[Analysis on the gastrointestinal motility disorder of gastroesophageal reflux disease and the mechanism of acupuncture-moxibustion from the perspective of autonomic nervous system].

From the perspective of autonomic nervous system, this paper analyzes the mechanism, current western medicine treatment methods and acupuncture-moxibustion treatment mechanism of gastroesophageal reflux disease (GERD). It is believed that the main cause of GERD is that the gastric acid goes to the wrong place due to gastrointestinal motility disorder, which belongs to "acid dislocation". At present, western medical treatment cannot effectively target the pathogenesis of the disease, and its effect is limited. Acupuncture-moxibustion could regulate the neuroendocrine immune network to regulate the function of autonomic nerve, restore the power of digestive tract to treat GERD, which is worthy of further research.

[Professor BAI Xing-hua's concept and experience in the diagnosis and treatment of gastroesophageal reflux disease].

In view of the five major misunderstandings in the clinical understanding of gastroesophageal reflux disease in traditional Chinese medicine, that is, wrong main symptoms, wrong position of the disease, wrong character of the disease, treating acid with acid, and attaching importance to drugs and neglecting acupuncture-moxibustion in treatment, Professor BAI Xing-hua has proposed the corresponding solving strategies, which includes grasping the main disease, carefully examining the disease position, distinguishing the character of disease, and no acid suppression for acid regurgitation. In addition, Professor BAI highly values the external treatment of traditional Chinese medicine. In particular, the acupuncture therapy of "Tongdu Jiangni (promote the circulation of the governor vessel and reduce the reversed qi)" based on many years of clinical experience provides new ideas and methods for the diagnosis and treatment of gastroesophageal reflux disease in traditional Chinese medicine.

[Clinical observation on gastroesophageal reflux asthma treated with tongdu jiangni needling technique].

OBJECTIVE: To compare the clinical effect on gastroesophageal reflux asthma between the tongdu jiangni needling technique of acupuncture (acupuncture for promoting the circulation of the governor vessel and reducing the reversed qi) and omeprazole enteric capsules (OME). METHODS: A total of 60 patients with gastroesophageal reflux asthma were randomized into an acupuncture group and a western medication group, 30 cases in each one. The basic treatment for anti-bronchial asthma was provided in both of the groups. Additionally, OME was prescribed for oral administration in the western medication group, twice a day, 20 mg each time, for 8 weeks. In the acupuncture group, the tongdu jiangni needling technique of acupuncture was added. The needles were inserted at the sites inferior to the spinous processes of T3 to T12. Acupuncture was given once in the morning on Tuesday, Thursday and Saturday respectively, totally for 8 weeks. Separately, before and after treatment, the score of reflux disease diagnostic questionnaire (RDQ), the score of asthma control test (ACT) and the tenderness threshold at the sites inferior to the spinous processes of T3 to T12 were observed and the clinical effect was evaluated in the two groups. RESULTS: ①The remarkably effective and curative rate was 46.7% (14/30) in the acupuncture group, higher than 3.3% (1/30) in the western medication group (P<0.01). The asthma control rate was 66.7% (20/30) in the acupuncture group, higher than 13.3% (4/30) in the western medication group (P<0.01). ②RDQ score after treatment was lower than that before treatment in either group (P<0.05). The decrease range of RDQ score in the acupuncture group was larger than that of the western medication group (P<0.05). After treatment, ACT score was increased as compared with that before treatment in either group (P<0.05) and the increase range of ACT score in the acupuncture group was larger than that of the western medication group (P<0.05). ③The tenderness thresholds at the sites inferior to the spinous processes of T3 to T8 and T10 to T12 were all increased after treatment as compared with those before treatment in the acupuncture group separately (P<0.05). In the western medication group, the thresholds were only increased at the sites inferior to the spinous processes of T6, T7 and T9 after treatment as compared with those before treatment separately (P<0.05). After treatment, the tenderness thresholds at T6 to T8 in the acupuncture group were all higher than the western medication group (P<0.05). CONCLUSION: The tongdu jiangni needling technique of acupuncture effectively relieves the symptoms of gastroesophageal reflux asthma and improves the quality of life in the patients and its effect is better than omeprazole enteric capsules.

[Acupoint selection rules in treating gastroesophageal reflux disease with acupuncture in China based on data mining].

OBJECTIVE: To analyze the rules of acupoint selection in the treatment of gastroesophageal reflux disease in China using data mining technology. METHODS: The published literature of treating gastroesophageal reflux disease with acupuncture was retrieved from electronic databases from January 1, 1983 to December 1, 2019, including SinoMed, CNKI, Wanfang and VIP database. Acupuncture prescription database was established, and the rules of acupoint selection were explored by statistical software SPSS 20.0 and SPSS Modeler 18.0. RESULTS: A total of 92 articles were included into this analysis, involving 92 acupuncture prescriptions, 76 acupoints. The total frequency of using these acupoints reached 549 times. Zhongwan (CV 12) was the most frequently used acupoint; the often selected meridians were conception vessel, stomach meridian, governor vessel, bladder meridian; the acupoints located at the abdomen, lower limbs and back were commonly selected; crossing points in the specific acupoints were commonly selected; the most frequently used group was Zusanli (ST 36)-Zhongwan (CV 12) and Neiguan (PC 6). CONCLUSION: Treating gastroesophageal reflux disease by acupuncture in China is dominated by shu-mu point combination, supplemented by mu-he point combination; yin meridians are emphasized as much as yang meridians; using specific acupoints is advocated, especially the crossing points.

[Clinical trial of acupuncture treatment of gastroesophageal reflux cough by needling dorsal segment of the Governor Vessel].

OBJECTIVE: To observe the curative effect of acupuncture stimulation of the back segment (10 spots below the spinous processes from T3 to T12) of the Governor Vessel in the treatment of gastroesophageal reflux cough (GERC). METHODS: A total of 60 cases of GERC patients were randomly divided into acupuncture and medication groups (n＝30 in each). For patients of the acupuncture group, the depression spots below the spinous processes from T3 to T12, including acupoints Shenzhu (GV12), Shendao (GV11), Lingtai (GV10), Zhiyang (GV9), Jinsuo (GV8) and non-acupoints (T4, T8, T12) were punctured with filiform needles, once every other day for 8 weeks. Patients of the medication group were ordered to take omeprazole capsules (20 mg/time), twice a day for 8 weeks. The therapeutic effect was assessed by using "Reflux Diagnostic Questionnaire"(RDQ, scores of symptoms of heartburn, retrosternal pain, acid regurgitation and food regurgitation, 0－40 points), cough symptom score (0－3 points) and "Leicester Cough Questionnaire" (LCQ, scores of physiological, psychological and social functions, 0－21 points), respectively. RESULTS: Following the treatment, RDQ score and cough symptom scores during both daytime and night were significantly decreased in both groups (P<0.05)，and the scores of physiological status, psychological health and social function of LCQ were significantly increased in both acupuncture and medication groups in comparison with their own pre-treatment (P<0.05). The therapeutic effect of acupuncture was markedly superior to that of medication in lowering RDQ score and cough symptom scores of daytime and night, and in raising LCQ scores of the physiological status, psychological health and social function (P<0.05). CONCLUSION: Acupuncture stimulation of the dorsal segment of the Governor Vessel is effective in improving clinical symptoms and living quality of GERC patients.

[Clinical Trial of Acupuncture Treatment of Gastroesophageal Reflux Disease Accompanied with Somnipathy at Acupoints of Governor Vessel at Back Segment].

OBJECTIVE: To observe the curative effect of needling stimulation of the back segment (10 spots below the spinous processes from T 3 to T 12)of the Governor Vessel in the treatment of gastroesophageal reflux disease(GERD)accompanied with somnipathy. METHODS: A total of 58 patients of GERD accompanied with somnipathy were randomly divided into acupuncture group (n＝28) and medication group (n＝30)according to random number table method. For patients of the acupuncture group, the spots below the spinous processes from T 3 to T 12, including acupoints Shenzhu (GV 12), Shendao (GV 11), Lingtai (GV 10), Zhiyang (GV 9), Jinsuo (GV 8), Zhongshu (GV 7) and non-acupoints (T 4, T 8, T 12) were punctured with filiform needles, once every other day for 8 weeks. Patients of the medication group were ordered to take Omeprazole capsules (20 mg/time), twice a day for 8 weeks. The therapeutic effect was assessed by "Reflux Diagnostic Questionnaire" (RDQ，scores of symptoms of heartburn, retrosternal pain, acid regurgitation and food regurgitation, 0－40 points), GERD symptom scale (scores of symptoms of the digestive system, five-sense organs, cardiovascular system, etc., 0－84 points) and Pittsburgh Sleep Quality Index (PSQI, scores of sleep quality, fall asleep time, sleep duration, sleep efficiency, etc., 0－21 points), respectively. RESULTS: After the treatment, RDQ score, GERD symptom scale score and PSQI score were significantly decreased in both acupuncture and medication groups compared with their own pre-treatment(P<0.01), and the decreased scores of RDQ, GERD scale and PSQI were significantly lower in the acupuncture group than in the medication group (P<0.01). The cured plus markedly effective rates for RDQ in the two groups were 43.3% (13/30) and 71.4% (20/28), respectively, and the effective rates of the medication and acupuncture groups were 56.7% (17/30) and 89.3% (25/28) for GERD scale, and 60.0% (18/30) and 92.9% (26/28) for PSQI, respectively. The cured plus markedly effective rate for RDQ, and the effective rates for GERD scale and PSQI were signi-ficantly higher in the acupuncture group than in the medication group respectively (P<0.05，P<0.01)．. CONCLUSION: Acupuncture stimulation of acupoints of Governor Vessel at the back segment is effective in improving symptoms of GERD patients with somnipathy.

[Clinical Trial of Acupuncture Treatment of Gastro-esophageal Reflex Disease by Needling Dorsal Segment of the Governor Vessel].

OBJECTIVE: To observe the curative effect of needling stimulation of the dorsal segment (7 spots below the spinous processes from T3 to T9) of the Governor Vessel for gastro-esophageal reflux disease (GERD). METHODS: A total of 60 cases of GERD patients were randomly divided into acupuncture group and medication group (n = 30 in each group). For patients of the acupuncture group, the depression spots below the spinous processes from T3 to T9, including both acupoints [Shenzhu (GV 12), Shendao (GV 11), Lingtai (GV 10), Zhiyang (GV 9), Jinsuo (GV 8)] and non-acupoints (T4, T8) were punctured with filiform needles, once every other day for 8 weeks. Patients of the medication group were asked to take Omeprazole capsules (20 mg/time) twice a day for 8 weeks. The curative effects were assessed by "Reflux Disease Questionnaire" score (RDQ score of heartburn, retrosternal pain, acid regurgitation and food regurgitation, 0-40 points, the "Guidelines for Clinical Research on Chinese New Herbal Drugs" (GRED symptom scale scores about the 38 symptoms of the digestive system, respiratory system, five-sense organs, cardiovascular system, back-pain, sleep, headache, daily life activity, etc. 0-114 points, 0-3 scales), and "the Consensus about Diagnosis and Treatment of GERD of Traditional Chinese Medicine", respectively. RESULTS: Following the treatment, both RDQ score and GERD symptom scale score were significantly decreased in patients of the acupuncture and medication groups (P<0.05), and the effect of acupuncture was markedly superior to that of the medication in lowering RDQ and GERD scale scores (P<0.05). The cured plus markedly effective rate for RDQ score and the effective rate for GERD scale score were 70.0% (21/30) and 93.3% (28/30) respectively in the acupuncture group, being significantly higher than those [43.3% (13/30) and 66.7% (20/30)] in the medication group (P<0.05). CONCLUSION: Acupuncture stimulation of the dorsal segment

[Response rules of pressing pain on back section in Governor Vessel in patients with gastroesophageal reflux disease].

The response rules of pressing pain on the back section in the Governor Vessel in patients with gastro-esophageal reflux disease (GERD) were studied to provide references for the diagnosis and treatment of GERD. Seventy-six cases of GERD were included into an observation group while 30 healthy volunteers were recruited into a control group. A mechanical measurement device of pressing pain that could measure the pain threshold was adapted to observe the pressing pain on the back section in the Governor Vessel in GERD patients and healthy volunteers. The test area is from spinous process of the 1st thoracic vertebra to that of the 12th thoracic vertebra (T1 -T12), including acupoints and non-acupoints on the Governor Vessel. As a result, in the observation group the pain threshold of T5-T7 spinous process clearance, which was the location of Shendao (GV 11), Lingtai (GV 10) and Zhiyang (GV 9), was lower than that in the control group (all P < 0.05). This result indicated that there was significant pressing pain in T5-T7 spinous process clearance in patients with GERD, which could be taken as an important auxiliary diagnosis and a new thinking method in the treatment of GERD with acupuncture.

[Periodization of international spread of acupuncture-moxibustion and their characteristics at each period].

The history of international spread of Chinese acupuncture and moxibustion is divided into three sta ges in this paper, and the spreading characteristics are analyzed. The first stage is approximately from the 6th century to the end of the 15th century, during which acupuncture and moxibustion were spread to neighboring countries by personnel exchanges; the spread towards Korean peninsula, Japan and Vietnam was considered the most successful communication. The second stage lasts from the beginning of 16th century to 1970. At the early time of this stage, the employees of the Dutch East Indian Company introduced acupuncture and moxibustion to European countries through Indonesia and Japan, leading to a short and small fashion; also the United States and Australia were involved. At the late time of this stage, by medical aid teams dispatched by China government, acupuncture and moxibustion were introduced to African countries. The third stage starts from 1971. With the establishment of Sino-US diplomatic relations as an opportunity, acupuncture and moxibustion were being spread rapidly to the world through radio, TV and internet. So far it has been introduced to more than 140 countries and areas. Performing serious studies on the spreading characteristics of three stages will promote the international communication of acupuncture and moxibustion, by which the world will have a better understanding onthe broad and profound traditional cultures of China.

[Restore of the ancient "moxibustion the pulse" method].

The manipulation of ancient "moxibustion the pulse" method are replicated and discussed through literature review. It turned out that the old year moxa was the best material for moxibustion in ancient times because of its mild heat power and uninjurious to the skin or blood and vessels; it was believed by the ancient people that the ideal fire to light moxa which could play the curative effect best was "sunfire" (lighted through the bronze concave mirror focussing) while the prohibited were "eight kinds of wood fire"; the moxibustion area were the convergence of the pulse on limb ends. The way to determine the time and amount of moxibustion were various, but in general the moxa amount was larger; still after moxibustion, proper exercise and diet were recommended, the nursing methods of the moxibustion sore were recorded. In ancient times, moxibustion was not only a treatment method but also an unique culture carrier to reflect the faith and worship.

[Original relations of acupoints with channels-collaterals and acupuncture therapy].

With analysis and systematization of ancient medical books being unearthed Mazoangdui tomb and other literatures, it is found that ancient names and meanings of moxibustion and acupuncture parts passed the courses from Mai to Maikou, the place and region above Mai, then to acupoints on the body surface showing channels, gi and blood. This change trace reveals original relationship acupoints with channels-collaterals, and acupuncture therapy. The acupoint is a point and channels-collaterals are lines, except a less acupoints which located by obvious anatomic markers, most of are special parts on the channels and collaterals, are not a isolated point. The acupoint is the gate of needle inserting the human body, proposal of this concept and increase of the number of acopoints are closely related with invention, popularity and spreading of acupuncture therapy.