Updated: Mar 6, 2019
Author: Zhuicheng Hu, Guanhu Yang
Abstract: HT 7 is the “Shu” acupoint belonging to the Heart Meridian of Hand Shaoyin, mainly applied clinically to heart and mental diseases. However, surprisingly, HT 7 can also be used to treat sciatica. This article elucidates the mechanism for using this acupoint in treating sciatica.
Shenmen (HT7), also known as Dui Chong or Zhong Du, is firstly mentioned as a term of Mo in Su wen (Plain Questions) and is considered the name of an acupoint in the Huang Di Ming Tang Jing (The Yellow Emperor’s Ming Tang Classic). The main treatment of this point aims at heart spirit or mental problems . Cheng Dan’an considered this point to be the main point used in treating mental illness and heart disease . Feng Shu Wei carried out statistical analysis of modern literature with the help of bibliometrics to analyze disease types treated by needling Shenmen. He discovered Shenmen successfully treated 39 different diseases; most commonly used to treat insomnia, anxiety, depression, dementia and other neurological disorders . I like to use it to treat sciatic pain conveniently, using fewer points with good efficacy. The principle and application is summarized below.
1. THE THEORY OF ZI-WU DUI CHONG (MIDNIGHT-MIDDAY FLOW IN YIN/YANG MERIDIAN PAIRS)
In this treatment, 12 two-hour periods of a day link to the 12 meridians. Qi and Blood flow into each successive Yin/Yang paired meridians, throughout the day, to balance their yin and yang . The paired meridians engender one another, such as Zi/Wu (midnight and midday). Foot Shao Yang meridians, Gallbladder/wood, engenders Hand Shao Yin, Heart/fire, expressed in the saying that flow-pairs engender one another. The flow-paired meridians and the associated organs moderate physiologically, influence pathologically and therefore can be used to treat each one another [5, 6]. Sciatica is diagnosed as Bi syndrome and is linked to the Foot Shao Yang meridian (Gallbladder) and Foot Tai Yang meridian (Bladder).
In the Zi-Wu Theory, since the Gallbladder and Heart are in paired-flow and the disease occurs in the Foot Shao Yang Gallbladder meridian, it can be treated by the Hand Shao Yin Heart meridian. Based on the law of “stream point governs heaviness and joint pain”, Shenmen is able to treat sciatica along the meridian of Foot Shao Yang Gallbladder Meridian.
2. RULE OF WU MEN SHI BIAN (FIVE GATES AND TEN CHANGES)
Rule of Wu Men Shi Bian was raised in “Treatment Rules of BianQue Acupuncture” written by Zhou Zuoyu in the chapter Tian Yuan Ji Da Lun of the Su Wen. In the year of Jia (A) and Ji (F), the Earth element governs; in the year of Yi (B) and Geng (G), Metal element governs; in the year of Bing (C) and Xin (H), Water element governs; in the year of Ding (D) and Ren (I), the Wood element governs; in the year of Wu (E) and Gui (J), the Fire element governs". Ten Heavenly Stems generate numbers from Hetu, making two numbers into one and change into Five Elements which are called Five Gates. Each gate has two ways to choose points: (1) Synthesis with each other and (2) Synthesis while changing. This is known as Ten Changes. The way of synthesis with each other is used to relieve pain. In the Five Gates, Ding (D, the Heart) and Ren (I, the Bladder) are synthesized. In sciatica, the disease occurs in the Heart Meridian, so we can choose a point from the Bladder Meridian to treat and vice versa. Since Shen Men is the stream point, I apply it to treat the sciatica along the synthesized Foot Tai Yang Meridian, with great efficacy.
3. TREATMENT EXPERIENCE OF A CASE
Mr. Li, male, 41 years old, came to the outpatient department with the chief complaint “right leg pain with problems walking for over one month duration” on Sept. 21, 2015. He experienced right buttock and leg pain for more than a month, with a cool sensation in the right buttock. This patient was unable to walk easily and had been diagnosed with sciatica by his local community health center. Prescription: Diclofenac sodium (50 mg, bid, P.O.), topical drugs (blood-activating and stasis-resolving medicine), acupuncture, cupping, TDP (heat lamp). Course: Five times (once every other day). For further treatment, the patient came to our department. Symptoms were as follows: pain in the right hip, middle-back of the right thigh and anterolateral right calf. There was a cool sensation in the right hip. Prolonged sitting and cold increased the pain. His gait was smooth; no intermittent claudication. Physical examination: No deformity and scoliosis of the spine, no lumbosacral tenderness, right hip tenderness (+), no palpable induration cord and muscle spasm, local skin temperature normal, the right straight leg raising test and reinforcement test showed 50° (–), left was 70° (–), lower extremity muscle strength and muscle tone were normal, skin perception symmetric, knees and Achilles tendon reflex in both lower extremities were normal, pathological sign (–). The patient was diagnosed with sciatica. Treatment: Left Shen Men, tip toward to Shao Fu (HT8), obliquely inserted 0.5 cun, with slight lifting, thrusting and twisting of the needle to maintain and strengthen the sense of De Qi. Pain in right buttock and leg remitted, and warmth was experienced in the right buttock. The needle was retained for 30 minutes, while it was suggested the patient walk with needle still in. After acupuncture, cupping and TDP (heat lamp) therapy were applied on the right buttock and leg. All symptoms disappeared. PE: Right hip tenderness disappeared, bilateral straight leg raising test 70°. Doctor’s advice: Avoid cold and keep warm, decrease sedentary life to prevent recurrence. Follow up: 3 days, no symptom recurrence; sciatica cured.
Based on symptoms and physical examination, the diagnosis of neural stem sciatica was caused by buttock muscle fasciitis. When treated by the local community service center with acupuncture, it relieved a somewhat but was not cured. Under the theory of Zi-Wu, Dui Chong and the rule of Wu Men Shi Bian, Shen Men, the Heart Meridian shu point can affect the Foot Tai Yang, Bladder and Foot Shao Yang, Gallbladder Meridians which are the distribution area of sciatica pain; passing two meridians simultaneously.
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