Q:  Just wondering what is the principle acupuncture points and supplementary points used in patients who wants to get help in losing weight? Her BMI index is overweight. She feels heavy in her lower abdomen and she has sweating of hands and feet (this is just a few of her symptoms) The OM diagnosis for this person is SP Qi def with dampness accumulation.

I have thought of this point: Open gate, Ren 12, Ren 6, St 36, Sp 9, St 40, KI 7 or KI 9 for water retention

Is e-stim useful in this case?
Ear seeds?



A:  Modern Chinese Acupuncture

1. The general treatment strategy in using acupuncture for weight loss: is to strengthen the Spleen, harmonize the Stomach, transform phlegm and drain dampness, warm and unblock the channels and collaterals, as well as raise the clear and descend the turbid

2. Select points: along the Foot Taiyin Spleen channel, Foot Yangming Stomach channel, the Ren channel and Foot Taiyang Bladder channel. Use tonifying or draining methods according to pattern diagnosis

3. Locations
● On the abdomen: choose ST25, RN6, and RN9. Insert the needles perpendicularly to a depth of approximately 1 cun
● On the upper limbs: use LI4 and SJ6. Insert the needles perpendicularly to a depth of approximately 1.5 cun
● On the lower limbs: select ST36, ST37 and ST39, use perpendicular insertion to a depth of approximately 2 cun. For all these points, needling should result in the area feeling achy and distended

4. Technique
● Select 4-6 points at a 1 or 2 cun from RN8. Needle all points obliquely towards the navel. Insert to about 1 cun, or until the area is achy and distended

5. Differentiation
● Spleen deficiency: add UB20, RN12, and RN4, using a tonification technique
● Stomach Heat: add UB21 and UB17. Use a draining technique, and strong stimulation.
● Liver and Gallbaldder damp-heat: add UB18, UB17, and LV3; use a draining technique
● Liver and Kidney Yin deficiency: add UB18, UB23, KD3, and SP6. Apply a tonifying technique
● Qi stagnation and Blood stasis: add UB18, UB17, LV3, and SP10. Use a draining technique on LV3 and tonifying on all other points.

6. Electro Acupuncture
After the arrival of Qi, an electrical acupuncture stimulation device may be applied to the needle handles. Use continuous waveform, with a frequency of 3-4 cycles/second, and an intensity as strong as the patient can tolerate. Treat for 30 minutes. Treatment should be given every other day; a treatment course consists of one month of treatment.

7. Key aspect
The key aspect of acupuncture treatment for weight-loss is to select points on the basis of pattern differentiation; and to use tonifying or draining manipulations suitable to the body's Yin and Yang, Zang Fu, Qi and Blood, and Channels. In this way, it can achieve similar treatment results for different patients.

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HB's tip

According to the element treatment, best treatment is tonify LI1 and sedate SP3.
LI1 is Metal point on Metal channel, Yangming (Dry Metal) channel
SP3 is Earth point on Earth channel, Taiyin (Damp Earth) channel
If someone want to gain weight, you can do vice versa (tonify SP3, sedate LI1)

You can tonify ST or LI in four needle technique.
Tonify ST: tonify LI5 & ST41, sedate GB41, ST43   for Earth deficiency
Tonify LI: tonify ST36 & LI11, sedate SI5 & LI5     for Metal deficiency
They are Yangming (Dry Metal) channels, thus good for the weight control.

I still think local point on the site (abdomen, thigh, upper arm, etc.) needling is most important.
1. I use 2-3 cun needles depending on the location.
2. Needle in the "fat" layer.  First needle about 2cm perpendicular and change the direction of needle and slid in the fat layer. 
3. After that, I use the machine creating a specific current which produces electolipolysis. 

Q:  Let's say that you want to treat a patient with signs of LIV Yang Rising or LIV Fire, such as severe headache and high blood pressure, with the following acupoints: GB 20, Tai Yang, possibly other local points on the head, TW 5, LI 11, SPL 6, LIV 2 or 3, and GB 43.  What is the order that the needles should be inserted, and why?  What is the order that the needles should be removed, and why?  What kind of manipulation would you do on each of the points?  Thank you.


A:  Needling order

1. Limbs - Trunk - Head
2. Leg, Yang channel first; Arm, Yin channel first (because of channel flow)

Let me reorganize your points again in order
GB43 - LV2 - SP6 - SJ5 - LI11 - GB20 - Head local - Taiyang

You can put needles on Foot first because LV Yang rising need to be draw down to foot first.  If head disorder, needle foot first; chest disorder, needle hand first.

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Withdrawal order

1. Head - Trunk - Limbs
2. Limb: the same order that you needled in

Taiyang - Head local - GB20 - GB43 - LV2 - SP6 - SJ5 - LI11

You don't have to take out needles at once.  You can take out needles from head and hands first, and leave foot point 5 minutes longer.  It will draw down LV Yang rising down more.  This "time difference" will increase the treament result to optimal level.

Q:  seeking helpful suggestions for treating chronic (20 year) plantar fascitis case.  Underlying pattern of liv/kid yin deficiency with liver qi stagnation


A: TREATMENT
ACUPUNCTURE
TCM style: PC7 (opposite side) + Local (electro-acupuncture)
Tung style: Wu Hu 5, Mu Guan & Gu Guan (opposite side)
Sa-Am style: Tonify LU8 and KD7, Sedate SP3 and KD3 (opposite side)
Pyung-chim style: Sedate KD2 and tonify KD10 (opposite side); Sedate UB60 and tonify UB66 (same side)

HERBAL FORMULA
According to your diagnosis, you can modify Yi Guan Jian to be taken internally, and put an herbal patch on the local area.

Q:  Female pt 33 yoa. Had 3 abortions between 18-21. Now she fears she can't have kids.

Menses: 28 days, heavy first 1 1/2 days, lasts 3 days, dk red color, medium size clots, slight cramps a few hours before period starts, slight lower back soreness, ovulation checked by MD is normal. She has slight work and family related stress. Sleep is not restful and wakes at 5am. Bowel movement is only soft (not loose) and sticky about 3-5 days prior to period. Other than that BM is usually firm and long. Her sex drive is low.

Tongue: teethmark, pink-red (sometimes purple), swollen MJ area (especially a few days before period starts).
Pulses: Bilateral deep, thready and weak.

Furthermore, she can't come in for acupuncture treatments so solely relies on herbal formulation. What kinds of herbs should I give her? The 4 phases or something else?

Is this a case of true infertility, or just fear of infertility?  How long has this patient been trying to conceive? 


A:  According to the symptoms, it looks like SP+KD deficiency with Blood stagnation.  In her case, the three abortions may have led to Blood stasis in the uterus.  The following formula will tonify the SP+KD, address the Blood stasis, and assist in creating a stable environment for the fetus:

10g  Du Zhong
10g  Xu Duan
10g  Sang Ji Sheng
10g  Shan Yao
10g  Bai Zhu
10g  Bai Shao
6g  Lu Jiao Jiao
6g  Ren Shen
4g  Zhi Gan Cao
4g  Huang Qin
8g  Sha Ren
8g  Dang Gui
8g  Xiang Fu

Q:  What to do when a patient can not hold down ginger tea, she has been dry heaving for 2 hours now!  any ideas?


A:  If they can't hold down ginger tea, try having them bite the fresh ginger or tangerine peel for few minutes.  If it's possible to administer acupuncture treatment, use PC6 + ST36 combination.  Then, Appropriate treatment should be applied by differential diagnosis. 

Q:  Does anyone have any information or provided treatment for enuresis in a 6 year old girl, this happens nightly?  Results?  Any information would be helpful.  Thank you!


A:  FORMULAS

Formula 1:
Yi Zhi Ren  12g
Ma Huang   9g
Sang Piao Xiao  15g
Shi Chang Pu  9g

Dosage Note:
6-9 years old: Use 1/2 - 2/3 of the regular dosage
9-14 years old: Use 2/3 - 3/3 of the regular dosage

Remark: Because it contains Ma Huang, I use only for the children who has Taiyin constitution (overweight with big belly) according to Korean Four constitutional theory.  If you are worry about using Ma Huang, you can remove it from the formula.

Formula 2
Sang Piao Xiao  10g
Bu Gu Zhi  10g
Yi Zhi Ren  10g
Fu Pen Zi  10g
Tu Si Zi  10g

Dosage Note: same as above
Remark: This formula tonify more than Formula 1.

Q:  Any idea for diagnosis/treatment of alternating thick yellow nasal discharge w. blocked nose (mornings/nights after waking up)clear thin nasal discharge daytime with runny nose and unblockage after movement, but increased sneezing and heavy head.
Symptoms onset after sleeping w. wet hair in combination with chronic sinus-allergies/infection due to mold/dust allergies.

Any idea what would be proper acupuncture treatment? (pt's, tonify/sedate) And which herbs would be beneficial?


A:  TREATMENT

HERBAL FORMULA
You can use two different formulas.

Before Bedtime: Huang Lian Tong Sheng San (=Fang Feng Tong Sheng San + Huang Lian 4g)
Take twice a day (every 4 hours)

During the Daytime: Xiao Qing Long Tang
Take twice a day (every 4 hours)

For example, if your patient's sleep pattern is 10 pm - 6 am:
8 am: Xiao Qing Long Tang
12 am: Xiao Qing Long Tang
4 pm: Huang Lian Tong Sheng San
8 pm: Huang Lian Tong Sheng San

Taking the formulas after a meal/snack is better than before.

When the thick yellow discharge has been removed after using these formulas some time, you can change the formula to strengthen this patients' defensive Qi:
Bu Zhong Yi Qi Tang + Chuan Xiong 4g, Fang Feng 4g, Chai Hu 4g, Jing Jie 4g, Zi Su Ye 4g, Bo He 4g

ACUPUNCTURE
Palpate both sides of LU1 to find the more painful side; sedate LU10 and tonify LU5 on the opposite side.  You can add any other symptomatic points yourself, like LI20, Bi Tong or UB7.

Q:  I currently have a patient suffering, among other things, of prostatitis (dx'd by MD).  His only overt symptoms that I can tell from this condition is his frequent urination.  He has come to see me to address a recent episode of a TIA, though, and on top of this, he has a congenital condition of tremors.  (Patient is in his 80s.)  I unfortunately don't have any books on male diseases/conditions, and the points I could find specifically addressing prostatitis were Master Tung points.  I treated him using the indicated Master Tung points as well as Ren 3, 5 and other points (to address his potential wind stroke), but I'd like to do better. Would anybody like to share any clinical point protocol they've found effective for prostatitis?


A: Prostatitis

Major Patterns
1. SP deficiency with Damp: from improper diet and lifestyle
2. Damp-Heat pouring downward: from improper diet and lifestyle
3. LV Qi stagnation or Cold in LV channel: from physical/mental stress
4. KD deficiency: from constitutional weakness or oversex

Herbal and Acupuncture treatment can be modified by the patterns.

Acupuncture
General acupuncture treatment that you can apply
One side: tonify LU8 and KD7, sedate SP3 and KD3
The other side: LU7(ren) and KD6(yinqiao) for REN treatment
Both side: SP6

Herbs
You can choose the formulas depending on the patterns and some of the following anti-inflammatory herbs can be added: Bai Jiang Cao, Bai Hua She She Cao, Yu Xing Cao, Tu Fu Ling, Jin Yin Hua

Q:  Hi, what is the protocol for using Bu Gu Zhi topically for vitilago patients?


A: External Application
1. Grind 300g of "Bu Gu Zhi (Psoraleae Fructus)" into powder.  Bu Gu Zhi can not be grinded into fine powder because it has oils inside.

2. Put 300g "Bu Gu Zhi" powder in 600mg of alcohol (70%) and leave 7 days.

3. After 7 days, you can start putting the tincture on local area.  Apply with 10-15 minutes each time, and 2-3 times/day.

Q:  Has anyone treated or heard reports of successful herbal Rx or acu Tx for pediatric bruxism. I am inquiring specifically about during sleeping patterns. The (4) four year old male child additionally suffers from bouts of nocturnal enuresis. There are no signs of Kidney, Spleen, or Lung xu.  The Sx are similar to Lv channel damp heat i.e., somnic bruxism, sleep talking, and rapid pulse. However the tongue is normal in color, and moist; also the urine is not fetid, but copious.
Would Long Dan Xie Gan Tang Jia Jian be applicable (long dan cao,Shan zhi zi, mu tong, chai hu, sheng di, ze xie, che qian zi gan cao  acu Tx Ye niao dian, Sp6, Ren 4, St 36


A: HERBAL FORMULA
For Pediatric Bruxism, there are many formulas can be used.
Formulas: Dao Chi San, Gui Pi Tang, Wen Dan Tang, Gan Mai Da Zao Tang, etc.

Dao Chi San: HT and LV Fire
Gui Pi Tang: HT and SP deficiency
Wen Dan Tang: Phlegm in HT
Gan Mai Da Zao Tang: HT and GB deficiency

I would not conclude the diagnosis by tongue and pulse of 4 year old baby.  You can look at his overall signs and symptoms and choose the best formula.

Modification
I like to add Ye Jiao Teng as a modification to formula.  Bruxism (grinding of teeth) is happening between the last points of REN(yin) and DU(yang) channel.  Ye Jiao Teng is a vine of He Shou Wu.  Red(yang) He Shou Wu and White(yin) He Shou Wu both have Ye Jiao Teng and they cross each other during the night.

ACUPUNCTURE
For Acupuncture, I often use 4 needle technique LU tonification for Bruxism.  I think that LU governs Qi include Sleep wave pattern.  It helps Bruxism with appropriate formula.   
LU tonification: Tonify SP3, LU9 and Sedate HT8, LU10