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Post-Stroke:
1. Main Points: Neiguan (PC 6), Renzhong (GV 26), Sanyinjiao (SP 6). Neiguan (PC 6) nourishes the heart, calms the shen (spirit), and promotes smooth circulation of qi and blood. Renzhong (GV 26) opens up sensory orifices, stimulates the brain and awakens the shen (spirit). The combination of Neiguan (PC 6) and Renzhong (GV 26) has been found to increase the contractile strength of the heart and the cardiac output of blood circulation to the brain. Sanyinjiao (SP 6) is the meeting point of the three yin channels of foot. Sanyinjiao (SP 6) nourishes the Kidney, tonifies the jing (essence) and the marrow to improve the function of the brain.
2. Local Points: Jiquan (HT 1), Chize (LU 5), Weizhong (BL 40), and Hegu (LI 4) are local points that open up the channels and collaterals and improve the circulation of qi and blood. Jiquan (HT 1), Chize (LU 5), and Hegu (LI 4) are used for paralysis and tremor of the arms and the hands; and Weizhong (BL 40) is used for paralysis of the legs. Fengchi (GB 20), Yifeng (TH 17), Wangu (GB 12) and Tianzhu (BL 10) are four excellent points that help patients who have speech impairment or frequent aspiration of food particles, leading to respiratory infections.
Shanshangdien (upper thunder point) and Xiashangdien (lower thunder point) are two extraordinary points that were discovered through clinical trial and experience. These two acupuncture points are very potent and should be reserved for those patients who have partial to complete paralysis.
Shanshangdien (upper thunder point) is located on the lateral side of the neck, on the same level with Adam's apple, and between the sternal head and clavicular head of m. sternocleidomastoideus. It is three cun posterior to the Adam's apple and one cun posterior-inferior. It is located slightly inferior to Futu (LI 18). Its indications include frozen shoulder, shoulder pain, paralysis of the arm, stiff and rigid muscle of the arm, and tremor of the hand.
Xiashangdien (lower thunder point) is located in the buttock region. Xiashangdien (lower thunder point) is the posterior tip of an equilateral triangle with greater trochanter and the iliac crest as the anterior two points. It is located slightly superior to Huantiao (GB 30). Its indications include pain in the lower back and hip region, muscular atrophy, sciatica, pain, weakness and muscular atrophy of the lower extremities, and hemiplegia.
3. Needling Technique: Stroke is an excess condition and sedation is warranted. This is because stroke is characterized by the shen (spirit) trapped inside the head with complete or partial closure of the sensory orifices. Therefore, the overall treatment focus should be to open up the sensory orifices, release shen (spirit), and awaken the brain.
To achieve the maximum benefit from acupuncture, the location for some of the acupuncture points and their corresponding needling techniques are slightly different. Neiguan (PC 6) should be needled bilaterally first. Insert the needle 1 to 1.5 cun, then stimulate the point for at least one minute by slightly turning the needle and moving it up and down. The healthy side should be tonified while the diseased side should be sedated.
Next, needle Renzhong (GV 26). Aim slightly upwards toward the top of the head and stimulate strongly until the patient shows tears in his or her eyes. Stimulation should be done with quick rapid movements, a motion similar to a woodpecker drilling trees.
The third point is Sanyinjiao (SP 6). The point of insertion for Sanyinjiao (SP 6) should be moved 0.5 cun toward the dorsal side of the body (or towards Kidney channel) for greater stimulation. Tonify Sanyinjiao (SP 6) by moving the needle up and down until the patient shows a "jerking motion" of the lower leg three times.
Jiquan (HT 1) should be needled with the patient raising his or her arm upward in the air. The point of insertion is moved 0.5 cun toward the fingers and away from the body. Jiquan (HT 1) should be sedated by moving the needle up and down until the patient shows "jerking motion" of the arm three times.
Weizhong (BL 40) may be needled with the patient lying on the back or on the stomach. Point of insertion should be moved 0.5 cun higher toward the buttocks along the Urinary Bladder channel. The needle should be inserted 1 to 1.5 cun deep, and the point should be sedated until the leg shows a "jerking motion" three times.
Hegu (LI 4) should be needled obliquely with the tip of the needle pointing toward Sanjian (LI 3). This point should be sedated until the index finger jerks three times.
Shanshangdien (upper thunder point) should be needled perpendicularly 1 cun deep, and stimulated until there is an "electric sensation" that runs through the entire length of the arm. The needle is then withdrawn at that time. Shanshangdien (upper thunder point) should never be needled downward toward the lung as it may puncture the lung and cause pneumothorax.
Lastly, Xiashangdien (lower thunder point) should be needled perpendicularly 1.5 to 3.0 cun deep, and stimulated until there is an "electric sensation" that runs through the entire length of the leg. The needle is then withdrawn at that time.
For maximum effect, acupuncture treatment should be conducted daily for seven days during the first course of treatment, every other day for 3 weeks for the second course of treatment, and two to three times per week for the next two months of treatment. Three days of resting period is given between each course of treatment. Evaluations are made one month and three months after the initiation of treatment.
To dispel blood stasis, add Xingjian (LR 2) thread to Taichong (LR 3) To tonify the Kidney, add Taixi (KI 3) Speech impairment, add Fuliu (KI 7) For insomnia, depression or suicidal thoughts, add Shenmen (HT 7)