonia, flushed face, vexation, irritability, dizziness, tinnitus, memory decline, aching lumbus and bone, red tongue with thin coating, wiry, thready and rapid pulse. Case with disharmony between heart and kidney manifests palpitation, insomnia, dreaminess, susceptibility to fright, dry throat, bitterness of mouth, feverish sensation in the chest, palms and soles, red tongue with little coating, thready and rapid pulse. Case with spleenkidney yang deficiency is accompanied by bright white complexion, poor spirits, chill, cold limbs, edema of lower extremities, weak appetite, loose stool, frequent nocturia, profuse and thin leukorrhea, light tongue with white coating, weak and deep pulse. Case with yin deficiency and liver-hyperactivity presents grief, desire to cry involuntarily, red tongue with little coating, wiry, thready and rapid pulse.
Performance: Fengchi (GB 20) is punctured 0.5 -1.2 cun with the needle tip towards the nasal apex instead of towards the contralateral tragus or the front edge of tragus to avoid the penetration into cranial cavity and reducing manipulation is performed by rotating and twirling the needle. Guanyuanshu (BL 26) is vertically punctured 1. O- 1.5 cun and reinforcing manipulation is performed by rotating and twirling the needle. Qihaishu (BL24) is vertically punctured 1.0 - 1.5 cun and reinforcing manipulation is given by rotating and twirling the needle. Zhongwan (CV 12) is perpendicularly punctured 1.0 - 1.5 cun and reinforcing manipulation is given by rotating and twirling the needle. Shenshu (BL23) is vertically punctured 0.5 -1.0 cun and reinforcing manipulation is given by rotating and twirling the needle. When Hegu (LI 4) is punctured, the fist should clench by half; the needle is vertically or obliquely upward inserted 0.5 - 1.0 cun; the artery must be not punctured and reinforcing or reducing manipulation is given by rotating and twirling the needle. Zusanli (ST 36) is vertically punctured 1.0 - 2.0 cun and reinforcing manipulation is given by lifting, thrusting, rotating and twirling the needle. Qugu (CV2) is perpendicularly punctured 0.5 - 1.5 cun, but less depth for filling bladder. Yintang (EX - HN 3) is obliquely punctured 0.3 -0.5 cun. Jiaoxin (KI 8) is vertically. The needles in the acupoints are retained for 20 -30 minutes and manipulated on the concrete conditions of disease. The treatment is given once a day.
