Qi Activity Research Articles

Exploration on the application of Qimen (LR 14) in Treatise on Febrile Diseases

In Treatise on Febrile Diseases, ZHANG Zhongjing had used Qimen (LR 14) for the most times compared with other acupoints among the limited numbers of acupuncture prescriptions. Qimen (LR 14) is the front-mu point of the liver meridian, acting on smoothing liver qi and regulating qi activity. It is commonly used to treat the disorders caused by retarded circulation of qi and blood, such as distension and pain of the hypochondriac region and masses. Based on the opening-closing-pivot theory of the six meridians, the specificity of the running course of the jueyin meridian and the property of Qimen (LR 14), the mechanisms of Qimen (LR 14) were analyzed on the treatment of febrile diseases, aiming to enhance the considerations and application of this points in clinical practice and contribute to the further understanding of ZHANG Zhongjing' s academic thoughts on the syndrome differentiation in the treatment of diseases.

Explanation on acupoint intention

The spiritual qi "circulating" "exiting and entering", and "nothing relevant with skin, flesh, tendon and bone" are the clues to understand the original intention of acupoint recorded in Lingshu (Miraculous Pivota). In the paper, regarding the interpretation of these words and phrases in Shuowen Jiezi (Origin of Chinese Characters), in combination with TCM theory, the connotations of acupoint are summarized in 4 aspects, including the essential characteristics of the changes in the antipathogenic qi, functional property of pathway communication, the clinical features of diagnosis and treatment and the three-dimensional structural characteristics. It is enlightened that the antipathogenic qi and its changes are the most essential rather than the anatomic structure of acupoint. The application of acupuncture and moxibustion acts on qi activity of acupoint rather than flesh and joint. All of those mentioned above indicate the essential issues on the clinical therapeutic effects of acupuncture and moxibustion, which are significant and valuable nowadays in clinical practice.

Clinical experience of acupuncture and moxibustion in the diagnosis and treatment of persistent somatoform pain disorder

The clinical manifestation and clinical diagnosis and treatment of acupuncture for persistent somatoform pain disorder (PSPD) were observed to explore its etiology. It is found that the causative factor of PSPD is probably relevant with pain memory induced by the negative emotions during the first attack of pain, which is in the category of "depression" in TCM. In clinical diagnosis, the medical history should be explored to discover the potential etiology and determine the diagnosis. In treatment, the root cause should be considered, focusing on mind and qi regulation and associating with analgesia. It is different from the common treatment for analgesia in other pain disorders. For PSPD, the root cause is considerable, with "mind regulation" in priority. The acupoints relevant with mind on the head[such as Baihui (GV 20) and Sishencong (EX-HN1)], the acupoints for warming and tonifying the primary qi[such as Qihai (CV 6), Guanyuan (CV 4) and Zusanli (ST 36)] and the auricular points (such as xin (CO15), gan (CO12), shenmen (TF4), neifenmi (CO18)) are selected to regulate qi activity and calm down the mind. Additionally, the therapy for reliving pain specifically is applied with transcutaneous electric stimulation, 2 Hz/100 Hz, disperse-dense wave at bilateral Zusanli (ST 36) and Sanyinjiao (SP 6) to erase pain memory trace. Ultimately, the therapeutic effects are achieved for mind regulation and pain easing.

Impacts on physical and mental health of patients with polycystic ovary syndrome treated with electroacupuncture:a randomized controlled trial

To explore the impacts on physical and mental health of the patients with polycystic ovary syndrome (PCOS) treated with electroacupuncture (EA) or Diane 35. Seventy-two patients of PCOS were randomized into an acupuncture group and a western medication group, 36 cases in each group. In the acupuncture group, acupuncture was applied to relieving liver stagnation and regulating qi activity at Ganshu (BL 18), Danzhong (CV 17), Qimen (LR 14), Zhongwan (CV 4), Tianshu (ST 25), Guanyuan (CV 4), Zigong (EX-CA 1), Sanyinjiao (SP 6), Zusanli (ST 36) and Taichong (LR 3). After qi arrival, the electric stimulation was added for 30 min. Acupuncture treatment was given 3 times a week. In the western medication group, Diane 35 was taken since the 5th day of menstruation and lasted for 21 days. The cycle of treatment was 3 months in the two groups. Before treatment and at the end of treatment, the symptom scores were evaluated and the self-report symptom inventory, symptom checklist-90 (SCL-90) was used for the mental health evaluation and the comparison was made between the two groups. Compared with those before treatment in the same group, the symptom scores were reduced significantly after treatment in the two groups (both P<0.01). After treatment, the symptom scores in the acupuncture group were reduced significantly as compared with those in the western medicationgroup (P<0.01). After treatment, the scores of somatization, interpersonal sensitivity, depression, anxiety and hostility were reduced significantly as compared with those before treatment in the acupuncture group (all P<0.05). After treatment, the scores of somatization, interpersonal sensitivity, depression, anxiety, hostility and phobic factor were lower significantly than those in the western medication group (all P<0.05). EA with relieving liver stagnation and regulating qi activity reduces the symptom scores of PCOS and SCL-90 scores, acting on regulating both physical and mental conditions. The effects achieved with acupuncture are better than those with Diane 35.

Development of QI Activity Evaluation Framework Based on PDCA and Case Study on Quality Improvement Activities

Purpose: This study was conducted to develop an evaluation framework for QI activity in medical institutions and to analyze QI activity cases by applying the developed evaluation framework. Method: A four-phase process was employed to develop the evaluation framework, and a descriptive survey was used for the QI case study. Data were collected in April, 2010 by examining 157 QI activity cases presented at conferences and published in Journal of Korean Society of Quality Assurance in Health Care over the past three years. Developed QI activity evaluation instruments were used for data collection. Data were analyzed using the SPSS 18.0 for Windows program. Result: A QI Activity Evaluation Framework was developed. This framework consisted of 45 items. The department with the highest level of QI participation was the nursing department. The most frequent QI activity theme was patient safety. QI activity levels in Korean medical institutions are relatively equalized without significant differences according to institution characteristics. Conclusions: From the quality aspect of QI activity, more systematic and scientific approaches are required to upgrade QI activity. This study could provide methodological guidelines for QI activity and be useful in setting goals and directions for QI activity in medical institutions in Korea.

Do managed clinical networks improve quality of diabetes care? Evidence from a retrospective mixed methods evaluation

Problem:System-wide improvement of chronic disease care is challenging because it requires collaboration and communication across organisational and professional boundaries. Managed clinical networks are one potential solution, but there is little...

Effects of Changjishu soft elastic capsule in treatment of diarrhea-predominant irritable bowel patients with liver-qi stagnation and spleen deficiency syndrome: a randomized double-blinded controlled trial

To evaluate the efficacy and safety of Changjishu soft elastic capsule, a new Chinese herbal medicine for smoothing liver, invigorating spleen and regulating qi activity, on diarrhea-predominant irritable bowel syndrome (D-IBS) patients with liver-qi stagnation and spleen deficiency syndrome. A randomized, double-blinded, and positive control method was adopted. One hundred and four cases of D-IBS conforming to the inclusive criteria were randomly divided into treatment group (78 cases) and control group (26 cases). Patients in the treatment group were treated with Changjishu soft elastic capsule, four capsules once daily and three times a day. Patients in the control group were treated with glutamine compound enteric capsule, three capsules once daily and three times a day. After 21-day treatment, the efficacy of Changjishu soft elastic capsule was evaluated by the changes of single symptom such as abdominal pain or discomfort, defecation frequency, and stool characteristics. The safety of Changjishu elastic capsule was assessed by laboratory data and adverse events. Abdominal pain or discomfort scores at days 7, 14, 21 and the declined score at day 21 in the treatment group significantly decreased as compared with the control group (P < 0.05). Defecation frequency score at day 14 and the declined score at day 21 in the treatment group significantly decreased as compared with the control group (P < 0.05). Stool characteristics score and the declined score at day 21 in the treatment group significantly decreased as compared with those of the control group (P < 0.05). Rugitus scores and the declined scores at days 14 and 21 significantly decreased as compared with the control group (P < 0.05). The total response rates in the treatment and control groups were 71.62% and 40.91%, and the recovery rates were 20.27% and 13.64%, respectively. There existed significant differences between the two groups in therapeutic effect (P < 0.01). The therapeutic effect of Changjishu elastic capsule was better than that of glutamine compound enteric capsule. Side effects and adverse events were not found in the two groups. Changjishu soft elastic capsule is effective and safe for treatment of D-IBS patients with liver-qi stagnation and spleen deficiency syndrome.

Treatment of 27 cases of hiccup by one-finger pushing manipulation

Hiccup is called as "Yue (retching)" and "Yue ni" in ancientry. Su Wen (《素问》) says: "Disorder of the stomach showing adverse rising of qi with hiccup". This symptom can occur alone or be seen in various diseases. TCM considers hiccup is caused generally by disharmony of middle energizer, adverse rising of stomach qi moving diaphragm, leading to inhibited activity of qi in diaphragm. The authors consider the left ascending and the right descending in transportation and transformation of qi activity in middle energizer; turbid qi belongs to yin and tends to descend, clear qi belongs to yang and tends to ascend. Turbid qi gets descending and then clear qi ascends, leading to harmony of qi activity and stop of hiccup. The therapeutic method was as follows. The patient with hiccup should stay in quiet room and was asked to drink properly warm water and swallow slowly in several times. Meanwhile, the doctor treated on the right side of patient. The order of selecting acupoints was: Shaoshang (LU 11), Shangyang (LI 1), Hegu (LI 4), Neiguan (PC 6), Yifeng (TE 17), Cuanzhu (BL 20), Jiuwei (CV 15), Shangwan (CV 13), Zhongwan (CV 120, Jianli (CV 11), Xiawan (CV 10), Zusanli (ST 36), Yongquan (KI 1), Yinbai (SP 1) and Lidui (ST 45). The above 15 acupoints were manipulated in sequence. Pushing 6 times and digital-pressing one time was calculated as one degree. Every acupoint was manipulated for 9 degrees. The left limb was treated in reversed order of the above acupoints. Pushing 9 times and digital-pressing one time was calculated as one degree. Every acupoint was manipulated for 9 degrees. The pressing strength of manipulation was decided by local soreness, distention and pain on acupoints to the patient’s tolerance. One-finger pushing manipulation with the above method was used to treat 27 cases of hiccup. Among them, 17 cases were diaphragmatic spasm or gastrointestinal neurosis and 10 cases were gastritis, advanced stage of hepatic cirrhosis, cerebrovascular disease or uremia with hiccup. Twenty-three cases were cured, 3 cases were improved and 1 case had no effect. Case report: A male patient of 17 years old asked for treatment for sustained hiccup and deep and weak voice for 38 h caused by post-operation of hematocele in cavitas pleuralis and fracture of rib. At that time, the patient had clear mind, weak voice, wheezy phlegm in throat, a red tongue with greasy coating and a slippery pulse. Shaoshang (LU 11), Shangyang (LI 1), Hegu (LI 4), Neiguan (PC 6), Yifeng 9TE 17), Cuanzhu (BL 20), Jiuwei (CV 15), Shangwan (CV 13), Zhongwan (CV 12), Jianli (CV 11), Xiawan (CV 10), Zusanli (ST 36), Yongquan (KI 1), Yinbai (SP 1) and Lidui (ST 45) were selected. The manipulation of reducing prior to reinforcing was given. One-finger pushing manipulation was applied on every acupoint for 9 degrees. The symptoms were alleviated after one treatment. After 6 h, another treatment was given and the patient was cured.

Pinelliae Rhizoma Herbal-Acupuncture Solution Induced Apoptosis in Human Cervical Cancer Cells, SNU-17

Pinelliae Rhizoma has been used traditionally in Korea to promote the liver Qi activity and the function of the digestive system. We investigated whether the Pinelliae Rhizoma herbal-acupuncture solution (PRHS) would induce cell-death on SNU-17, human cervical cancer cells. 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay was used to investigate the cytotoxicity of PRHS. The cell death was identified as apoptosis with 4, 6-diamidineo-2-phenylindole (DAPI) staining, and terminal deoxy-nucleotidyl transferase (TdT)-mediated dUTP nick end labeling (TUNEL) assay. PRHS could induce apoptosis of SNU-17 via Bax-related caspase-3 activation. The expressions of both Bax, a pro-apoptotic gene, and caspase-3, an apoptotic gene, were increased. The results might provide the experimental data for the clinical use of Pinelliae Rhizoma on cervical cancer.

Citri Reticulatae Viride Pericarpium extract induced apoptosis in SNU-C4, human colon cancer cells

Citri Reticulatae Viride Pericarpium (CR) has been used traditionally in Korea to promote the Liver Qi activity and the function of digestive system. We investigated whether the immature peels of Citrus reticulata Blanco (Rutaceae) induced cell-death on SNU-C4, human colon cancer cells. Cytotoxicity of CR was assessed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The cell death was identified as apoptosis using 4,6-diamidineo-2-phenylindole (DAPI) staining and terminal deoxy-nucleotidyl transferase (TdT)-mediated dUTP nick end labeling (TUNEL) assay. The expression of pro-apoptotic gene, Bax, was increased and the expression of anti-apoptotic gene, Bcl-2, was decreased by CR-treatment. The expression and activity of major apoptotic gene, caspase-3 was significantly increased by CR-treatment. Considering the above results, CR could induce the apoptosis on SNU-C4, human colon cancer cells via Bax-related caspase-3 activation. And it might provide the experimental data for the future clinical use of CR on colon cancer.

Observation on therapeutic results in Tuina treatment of 56 cases of infantile constipation

After 56 cases of infantile constipation were divided into the pattern of stagnation of heat in the stomach and intestines, pattern of obstruction of qi activity and pattern of deficiency in both qi and yin, the treatments were given by infantile Tuina techniques on the infantile points of Dachang (Extra), Zhongwan (CV 12), Bagua (Extra), Qijiegu (Extra), Chengshan (BL 57), Zusanli (ST 36) and Yingxiang (LI 20). The results showed cure in 45 cases, effectiveness in 9 cases, failure in 2 cases and the total effective rate was 96.5%.