Unity and separation of lifting-thrusting and twirling reinforcing-reducing manipulation / 中国针灸

To analyze the collaborative use and separation reasons of lifting-thrusting and twirling reinforcing and reducing manipulation. Lifting-thrusting manipulation and twirling manipulation are two important contents of acupuncture methods. In traditional acupuncture and moxibustion, the two methods were used in reinforcing and reducing concert, which was mainly related to the therapeutic thought guided by the

Exploration on even reinforcing-reducing technique of acupuncture / 中国针灸

The even reinforcing-reducing technique of acupuncture is one of the common needling methods in clinical practice at present, but there are various understandings on it among scholars. In the paper, the origin of the even reinforcing-reducing technique of acupuncture was explored on the base of literature collection and clinical practice. The comments were put forward in association with the initial understanding of reinforcing and reducing techniques of acupunctures and actual clinical applications. In ancient time, the even reinforcing-reducing method includes two meanings. The first one refers to the compound reinforcing-reducing needling technique for mixture of cold and heat or of deficiency and excess, in which, the reinforcing and reducing techniques are used alternatively at same acupoint. The second one implies the imbalance of and with human body or meridian involved. For example, in the syndromes as excess in the upper part of body and deficiency in the lower part, heat on the left and cold on the right, the treatment for reinforcing the lower and reducing the upper, or reinforcing the right and reducing the left is adopted to rebalance and . Hence, it is regarded as a treating principle or a needling method. No matter at the same acupoint or at different acupoints, the final target of treatment is to harmonize and . The acupuncture scholars in modern times seldom describe even reinforcing-reducing technique. Since the foundation of People's Republic of China, the relevant technique is again called even reinforcing-reducing manipulation, characterized as evenly lifting, thrusting and rotating of needle and has been developed gradually as the common needling technique in present clinical practice, which is widely divergent from the traditional understanding. The reinforcing-reducing techniques of acupuncture are different in understanding between the ancient time and the present. It is necessary to identify the origin for the better contributions to clinical application.

Summary and core technique on the origin and evolution of reinforcing-reducing manipulation achieved by lifting and thrusting the needle / 中国针灸

By analyzing the evolution of reinforcing-reducing manipulation achieved by lifting and thrusting the needle recorded in ancient literature of traditional Chinese medicine, it is found that the main contents of reinforcing-reducing manipulation by lifting and thrusting the needle include manipulating speed change, manual amplitude, insertion layer, gender, the direction to the acupuncture receiver, forenoon and afternoon and relevant quantity. Among them, gender, the direction to the acupuncture receiver, forenoon and afternoon and relevant quantity are the unnecessary parameters, while the manipulating speed change, manual amplitude and insertion layer are the indispensable parameters. The manipulating speed change is the core of the necessary parameters for the reinforcing-reducing manipulation achieved by lifting and thrusting the needle. Combined with the manual amplitude, the manipulating speed of needle determines the volume of needling stimulation. The insertion layer is decided on the base of the clinical demand. In the core technique of reinforcing-reducing manipulation by lifting and thrusting the needle, the reinforcing is achieved by thrusting the needle forcefully and quickly and then lifting the needle body slowly and evenly back to the original layer. The reducing is achieved by lifting the needle forcefully and quickly and then thrusting the needle body slowly and evenly back to the original layer. The manipulating speed and manual amplitude of needling are the parameters to quantize acupuncture manipulation. In association with the acupuncture effects in human body, these parameters contribute to the interpretation of the dose-effect relationship of acupuncture and the improvement of clinical effects.

Exploration into the simplex reinforcing-reducing manipulation of acupuncture / 中国针灸

Four controversial types of simplex reinforcing-reducing manipulation of acupuncture and their possible meanings were summarized to explore several key elements of reinforcing-reducing manipulation of acupuncture, in addition, the simplex reinforcing-reducing manipulation of acupuncture was classified by single factor. It is concluded that the definition of simplex reinforcing-reducing manipulation of acupuncture should try not to include other non-manipulative elements. According to single factor, it can be divided into: needle-oriented reinforcing-reducing manipulation, twisting reinforcing-reducing manipulation, lifting and interpolating reinforcing-reducing manipulation, fast and slow reinforcing-reducing manipulation, breathing reinforcing-reducing manipulation, opening and closing reinforcing-reducing manipulation. In addition, after considering the effect and principle of number reinforcing-reducing manipulation, it can be considered.

Therapeutic Efficacy of Tian Yuan Acupuncture Method for Liver Cancer Pain and Its Effect on Quality of Life and Adverse Reactions / 上海针灸杂志

Objective To observe the therapeutic efficacy of Tian Yuan acupuncture method in treating liver cancer pain and its effect on quality of life (QOL) and adverse reactions. Method A total of 108 patients with liver cancer were randomized into an observation group and a control group, with 54 cases in each group. The observation group was intervened by Tian Yuan acupuncture method, while the control group was intervened by the three-step analgesic ladder recommended by the World Health Organization (WHO). The clinical efficacies, changes in Visual Analogue Scale (VAS) and QOL, and the occurrence of adverse reactions in the two groups were observed. Result The total effective rate in the observation group was significantly higher than that in the control group (P<0.05); the VAS and QOL scores showed improvement after treatment in both groups and the improvements in the observation group were more significant than those in the control group (P<0.05); adverse reactions occurred in both groups, and the occurrence rate was 25.9％ in the observation group, significantly lower than 53.7％ in the control group (P<0.05).Conclusion Tian Yuan acupuncture method can produce significant clinical efficacy in treating liver cancer pain. It can effectively improve the symptoms of cancer pain and enhance the QOL.

The clinical observation of the repletion and depletion acupuncture combined with Wumei pill for the sleep disorders after stroke / 国际中医中药杂志

Objective In order to evaluate the clinical curative effect of double repletion and depletion acupuncture combined with Wumei pill for the sleep disorders after stroke.Methods A total of 150 patients of sleep disorders after stroke that accorded with the inclusion criteria was randomly divided into the treatment group and the control group.Thirteen patients were off loss in the study with 8.7％.And a total of 137 patients completed the protocol,including 70 in the treatment group and 67 in the control group.Both groups were treated with basic treatment.Besides,the treatment group added the treatment of double repletion and depletion acupuncture combined with Wumei pill;while the control group Estazolam tablet.There were 2 weeks for one course and 2 courses in total with 6 months follow-up.The PSQI,neurokinetic energy assessment and cognitive impairment were evaluated after treatment and 6 months follow-up.After treatment,plasma 5-HT and BDNF level were detected and clinical curative effect was observed.Results The PSQI score after treatment (6.3 ± 0.9 vs.9.3 ± 1.1,t=-3.424) 6 months followed up (4.2 ± 0.3 vs.7.5 ± 0.4,t=-3.675) in the treatment group was significantly lower than those in the control group (P＜0.05).The NIHSS score after treatment (8.2 ± 1.0 vs.11.4 ± 1.0,t=-4.557) and 6 months followed up (5.1 ± 0.5 vs.7.6 ± 0.9,t=-3.135) in treatment group was significantly lower than the control group (P＜0.05).The MMSE score after treatment (22.7 ± 2.9 vs.18.3 ± 2.8,t=-4.691) and 6 months followed up (25.0 ± 2.6 vs.21.5 ± 2.6,t=-4.902) in treatment group were significantly higher than the control group (P＜0.05).After treatment,the level of 5-HT (131.85 ± 11.72 ng/ml vs.101.21 ± 10.23 ng/ml,t=0.014) and BDNF (45.17 ± 6.03 ng/ml vs.38.46 ± 5.28 ng/ml,t=5.406) in treatment group were significantly higher than those in the control group (P＜0.05).After treatment,the treatment group effective rate was 92.9％ (65/70) and 81.6％ (54/67) in the control group.The difference was statistically significant (Z=-2.644,P=0.008).Conclusions The double repletion and depletion of acupuncture combined with Wumei pill can improve the sleep quality and cognitive behavior of patients with post-stroke sleep disorders.The possible mechanism is related with improvement of the expression level of 5-HT and BDNF.

Observation on lower-reinforcing and upper-reducing acupuncture method for hyperplasia of mammary gland and its influence on estradiol and progesterone / 针灸推拿医学（英文版）

Objective:To observe the clinical effect of lower-reinforcing and upper-reducing acupuncture method for hyperplasia of mammary gland (HMG) and its influence on estradiol (E2) and progesterone (P).Methods:A randomized,single-blinded and controlled trial was conducted.A total of 124 cases conforming to the inclusion criteria were randomized by random number table into a treatment group and a control group,with 62 cases in each group.Patients in both groups received acupuncture therapy at the same acupoints,while patients in the treatment group received lower-reinforcing and upper-reducing method,and patients in the control group received even reinforcing-reducing manipulation.The treatment started around 10 d before menstruation and was conducted every other day.Patients received 5 treatments in each menstruation cycle for consecutive 3 cycles.The levels of E2,P and E2/P and clinical efficacy were measured before and after treatment.Results:After treatment,the breast lump size,pain intensity and concomitant symptoms score in both groups were substantially lower than those before treatment,showing statistical significances (all P＜0.01),and the improvement in the treatment group was higher than that in the control group,and the between-group comparisons showed statistical significances (all P＜0.01).After treatment,the overall effective rate was 91.9％ in the treatment group,higher than 72.6％ in the control group,and the between-group comparison showed a statistical significance (P＜0.01).After treatment,levels of E2,P and E2/P value showed no statistical significance when compared with those before treatment in the two groups (all P＞0.05).Conclusion:Lower-reinforcing and upper-reducing acupuncture method can effectively alleviate clinical symptoms and signs in HMG patients,and produce a better effect than even reinforcing-reducing manipulation.The majority of HMG patients' E2,P level and E2/P value were not beyond the normal ranges;therefore,acupuncture showed no substantial influence on E2 and P levels and E2/P value.

Acupuncture mainly with " manipulation for amblyopia in children / 中国针灸

<p><b>OBJECTIVE</b>To observe the effect difference between reinforcing-reducing manipulation and "" manipulation for amblyopia in children.</p><p><b>METHODS</b>A total of 68 children patients with amblyopia were assigned into an observation group and a control group by random number table, 34 cases (68 eyes) in each one. In the observation group, reinforcing-reducing manipulation was used at Yuyao (EX-HN 4), Taiyang (EX-HN 5), Tongziliao (GB 1), Jingming (BL 1), Cuanzhu (BL 2), and Chengqi (ST 1); twirling-reinforcing method was applied at Ganshu (BL 18), Shenshu (BL 23), and Guangming (GB 37);""manipulation was applied at bilateral Fengchi (GB 20). The acupoints and manipulations in the control group were the same as those in the observation group, except Fengchi (GB 20) with reinforcing-reducing method. All the treatment was given for 4 courses, 5 times as a course and once a day. The vision improvement was observed half a year after treatment.</p><p><b>RESULTS</b>The effective rates for ametropic amblyopia in the observation and control groups were respectively 92.0% (23/25) and 70.4% (19/27); anisometropic amblyopia, 85.7% (18/21) and 55.0% (11/20); strabismic amblyopia, 66.7% (12/18) and 29.4% (5/17). The effect of each type in the observation group was better than that in the control group (all<0.05).</p><p><b>CONCLUSION</b>""manipulation for amblyopia is superior to reinforcing-reducing method and can obviously improve the vision.</p>

Role of pressing hand in the clinical practice of acupuncture / 中国针灸

The importance of pressing hand in clinical practice of acupuncture was explored in this paper. Through literature review and clinical experience, the role of pressing hand before, during and after acupuncture was summarized and analyzed. Before acupuncture, the pressing hand helped to diagnose diseases, examine pulse and locate acupoints; during acupuncture, it participated in needle insertion and reinforcing-reducing manipulation; after acupuncture, it played a role in needle withdrawal and regulate human body. It is indicated the pressing hand is a key role not only during acupuncture or reinforcing-reducing manipulation, but also participates in the overall process of acupuncture, which has great significance in guiding clinical treatment and enhancing practice level.

Observations on the Efficacy of Mother-child Reinforcing-reducing Acupoint Combination in Treating Migraine of Liver Yang Hyperactivity Type / 上海针灸杂志

Objective To investigate the clinical efficacy of mother-child reinforcing-reducing acupoint combination in treating migraine of liver yang hyperactivity type.Methods Forty patients with migraine of liver yang hyperactivity type were randomly allocated to treatment and control groups, 20 cases each. The treatment group received acupuncture by mother-child reinforcing-reducing acupoint combination and the control group, acupuncture with conventional acupoint combination. Headache symptoms were scored in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups.Results There was a statistically significant pre-/post-treatment difference in the headache symptom score in the two groups (P<0.05). There was a statistically significant difference in pre-/post-treatment headache symptom score difference value between the treatment and control groups (P<0.05). The total efficacy rate and the cure and marked efficacy rate were 90.0% and 75.0%, respectively, in the treatment group and 85.0% and 35.0%, respectively, in the control group. There was a statistically significant difference in the cure and marked efficacy rate between the two groups (P<0.05).Conclusion Mother-child reinforcing-reducing acupoint combination is an effective way to treat migraine of liver yang hyperactivity type.

Observation on the Efficacy of Acupuncture at Xinming Points plus Strong Reinforcing Manipulation in Treating Optic Atrophy / 上海针灸杂志

Objective To observe the clinical efficacy of acupuncture at Xinming points (Extra) plus strong rein-forcing mani- pulation in treating optic atrophy.Methods Forty (56 eyes) optic atrophy patients were randomly allocated to a treatment group of 20 cases (29 eyes) and a control group of 20 cases (27 eyes). The control group received conventional medications, and the treatment group received acupuncture at Xinming points (Extra) plus strong reinforcing manipulation in addition. The visual acuity, the mean visual sensitivity (MS) of visual field and the P100 wave latency of P-VEP were recorded in the two groups before and after the treatment. The clinical therapeutic effects were compared between the two groups.Results The visual acuity, the MS of visual field and the P100 wave latency of P-VEP were significantly changed after treatment in both two groups (P<0.05). After the treatment, there were statistically significant differences in the visual acuity, the MS of visual field and the P100 wave latency of P-VEP between the two groups (P<0.05). The total efficacy rate was 75.0% in the treatment group versus 35.0% in the control group, and the difference was statistically significant (P<0.05).Conclusions Acupuncture at Xinming points (Extra) plus strong reinforcing manipulation is an effective method for optic atrophy.

Clinical Observation of Reinforcing-reducing Needling Methods for Peripheral Facial Paralysis / 上海针灸杂志

Objective To observe the clinical efficacy of reinforcing-reducing needling methods in treating peripheral facial paralysis. Method Seventy facial paralysis patients were randomized into two groups to compare the reinforcing-reducing needling methods and conventional acupuncture. The House-Brackmann (H-B) scale was observed and compared prior to the treatment, right after the treatment, and respectively after 30-day, 3-month, and 6-month treatments, and the clinical efficacy was evaluated after 6-month treatments. Result The H-B score of the reinforcing-reducing manipulation group was superior to that of the conventional group (P<0.05), and the therapeutic efficacy of the manipulation group was more significant than that of the conventional group (P<0.05). Conclusion The reinforcing-reducing needling methods can produce a better therapeutic efficacy in treating peripheral facial paralysis compared to conventional acupuncture.

Comparative Study on Immediate Effect of Twirling Reinforcing-reducing Manipulation on Acute Ischemic Stroke / 中国中医药信息杂志

Objective To investigate the immediate effect of twirling reinforcing manipulation, twirling reducing manipulation and mild reinforcing-reducing manipulation on motor functions for patients with acute ischemic stroke. Methods Totally 116 patients with ischemic stroke were randomly divided into twirling reinforcing manipulation group (TRFM, n=39), mild reinforcing-reducing manipulation group (TRRM, n=37), and twirling reducing manipulation group (TRDM, n=40) by stratified blocked randomization. Each group was treated in Baihui-Taiyang acupoint area accordingly with twirling reinforcing manipulation, mild reinforcing-reducing manipulation and twirling reducing manipulation once. The operation time for each needle was 1 minute. Interval time between every 2 needles was 10 minutes, and each needle was retained for 30 minutes. Neurological deficit score (NDS) and simplified Fugl-Meyer assessment (FMA) were evaluated before and immediate time, 1 h, 2 h and 3 h after treatment. Results FMA in TRFM was higher than that of TRDM and TRRM at immediate time, 1 h and 2 h after treatment (P0.05). DNS in TRFM decreased sharply at immediate time, 1 h, 2 h and 3 h compared with TRDM and TRRM (P0.05). Conclusion TRFM has an advantage over TRDM and TRRM in immediate effect of motor functions for patients with acute ischemic stroke.

Effect of complex reinforcing-reducing manipulation on lower limb motion and balance disorder in patients with subacute combined degeneration of the spinal cord / 针灸推拿医学（英文版）

Objective:To observe the effect of complex reinforcing [Shao Shan Huo (Mountain-burning Fire)] and reducing [Tou Tian Liang (Heaven-penetrating Cooling)] manipulations on motion and balance of the lower limbs in patients with subacute combined degeneration of the spinal cord (SCD). Methods:A total of 100 SCD cases were randomly allocated into an observation group and a control group by their visit sequence, 50 cases in each group. On the basis of Western medical treatment, cases in the observation group were also treated with acupuncture therapy plus complex reinforcing-reducing manipulation; whereas cases in the control group were only treated with the same Western medical treatment as those in the observation group. Before and 2 months after treatment, kinematic parameters including muscle force, muscle tone and range of motion of the hip and knee joints were measured. In addition, balancing parameters including the path length of center of pressure (COP), peripheral area, COP path length per unit area and rectangular area were also measured before and after treatment. Results:After treatment, there were statistical intra-group differences in COP path length, peripheral area, COP path length per unit area, left-right offset, rectangular area, coefficient of stability and coefficient of weight distribution (P<0.01). There were statistical inter-group differences in muscle force, muscle tone and range of motion of hip and knee joints (P<0.01). The total effective rate was 83.3% in the observation group, versus 60.0% in the control group, showing a statistical difference (P<0.05). Conclusion:Complex reinforcing-reducing manipulations can improve the lower limb motion and balance in SCD patients.

Effect of complex reinforcing-reducing manipulations on hip and knee flexion and extension angles after surgery of gluteus maximus contracture / 针灸推拿医学（英文版）

Objective: To observe the effect of complex reinforcing-reducing manipulations of acupuncture on flexion and extension angles of hip and knee in patients after surgical treatment of gluteus maximus contracture. Methods: A total of 66 cases following surgery of gluteus maximus contracture were randomly allocated into an observation group and a control group by the random digits table, 33 in each group. In addition to basic treatment, cases in the observation group were treated with reducing manipulation [Tou T ian Liang (Heaven-penetrating Cooling)] on Zhibian (BL 54), Huantiao (GB 30) and Juliao (GB 29) on the affected side and reinforcing manipulation [Shao Shan Huo (Mountain-burning Fire)] on Biguan (ST 31), Futu (ST 32), Zusanli (ST 36), Fenglong (ST 40), Xuehai (SP 10), Diji (SP 8) and Yanglingquan (GB 34). Patients in the control group only received the same basic treatment as the observation group. The treatment was done once a day, 30 d for a course and a 1-week interval between two courses. Then the flexion and extension angles of hip and knee were evaluated using the Lokomat full automatic robot gait evaluation system after 3 courses of treatment. Results:There were intra-group statistical differences in hip flexion angle on foot followed (HFA-FF), the maximum of hip flexion angle (MAX-HFA), the maximum of hip extension angle (MAX-HEA), knee flexion angle on foot followed (KFA-FF), the maximum of knee flexion angle on stance phase (MAX-KFA-TP) and the maximum of knee flexion angle on swing phase (MAX-KFA-WP) in the observation group and in HFA-FF, MAX-HEA and KFA-FF in the control group (P Conclusion: The complex reinforcing-reducing manipulations of acupuncture can effectively improve the hip/knee functions following surgery of gluteus maximus contracture.

Therapeutic Observation of Twirling Manipulations at Quchi (LI 11) for Primary Hypertension / 上海针灸杂志

Objective To observe the clinical efficacy of acupuncture in treating primary hypertension and the effect of twirling reinforcing-reducing manipulations on the treatment of primary hypertension. Methods Totally 126 patients with primary hypertension were randomized into treatment group 1 of 40 cases, treatment group 2 of 44 cases, and a control group of 42 cases. The treatment groups were both intervened by acupuncture at Quchi (LI 11), while twirling reinforcing-reducing manipulations (twirling towards left) were applied in treatment group 1, while the manipulations (twirling towards right) were applied in treatment group 2;the control group was intervened by medication. The change of blood pressure after 10 min treatment was observed, and the clinical efficacies were compared. Results The total effective rate was 85.0%in treatment group 1, versus 88.6%in treatment group 2 and 61.9% in the control group, and the total effective rates in the two treatment groups were significantly different from that in the control group (P0.05). Conclusions Acupuncture at Quchi (LI 11) is an effective approach in treating primary hypertension, and the reinforcing manipulation and reducing manipulation are both effective.

Observation on Therapeutic Effect of Yin-yang Meridian Acupuncture by Reinforcing-reducing with Patient's Respiration on Lower Limb Function among Post-stroke Patients / 世界科学技术-中医药现代化

This study was aimed to investigate the therapeutic effect of yin-yang meridian acupuncture by reinforc-ing-reducing with patient's respiration on lower limb function among post-stroke patients. A total of 100 stroke pa-tients were enrolled and randomly divided into two groups, which were the control group and the treatment group, with 50 cases in each group. Basic treatment was given in the control group with no related rehabilitation treatment. Basic treatment was given in the treatment group combined with yin-yang meridian acupuncture by reinforcing-re-ducing with patient's respiration. All patients were assessed with kinematics time parameters at the beginning of the treatment and 28 days after the treatment on muscle strength, muscular tension and the change of joint movement of hip joint and knee joint among patients. The results showed that compared with the control group, there was significant difference in treatment group on muscle strength, muscular tension and the change of joint movement of the hip joint and knee joint 28 days after the treatment (P < 0.01). It was concluded that yin-yang meridian acupuncture by reinforcing-reducing with patient's respiration can effectively increase the muscle strength, reduce muscular tension, and improve the change of joint movement, in order to increase the lower limb movement func-tion among stroke patients.

Therapeutic Efficacy Observation on‘Setting F ire on the Mountain’ Manipulation by Lu Shou-yan for Cervical Radiculopathy / 针灸推拿医学（英文版）

Objective:To observe the clinical effect of‘setting fire on the mountain’ manipulation by Lu Shou-yan for cervical radiculopathy as well as the infrared thermographic changes of the cervical area before and after treatment. Methods:A total of 120 eligible cases with cervical radiculopathy were randomly allocated into an observation group and a control group, 60 in each group. Cases in the observation group were treated with Lu Shou-yan’s ‘setting fire on the mountain’ manipulation, whereas cases in the control group were treated with even reinforcing-reducing manipulation. After two courses of treatment, the infrared thermographic changes and overall therapeutic efficacies in the two groups were compared. Results: The recovery rate and total effective rate in the observation group were 68.3%and 98.3%respectively, versus 28.3%and 81.7%in the control group, showing statistical differences in recovery rate and total effective rate (both P Conclusion:‘Setting fire on the mountain’ manipulation by Lu Shou-yan is better than even reinforcing-reducing manipulation for cervical radiculopathy.